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Pediatric COVID-19 Vaccination
Pfizer-BioNTech and Moderna COVID-19 vaccines are authorized for use in people 6 months through 17 years of age. The Novavax COVID-19 vaccine is authorized for use in people 12 years of age and older. Preparing to Vaccinate Young Children: COVID-19 can help you prepare to vaccinate children.
If you are new to using COVID-19 vaccine, there are several critical differences in the storage and handling, administration, and clinical considerations for COVID-19 vaccine compared to routine immunizations. The COVID-19 vaccines for children under 12 are different formulations identified by specific-colored caps.
- The Pfizer COVID-19 vaccine for 6 months through 4 years is identified by a maroon cap. The Pfizer COVID-19 vaccine for 5 through 11-year-olds is identified by an orange cap. The Pfizer COVID-19 vaccine for people 12 years and older is identified by a gap cap. Make sure you have the correct vaccine and know how to use it.
- There are two different Moderna COVID-19 vaccines for children 6 months through 5 years depending on number of doses they've previously received. One has a dark blue cap and the other has a dark pink cap. The Moderna COVID-19 vaccine for children 6 years and older is identified by a dark blue cap.
- Children age 6 months through 5 years may need multiple doses of COVID-19 vaccine to be up to date, depending on the number of doses they've previously received and their age. Everyone age 6 years and older should get one updated Pfizer or Moderna bivalent COVID-19 vaccine to be up to date.
Pfizer, Moderna, and Novavax vaccine guidance
Review training required for staff who receive, handle, manage, prepare, or administer COVID-19 vaccines at COVID-19 Vaccine Providers. Document staff training, including date completed for your records.
Training Transcript: COVID-19 Vaccines in Young Children (PDF)
Key things to know and share with patients
All parents/guardians and patients must receive an emergency use authorization (EUA) fact sheet before vaccination and have their questions answered.
- FDA: Pfizer-BioNTech COVID-19 Vaccine
Fact sheets for recipients and caregivers are available in many languages. - FDA: Moderna COVID-19 Vaccine
Fact sheets for recipients and caregivers are available in many languages. - FDA: Novavax COVID-19 Vaccine, Adjuvanted
Fact sheets for recipients and caregivers are available in many languages.
Parent or guardian consent is needed for vaccination, except under certain circumstances. Refer to Minnesota Statutes, sections 144.341 (minor living apart); 144.342 (minor who has given birth or been married) and 144.345 (recognizing good faith reliance upon representations of the minor).
- Explain what side effects to expect and how to manage them. Find information on side effects at CDC: Stay Up to Date with COVID-19 Vaccines.
- Vaccination providers should consider observing vaccine recipients for at least 15 minutes after vaccination, especially adolescents.
- Make an appointment before they leave to get the next dose per the CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines vaccination schedule.
- Do your part to reach adolescents and children in Minnesota hit hardest by COVID-19.
Benefits of pediatric vaccination talking points
Use these talking points to help convey the importance of COVID-19 vaccination for adolescents and children.
- The COVID-19 vaccine remains very effective at preventing hospitalizations, intensive care stays and death in children and teens. COVID-19 can be severe for children and adolescents, even children who do not have underlying health conditions, and we can't predict who would get very sick.
- Because variants may spread easily, it is possible children or teens could still get COVID-19 after being vaccinated, but it's very unlikely they would get very sick from COVID-19.
- The immune response to three doses of the Pfizer vaccine in children 6 months through 4 years, two doses of the Pfizer COVID-19 vaccine in children 5-11 years and adolescents 12–15 years who have not had COVID-19 before was at least as high as the response observed in people age 16–25 years. The immune response to two doses of Moderna vaccine in children 6 months through 5 years also produced a high level of response.
- The clinical trials for children under 11-years-old did not have any reports of these rare side effects: myocarditis (inflammation of the heart muscle), pericarditis (inflammation of the lining outside the heart), or anaphylaxis (an allergic reaction). Learn more at CDC: Myocarditis and Pericarditis After mRNA COVID-19 Vaccination.
