FDA approves updated COVID-19 vaccines for kids 6 months and up

In this article: 

• The CDC and FDA have authorized updated, or bivalent, COVID-19 vaccines for kids as young as 6 months old.

• There is no reason to put off scheduled vaccinations if your child is eligible for an updated booster. You should speak with your provider about the best scheduling of vaccines and boosters. 

• With the flu and RSV spreading, it's important to make sure your child gets a flu shot in addition to their COVID-19 booster.    

Following a December 8 authorization by the U.S. Food and Drug Administration (FDA), the U.S. Centers for Disease Control and Prevention (CDC) on December 9 expanded the use of updated or bivalent COVID-19 vaccines for children ages 6 months to 5 years old. 

According to the CDC, children ages 6 months through 5 years who previously completed a Moderna primary series of the vaccine are eligible for the bivalent vaccine two months after the final primary series dose. Children ages 6 months through 4 years who are currently completing their Pfizer-BioNTech primary series vaccination, will receive third primary series dose of the bivalent vaccine. 

We spoke with Frank Bell, M.D., a pediatric infectious disease specialist here at Swedish, to help us understand this new guidance and make the right decisions for our kids. 

Why did the FDA authorize updated COVID vaccines for such young children?

The updated COVID vaccines are called bivalent because they contain components of the original strain of the COVID virus, together with constituents from variants circulating more recently. As such, the updated vaccines broaden protection to include strains responsible for most current COVID-19. At the same time, they provide a boost to recharge levels of protection against the original strains of the virus. Young children are currently being infected with COVID-19. They are also infecting others in the community. Younger children are likely to benefit from this additional vaccine protection against COVID-19 disease

Are there differences between the Pfizer-BioNTech and Moderna updated vaccines?

As with the original or monovalent COVID-19 vaccines, the two updated vaccines from Pfizer-BioNTech and Moderna are similar in terms of the protection and side effects associated with vaccination.

Current recommendations for the numbers of vaccine doses required for younger children and recommendations for administering updated vaccines vary between the two manufacturers

• Children under the age of 6 years old who are immunized with the Moderna vaccine should receive 2 doses of the monovalent vaccine to complete the primary series and are eligible to receive an updated bivalent booster if it has been at least 2 months since the last dose of the primary series
• Children under the age of 5 years old who are immunized with the Pfizer-BioNTech vaccine should receive 3 doses to complete the primary series and should get an updated bivalent vaccine if they have not yet received the 3^rd dose of this ‘primary’ series.

Young children who have received all 3 primary doses of the Pfizer-BioNTech vaccine are not currently eligible for bivalent vaccine, but parents should look out for recommendations for bivalent booster dose eligibility for these children in the new year.

It’s important to make sure that in addition to the updated COVID-19 shot, your child gets immunized against influenza. It’s not too late for the current season. Unfortunately, we don’t yet have a vaccine effective against RSV, but masking-up and handwashing will help to protect your child against COVID-19, influenza and RSV, in addition to a host of other respiratory viruses this winter.

My child has already received their COVID vaccination and booster; do they need this one?

The updated bivalent vaccines produce broader protection against recently circulating variants, and provide an effective boost against COVID-19, as we know that vaccine immunity tends to wane or lessen over time from the last immunization. So yes, the U.S. Centers for Disease Control and Prevention recommends that everyone who is eligible for vaccination, aged 6 months old and up, get an updated COVID vaccine this winter.

Are there particular side effects for young children I need to be concerned about?

The side-effects associated with the new updated bivalent boosters are like those experienced with the primary dose series, with the most commonly noted side effects of fussiness and fatigue in the day or two after vaccine administration.

Will this vaccine interfere with other vaccinations we have already scheduled for my child?

There is no reason to put off other needed vaccines if your child is eligible for an updated COVID-19 booster. Both can be given together at the same visit but feel free to talk to your provider about options for dividing up vaccines at a second visit in the not-so-distant future.

Will this protect my child from RSV or influenza?

No, it’s important to make sure that in addition to the updated COVID-19 shot, your child gets immunized against influenza. It’s not too late for the current season. Unfortunately, we don’t yet have a vaccine effective against RSV, but masking-up and handwashing will help to protect your child against COVID-19, influenza and RSV, in addition to a host of other respiratory viruses this winter!