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COVID-19

Vaccinations for children 5 to 11 years

First and second dose  (primary series)

The paediatric COVID-19 vaccine  (Pfizer-BioNTech (10 mcg)) is available for children aged five to 11 years. Two doses of the vaccine are recommended with eight weeks between the first and second dose to offer the strongest possible protection against COVID-19.

Ready to get vaccinated?

For children five to 11 years who get COVID-19 and have not had any COVID-19 vaccine or are in between doses of their primary series, it is suggested they receive any doses of their primary series 8 weeks after symptom onset or positive test (if asymptomatic).

If your child (five to 11) got COVID-19 and had previously experienced multisystem inflammatory syndrome (MIS-C), the suggested timing of beginning COVID-19 vaccines or completing the primary series is at least 90 days after the onset of MIS-C or after clinical recovery, whichever is longer.


The COVID-19 vaccine is the best way to protect your child from getting very sick from COVID-19 and its potential complications. Although these risks are low for most children, there are both potential short and long-term health complications from COVID-19 in children, as well as the risk of a rare condition associated with COVID-19 infection called Multisystem Inflammatory Syndrome. Similar to adults, children can also experience complications with ongoing symptoms (Post-acute COVID-19 or Long-COVID-19) after recovering from the initial infection. It is estimated more than 50 per cent of people (adults and children) who were previously infected with COVID-19 continue to experience ongoing symptoms. The most common symptoms in children are fatigue, headache, trouble concentrating, insomnia and cough.

Like adults, children with underlying medical conditions are at higher risk of getting very sick compared to children without underlying medical conditions. For these children, it is even more important to provide the additional protection of getting vaccinated against COVID-19. Because we are still learning about COVID-19, all factors that may increase a child’s risk of severe illness are not known. What we know so far is that children with the following conditions/illnesses are at increased risk for severe illness:

  • genetic, neurologic, or metabolic conditions
  • congenital heart disease
  • obesity
  • diabetes
  • asthma/chronic lunch disease (e.g., cystic fibrosis)
  • sickle cell disease
  • immunocompromising conditions (see section for children with immunocompromise for more information)

It's preferred that children receiving their vaccine at one of our community clinics have a parent or legal guardian present at the clinic with them. If necessary, children can go with an alternative caregiver to get vaccinated. A parent or legal guardian must be available by phone to provide verbal consent and review health history.

Children five to 11 need to attend clinic with a parent/legal guardian and/or come with a consent form completed by the parent/legal guardian.

For school-based clinics, consent forms will be sent home from the school for parents to complete to give consent for their child to receive the vaccine during school hours without their parent present.

 

The COVID-19 vaccine is safe and the benefits of getting your child vaccinated outweigh the potential risks. Serious side effects after receiving the vaccine are rare, with the majority of observed side effects in the five to 11 age group being mild, like those seen in adults and older children.

    These include:

  • arm tenderness,
  • fatigue,
  • headache,
  • muscle pain,
  • joint pain,
  • chills and fever, which can also be seen with other vaccines recommended for children.
  • Although rare cases of myocarditis and pericarditis (heart inflammation) have been reported after getting the COVID-19 mRNA vaccine in youth and young adults, the reporting of myocarditis/pericarditis in children five to 11 has been even more rare based on Ontario and United States monitoring to date (one confirmed report in Ontario as of June 23, 2022). It is important to know that the risk of myocarditis and pericarditis caused by COVID-19 infection is much higher than the risk following COVID-19 vaccination.