COVID-19 is still spreading in our communities. We have more tools available — such as COVID-19 vaccines, testing, and medications — to help manage this disease, and it’s important for us to continue using these and other strategies to keep COVID-19 from spreading.
There is no need to wait to give the COVID-19 vaccine if the child needs other vaccines at the same visit.
- The most common side effects are injection site pain, tiredness, headache, chills, muscle pain, fever, and joint pain. Side effects occur more frequently following the second dose.
- These side effects mean the immune system is responding to the vaccine. It's also OK if the child does not have side effects – people respond to the vaccine in different ways.
Vaccine administration tips
- Answer any questions the child or parent/guardian has about vaccination.
- Use comfort measures to decrease pain and anxiety. Suggest the child:
- Listen to their favorite music with headphones.
- Breathe! Take slow, deep breaths.
- Make eye contact with a supportive person.
- Close their eyes and think of a favorite place or activity.
- Focus on something in the room, like a poster.
- Fainting (syncope) can be common among children immediately after getting shots. For this reason, experts recommend having patients sit in a chair or lay down when they receive a vaccination. In addition, patients may be observed for 15 minutes after vaccination. For more information, visit CDC: Fainting after Vaccination.
- Find administration tips for young children at Preparing to Vaccinate Young Children: COVID-19.
Reach the most disadvantaged children
Our equity allocation goal for the state and our vaccinating partners is that 40% of all doses administered should be prioritized to communities hit hardest by the COVID-19 pandemic, using our Social Vulnerability Index ZIP code quartile equity metric. Learn more at COVID-19 Vaccine Equity in Minnesota.
Pediatric providers can take several steps to prevent equity gaps when expanding COVID-19 vaccine to children 6 months and older.
Be prepared to address COVID-19 vaccine questions
- Hopefully, providers are talking to parents and their children about the importance of staying up to date with COVID-19 vaccinations. Some concerns may linger as they weigh the pros and cons of vaccination.
- Consider hosting or participating in information sessions with parents and their children to address questions and concerns and promote the safety and efficacy of COVID-19 vaccines. People are looking for information from community members they trust.
Find ways to decrease barriers for families
- Offer multiple ways to schedule and/or allow walk-ins for COVID-19 vaccination.
- Have translated vaccination materials or interpretation readily available, if possible.
- Late-arrival or no-show policies will delay care. Allowing walk-ins helps avoid this.
- Extend hours: Offer early morning, evening, or weekend appointments for caregivers to bring in children for COVID-19 vaccination.
- Consider working with schools, local health departments, other local community organizations, or mobile vaccination units to help facilitate community vaccination drives specifically for children and families from areas with high social vulnerability factors.
- Find a list of MDH's COVID-19 Community Coordinators and Engagement Contractors at COVID-19 Contracts for Diverse Media Messaging and Community Outreach.
- Use care coordinators or other supports to proactively reach out to children in communities already hardest hit by COVID-19 and who may need additional assistance for vaccination
- Use the list of ZIP codes by social vulnerability index quartile, provided to our vaccination partners, to reach out to families. Prioritize those in high-risk ZIP codes for offers of assistance in arranging transportation to the appointment via their medical benefits/health insurance.
- The Minnesota Immunization Information Connection (MIIC) can be used to identify patients in these ZIP codes who have yet to receive COVID-19 vaccine and/or their routine immunizations. Using the client follow-up functionality in MIIC, providers can pull a list of clients and their contact information (including ZIP code). The user guidance for this function can be found at Client Follow-Up.
- Identify families that will benefit from interpreter services to schedule and be present at their appointment.
Reach out to highly impacted communities
In addition to focused efforts targeting children who live in ZIP code areas with high social vulnerability factors, consider reaching out to children and families in communities that have experienced a high burden of COVID-19 disease and impact, including:
- Black, Indigenous, Hispanic, and Asian Pacific Islander communities
- Children with disabilities
- Children with other medical comorbidities per CDC guidance: People with Certain Medical Conditions.
- Children from households where the language spoken is not English (e.g., Somali, Spanish, etc.)
- Children on Medicaid/Minnesota Health Care Programs