Pediatric COVID-19 Vaccination - Minnesota Dept. of Health

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 also now authorized for use in people 12 years of age and older.

Preparing to Vaccinate Young Children: COVID-19 can help 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. They require different amounts of diluent. Make sure you have the correct vaccine and know how to use it.
  • The Moderna COVID-19 vaccine for children 6 months through 5 years is a different formulation (smaller dose) and is identified by a dark blue cap and magenta label. The Moderna COVID-19 vaccine for 6 through 11-year-olds is another formulation (smaller dose) and is identified by a dark blue cap and purple border.

Bivalent booster doses are now available for children age 12 years and older.

  • Currently, the Pfizer COVID-19 vaccine is the only authorized bivalent booster in this age group.
  • The original, monovalent vaccine is no longer authorized for booster doses for anyone age 12 years and older.
  • Children 5-11 years should continue to get the orange cap monovalent booster dose as scheduled.

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)

Read the following FDA EUA fact sheets for the vaccine(s) that will be provided by your site as well as the appropriate age group:

Key things to know and share with patients

Benefits of pediatric vaccination talking points

Use these talking points to help convey the importance of COVID-19 vaccination for adolescents and children.

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  • 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 the Omicron variant spreads 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 to us now — 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. To help prevent any injuries that could occur from a fall while fainting, children should stay seated for 15 minutes after the shot. 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, all providers have started talking to parents about getting their own COVID-19 vaccinations to help protect their children. Now that it is their children's turn, many of the same concerns may linger as they weigh the pros and cons of vaccination. MDH has put together What You Should Know About COVID-19 Vaccines (PDF) with answers to common myths and misconceptions about COVID-19 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.
  • 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


Updated Monday, 12-Sep-2022 07:56:24 CDT