On November 2, 2021, the Centers for Disease Control recommended the Pfizer-BioNTech COVID-19 vaccine for children ages five to 11. (Right now, kids and teens can only receive the Pfizer-manufactured shot; this is because studies for use of the Moderna and Johnson & Johnson in kids are ongoing).

The Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee—its members are not FDA employees but pediatricians, infectious disease experts, and epidemiologists—voted 17 to zero to approve the vaccine. This decision comes after a worldwide series of clinical trials by Pfizer and participating health institutions, which tested two doses (at one-third the amount for adults) in 2,268 children total. They found it 90.7 percent effective in preventing COVID-19 infection.

Children’s Hospital Colorado, considered a “supersite” for clinical trials, included 252 children with a racial demographic makeup even more diverse than the city of Aurora. About 166 got the Pfizer vaccine, the others got a placebo. 

Local reporting suggests that many kids came excited to contribute to the Children’s scientific trial. If your child is not so enthusiastic, check out our story about decreasing fears about injections. We’ve also asked Dr. Lalit Bajaj, a pediatric emergency medicine physician who helped coordinate the trial at Children’s, about COVID-19 vaccines and children, for parents’ peace of mind.

How confident are you in the Pfizer vaccine given its rapid development? 

It’s important to note that the [mRNA] technology that was used for the [Pfizer] vaccines has been under development for about 20 years, and it’s well vetted from a science standpoint. This is the largest use case this technology has ever had… I think that it’s really turning out to have fabulous effects. I’m pretty confident that it’s a really good vaccine, probably one of the best we’ve ever seen, and it’s very safe.

With the clinical trial at Children’s, could you provide any details about the participants’ side effects?

We only saw the fever, fatigue, headache, and chills kinds of side effects in the kids. There were no reports in the trial participants of any myocarditis*, Guillain-Barré, or any other concerning serious side effects that people worry about. Now, the trial itself was not designed to pick those up, because you need hundreds of thousands of patients to figure that out.

I think it’s important to know that, because it’s a third of the dose in the five to 11 year olds, they actually saw less side effects, like the fatigue and headache and fever, than they did in kids above the age of 16. They did a comparison study; so it’s tolerated better in this lower age group with this lower dose.

*Editor’s note: Confirmed cases of myocarditis or pericarditis (swelling of the heart muscle and the sac around the heart) have occurred rarely, and primarily in male adolescents and young adults age 16 years or older. Typically, symptoms showed within several days of vaccination, and most patients who received treatment responded well and quickly.

If a child already had COVID-19, do they need to get vaccinated?

We are recommending that they do. We’re finding that the vaccine is significantly boosting immunity in folks who have had COVID, that’s mainly in the older age groups that have been in more studies. But we know it’s safe, and we know it adds additional immunity, because immunity from natural COVID infection probably wanes faster than immunity from the vaccine.

Can kids get other boosters like the influenza vaccine at the same time? 

We recommend that they can get the flu vaccine and the COVID vaccine at the same time or in close proximity.

How does the Pfizer vaccine compare to others that children receive regularly?

[Pfizer vaccines have] just a small piece of code for a tiny piece of the coronavirus proteins, which allows our bodies to recognize that as foreign and generate an immune response. That little piece of mRNA is so short lived [in the body], a matter of seconds, and it’s gone, and has really no ability to actually create illness itself, biologically it can’t do that. Most vaccines really don’t either, but as opposed to previous vaccines or other kinds of vaccines, these don’t contain any actual live virus or really any piece of a killed virus. There’s concerns about fertility, that RNA is so short lived, and there have been no reports or studies suggesting that any infertility issue has been reported so far from mRNA vaccines.

So as a physician, I understand the biology of the vaccine, I understand growing kids and how this may or may not affect that. And I have also seen the ravaging effects of COVID on some children, and realized that getting natural COVID infection is much riskier than getting this vaccine.

What conditions could make a child less likely to build up the immunity projected by clinical trials?

Kids who have immune conditions or they’re on particular antibodies for things like lupus or other rheumatologic diseases, or cancer, they may not be able to generate that immune response because they don’t have normally functioning immune systems for one reason or another. That’s also a good reason for everybody else to get vaccinated so that they can protect those folks who can’t generate this immune response.

Any other questions you’ve been fielding from parents?

They want to know if the vaccine will require a third dose in the future [since the booster has been recommended for adults]. We don’t know the answer to that question yet, since we’ve just started immunizing these kids on a large scale. [Scientists] will be keeping a close eye on how long this immunity lasts [in kids versus adults], as well as different variants may pop up that may impact how efficacious this vaccine is.

I think this is a really great reason to be optimistic that we’re going to try to get so many of these kids vaccinated and we can hopefully get back to some semblance of normalcy.

Where to find a dose

Approximately 480,000 Colorado children, about 8 percent of the state population, are now eligible to receive the vaccine. Here’s where you can find a clinic close to you:

• The Colorado Department of Public Health and Environment keeps an updated list of clinics with availability each day across the state. Find vaccinations, testing, and screening for all ages online.
• Some retail pharmacies like CVS and Walgreens are taking appointments for children ages five to 11. Find an appointment at a pharmacy near you at vaccines.gov.
• Colorado’s mobile vaccine clinics, popping up at local businesses, organizations, and health centers across the state, have Pfizer doses available for age five and up. Make a free, no insurance required appointment at mobilevax.us/clinics.
• Children’s Hospital and the Colorado Department of Health and Environment are partners in offering clinics for kids. Find dates and reservations for all four Children’s locations (Broomfield, Aurora, Highlands Ranch, Colorado Springs) online.
• Three Black women-led organizations, Apex Pharmacy, Colorado Black Health Collaborative, and Soul 2 Soul Sisters, have launched a vaccination incentive program for Black community members in the Denver metro area. Each person receiving their first dose (while supplies last) receives a $100 Visa gift card; Uber codes for free rides to and from appointments are also available. At least a dozen children ages five to 11 have received the vaccine from providers at Apex Pharmacy in Aurora.
• Out Boulder County and Boulder County Public Health are hosting clinics Thursday through Saturday until the end of the year. All individuals age five and up are eligible (Fridays and Saturdays are reserved for youth). No identification or insurance is needed, and Spanish speakers are available to assist. Schedule an appointment for a vaccine at the St. Vrain Community Hub in Longmont online.
• Butterfly Pavilion, working with the Colorado Department of Public Health & Environment (CDPHE), will hold a COVID-19 vaccination clinic providing free first and second Pfizer doses for children ages five to 11. Kids who get a shot will receive free entrance into the center for that day and one child Living Lights festival ticket (online reservation required). Accompanying parent or guardian “walk ins” are available as time and doses last. Register online.
• Yum Yum’s Ice Cream is giving out free extra scoops (with purchase of one scoop) to kids ages five to 11 with proof of a COVID-19 vaccine. Swing by the location next to Denver Beer Co. in the Rosedale neighborhood through January 1, 2022.