  • After a vaccine is approved, its safety continues to be monitored by Public Health Ontario, Health Canada, and internationally.
  • Adverse events following immunization (AEFIs) are taken seriously and in Ontario, health professionals are required to report AEFIs to their local public health unit. Public health units investigate AEFIs and provide support to immunizers, individuals, and their families.
  • Surveillance information of Pfizer-BioNTech COVID-19 vaccine given to five to 11 years old in Ontario continues to show the vast majority of AEFIs are non-serious.To see up-to-date reports for AEFIs in Ontario visit Public Health Ontario.
  • Surveillance information from over 8 million doses of Pfizer-BioNTech COVID-19 vaccine given to five to 11 years old in the United States as of December 19, 2021, has shown that 98 per cent of AEFIs are non-serious.
The paediatric Pfizer BioNTech vaccine is the same formula, the only difference is that children five to 11 years will get a lower dose (10 mcg) than people aged 12 and over (30 mcg). This is because children five to 11 years have smaller bodies and a stronger immune response, so they only need a small amount of vaccine to get the same protection. The vaccine will be given to children in two doses (10 mcg each).

No. Recently a myth around infertility circulated and spread on social media. It was centred around a belief that the spike protein in the vaccine is similar to one found in the placenta (the organ that gives a growing baby oxygen and nutrients), however the spike proteins are actually completely different and therefore any antibodies we make from the vaccine will not impact the placenta.

If your child has a known severe allergy to any ingredients in the vaccine they should not get it. If your child has a history of any severe allergic reactions or any type of immediate allergic reaction to another vaccine or injectable therapy, you should let the immunization staff at the clinic where your child is getting vaccinated know so that your child can be monitored for at least 30 minutes after getting the vaccine.

Making a child’s vaccination experience better and decreasing the amount of pain they may feel is very important. If a child has a bad experience getting a vaccine they may not trust their  healthcare provider and may not want to get other vaccines or health care when needed in the future.

There are many things that can decrease pain and lessen stress and anxiety for children and their parents.  Using a numbing cream, giving children a chance to ask questions,  and informing them about what to expect, letting them choose ways they can be most comfortable when getting a vaccine, and choosing things they can do to distract them can help make children’s vaccination experience uneventful and even positive. 

Third dose for immunocompromised children (extended primary series)

Three doses of vaccine is recommended as part of a primary series for everyone with moderate to severe immunocompromise, including children five to 11. A third dose is recommended because people who are moderately to severely  immunocompromised:

  • get less immunity protection from two doses compared to those who are healthy, and
  • are at greater risk of getting seriously sick if they get COVID-19.

Safety information from vaccinating people with severe to moderate immunocompromised conditions show there are no increased safety concerns and no worsening of other conditions after vaccination.

A fourth dose (booster) is not currently recommended for moderately to severely immunocompromised children under age 12. If your child recently had a COVID-19 infection, please read about when they can get their vaccination after infection above.

Immunocompromised children aged 5 to 11 eligible for a third dose to complete their primary series include children who are:

  • receiving dialysis (hemodialysis or peritoneal dialysis).
  • receiving active treatment (e.g., chemotherapy, targeted therapies, immunotherapy) for solid tumour or hematologic malignancies.
  • recipients of solid-organ transplant and taking immunosuppressive therapy.
  • recipients of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy).
  • diagnosed with moderate to severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • diagnosed with HIV with prior AIDS defining illness or prior CD4 count ≤ 200/mm3 or prior CD4 fraction ≤ 15% or (in children 5-11 years) perinatally acquired HIV infection.
  • receiving active treatment with the following categories of immunosuppressive therapies: anti-B cell therapies2 (monoclonal antibodies targeting CD19, CD20 and CD22), high-dose systemic corticosteroids (refer to the Canadian Immunization Guide for suggested definition of high dose steroids), alkylating agents, antimetabolites, or tumor-necrosis factor (TNF) inhibitors and other biologic agents that are significantly immunosuppressive.

A third dose can be accessed through local community and pop-up clinics and other local providers. Proof of immunicompromise (docotor's note, prescriptions) and/or self-attestation may be required.

It is recommended that eligible immunocompromised children who have already received two doses be given a third dose to complete their primary series. The recommended interval between second and third dose is at least two months (56 days). The minimum interval is one month (28 days); however, a longer interval will likely result in a better immune response.


Page last updated: April 29, 2022

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