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COVID-19

Vaccinations for children six months to 11 years

The bivalent COVID-19 booster is available for five- to 11-year-olds. It targets the original COVID-19 strain and the Omicron BA strain. Booster doses help to restore protection that may have decreased since your child’s last dose.

Staying up to date with COVID-19 vaccines continues to be the most effective way to protect ourselves and our loved ones from the most serious effects of COVID-19.

Staying up to date means:

  • 6 months to under 5 years - received a primary series
  • 5 to 11 years - received a primary series and a COVID-19 booster dose on or after September 1, 2022.

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.

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

Children Six Months to Under Five Years

Two paediatric vaccines are available for children aged six months to under five years.

A primary series is considered complete when either:

  • two doses of paediatric Moderna (25 mcg) are given at eight weeks apart; or
  • three doses of paediatric Pfizer (3 mcg) are given at 8 weeks between doses.

Note: The series must be completed with the same vaccine.

The National Advisory Commitee on Immunization's recommendations support getting a COVID-19 vaccine at the same time as other vaccines in children under 5 years of age. Children 6 months and older may receive a COVID-19 vaccine with or at any time before or after non-COVID vaccines.

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 COVID-19 vaccine.

For children who are moderately to severely immunocompromised, the monovalent Moderna (25mcg) is preferred and recommended by NACI. This will allow children to complete their primary series after three doses instead of the four doses needed with the monovalent Pfizer-BioNTech (3mcg).

Children Five to 11 Years 

The paediatric Pfizer-BioNTech 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.

Booster doses of the Bivalent Pfizer-BioNTech Comirnaty (10 mcg) COVID-19 vaccine are available to children five to 11 years. Your child is up to date with their COVID-19 vaccines when they have received their primary series and a COVID-19 booster dose on or after September 1, 2022.

It is strongly recommended by the National Advisory Committee on Immunization (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. 


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 have a parent or legal guardian present with them. A parent or legal guardian must be available by phone to provide verbal consent and review health history.

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.

Page last updated: March 6, 2023

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