CDC Recommends COVID Boosters for 5- to 11-Year-Olds

The Centers for Disease Control and Prevention (CDC) on Thursday officially recommended a Pfizer COVID-19 booster shot for children ages 5–11.

The recommendation follows a Food and Drug Administration (FDA) decision to authorize a booster for young children earlier in the week.

Under a recommendation from their Advisory Committee on Immunization Practices (ACIP), the CDC specifies that “children ages 5 through 11 years should receive a booster shot 5 months after their initial Pfizer-BioNTech vaccination series.”

Judith Flores, MD, a pediatrician and a fellow of the American Academy of Pediatrics (AAP) and the New York Academy of Medicine, told Verywell that the booster recommendation was an important step in increasing community protection. Plus, it offers children and families “some relief” during current surges.

“With a rising infection rate [and] a potential for rising hospitalizations, we have to make sure that protection is widespread,” Flores said. “By giving children these boosters, we will be able to protect their exposure to people who are not vaccinated, particularly younger brothers and sisters that still can’t be vaccinated. And they will add to the general protection that we have in our community.”

Two-Thirds of Young Kids Still Need First Doses

With the new recommendation, children 5 and older who have received two doses of a Pfizer vaccine will be eligible for a booster 5 months after their second dose. But before the boosters can make a large impact, more children will need to get their initial vaccination series.

About 30% of children ages 5 to 11 are fully vaccinated without a booster, and about 35.5% of children have received one shot, according to CDC data.

Flores stressed the importance of increasing the rate of the initial vaccine series along with the booster rollout, adding that a bulk of her current work goes into conversations with parents about the vaccine’s safety and effectiveness.

“I do a lot of work with parents who might be initially questioning, hesitant, or, frankly, don’t want to vaccinate their children at all,” Flores said. “A lot of the work is to make sure that we still are able to address parents’ issues, address caretaker issues, be as transparent as possible, and be there to answer questions. If we do that, consistently, parents will come around and get their children the protection they need.”

On Thursday, some ACIP panelists stressed the importance of focusing on the initial vaccination series.

“I really do want children to be vaccinated, but I think if only 30% of children have received one—if not even two—doses, we really need to spend our time and effort on educating the 70% who have not been,” said Helen Keipp Talbot, MD, MPH, the only panelist to vote against the recommendation for boosters. “Boosters are great—once we’ve got everyone their first round.”

Vaccines Pass Safety Check for Kids

Prior to their vote, panelists listened to presentations that discussed the safety and efficacy of the current mRNA series for 5- to 11-year-olds, as well as a comparison to the data on boosters for the 12- to 17-year-old–age group. The panel concluded that the shots have so far been safe and effective among both age groups, and that known benefits appeared to outweigh known risks. 

One risk discussed included myocarditis, or heart inflammation. While rare, myocarditis primarily affects young men. This risk appears to be lower in younger age groups, making myocarditis less likely for 5- to 11-year-olds than it is for 12- to 17-year-olds, according to the data presented.

The panelists also analyzed data from the Vaccine Adverse Events Reporting System (VAERS) to look at the overall risk of side effects reported so far. Among the 9,001 reports, the highest percentage—22%—showed no adverse events at all. After that, the data showed that product preparation issues and incorrect dosage were the most common adverse events, each at 18% of reports. Overall, 97% of the VAERS reports were determined to be “non-serious.”

Norma Perez, MD, a pediatrician with AltaMed Health Services, told Verywell that for the most part, side effects from the children’s vaccine appear to be mild. They commonly include pain or redness at the injection site, fatigue, fever, and body aches.

Gastrointestinal side effects like nausea or vomiting also appear to be more likely in children, she said.

“The side effects have been pretty similar across the board; there hasn’t been anything out of the ordinary that we’ve seen in this age group of 5 to 11,” Perez said. “My own kids were vaccinated, I think they probably did better than I did.”

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