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COVID-19

Vaccinations for children six months to 11 years

Booster doses are available for everyone aged five and over to help restore protection that may have decreased since your last dose. 

Vaccination continues to be the most effective way we can protect ourselves and our loved ones from the most serious effects of COVID-19. Individuals aged five and over who are not considered high risk for severe COVID-19 illness are recommended to receive a booster dose six months since your last dose.

The benefits of being protected against COVID-19 far outweigh the risk of any side effects from the vaccine. While most children who get COVID-19 have mild or asymptomatic disease, some children experience severe disease and require hospitalization. There is also the risk of a rare condition associated with COVID-19 infection called Multisystem Inflammatory Syndrome.

Cases and hospitalizations in children remain low but have increased significantly since Omicron became the dominant variant.

Ready to get vaccinated? Click here to find a location to get the COVID-19 vaccine. 

Children Six Months to Under Five Years

The paediatric Moderna Spikevax COVID-19 vaccine is available for children aged 6 months to under five 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. Each dose of the paediatric Moderna Spikevax COVID-19 vaccine for children six months to under five years is half the dose given to children five to 11 years of age because younger children need a smaller dose of vaccine to get the same protection from COVID-19.

Please note: 

You can schedule an appointment for your child who is not yet six months old for a later date. Children must be at least six months or older at the time of their appointment in order to receive the paediatric Moderna Spikevax COVID-19 vaccine.

As this vaccine is newly authorized for this age group, this vaccine should not be given on the same day as other vaccines, rather 14 days before or after getting this vaccine is recommended for getting other vaccinations. This is the same recommendation given when new COVID-19 vaccines have been approved or are approved for use in a new age group. The reason for giving time between vaccinations is so that if any side effects are experienced it is easier to determine what the side effect is due to.

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It is recommended that children six months to under five years, who are moderately to severely immunocompromised, get a three-dose series with four to eight weeks between each dose.A fourth dose (booster) is not currently recommended for moderately to severely immunocompromised children six months to under five years.

Children Five to 11 Years 

The paediatric Pfizer-BioNTech Comirnaty COVID-19 vaccine 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.

It is recommended that children five to 11 years who are moderately to severely immunocompromised get a three-dose series with four to eight weeks between each dose.

A fourth dose (booster) is not currently recommended for moderately to severely immunocompromised children under age 12.

Booster doses of the Pfizer-BioNTech Comirnaty (10 mcg) COVID-19 vaccine are available to children five to 11 years.

It is strongly recommended by the National Advisory Committee on Immunziation (NACI) for children in this age group with an underlying medical condition that places them at high risk of severe illness due to COVID-19 to get the booster dose, at a recommended  interval of six months from their last dose. The minimum interval is three months from the last dose.  

For all other children five to 11 years of age NACI states that a booster dose may be offered at a recommended  interval of six months from their last dose. The minimum interval is three months from the last dose.  

For children who are moderately to severely immunocompromised, the booster dose would be the fourth dose received.


General Information 

If you have more questions, we encourage you to:

Speak with your health care provider.

Call the Provincial Vaccine Contact Centre at 1-833-943-3900.

Visit the COVID-19 Vaccine Consult Service to book a phone appointment with a SickKids Registered Nurse.

Before Primary Series: 

  • Recommendations for immunization after infection for children six months to 11 years is two months (56 days) after symptom onset or positive test which may be shortened to a minimum of four weeks if the child is moderately to severely immunocompromised.

Before a Booster Dose:

  • Recommendations for immunization after infection for children six months to 11 years is three months (84 days) after symptom onset or positive test; however, a six-month (168 day) interval may provide better immune response.
  • Although infection does provide some protection, research in adults shows protection from vaccination is stronger and lasts longer (at least six months) than immunity from having the virus.
  • Having immunity from both infection and vaccination (hybrid immunity) gives even stronger and longer lasting immunity than either immunity from infection or vaccination alone.

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.

Examples of underlying conditions that increase the risk of severe disease in children six months to under five years:  premature birth, heart and breathing conditions, neurological disorders, feeding tube dependence, hypertension, neurodevelopmental disorders, epilepsy/convulsions, obesity, chronic metabolic disease and immunosuppression.

Examples of underlying conditions that increase the risk of severe disease in children five to 11 years : genetic, neurologic, or metabolic conditions, congenital heart disease, obesity, diabetes, asthma/chronic lung disease (e.g., cystic fibrosis), sickle cell disease and immunocompromising conditions.

Children who have an underlying medical condition are at higher risk of getting very sick, severe disease including multi-system inflammatory syndrome (MIS-C). MIS-C is a rare but serious complication that happens after having COVID-19 and generally requires hospital admission.
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.

The COVID-19 vaccine is safe and the benefits of getting your child vaccinated outweigh the potential risks. COVID-19 infection may cause longer-lasting symptoms and health problems for some people, including children, which is why it’s important that children get vaccinated as soon as possible.

Risk of serious side effects from vaccination are very rare.

Most side effects from vaccination were mild to moderate, happened within two days of getting vaccinated and were more likely to be reported after the second dose of vaccine.

Side effects to getting vaccinated include redness, pain and swelling at the injection site, fever/chills, irritability and crying, joint/body pain/aches, fatigue/sleeplessness, headache, and loss of appetite.

No cases of myocarditis and/or pericarditis have been reported for the six months to under five years of age group after getting the Moderna vaccine, with the risk of these effects being even lower than in adolescents and young adults.

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 January 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. To see up-to-date reports for AEFIs in Ontario visit Public Health Ontario. 

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. 

The following list are some things you can do to help your child (six months to under 5 years) during the vaccination include:

  • Relax. Your child may react to your emotions. When you relax and stay positive, your child will feel safe and happy too.
  • Cuddle. Hold and talk to your child during the vaccination.  Hold your child in a supportive position on your lap like in a sitting or semi-sitting position. Studies have found that children who are held while getting a needle cry less.
  • Breastfeed. If you are breastfeeding, try nursing your baby right before, during or after the needle. This will be comforting to your baby.
  • Distract. Your gentle, soothing voice or touch can help comfort your baby. So can a favourite toy, telling a story or singing, playing music, or pointing to a picture or object in the room.

Other Resources 

Page last updated: August 31, 2022

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