COVID-19 Vaccines in Kids: Benefits vs. Risks

Medically Reviewed By William C. Lloyd III, MD, FACS
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teen girl wearing face mask smiles as she take a selfie while getting vaccine outdoors at pop-up vaccine clinic
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COVID-19 vaccines have been available for children ages 12 to 15 since May 2021, when the U.S. Food and Drug Administration (FDA) extended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine for this age group. The FDA authorized the vaccine for even younger children, ages 5 to 11, on October 29, 2021. (The Pfizer-BioNTech vaccine has been available for children ages 16 and older since late 2020.)

The safety record for COVID-19 vaccines in children is very good—that’s why the FDA authorized the vaccine for kids ages 5 to 15. However, reports of heart inflammation after COVID-19 vaccination—mostly in adolescent males—have parents concerned.

Understanding the benefits and risk of COVID-19 vaccination will help you make an informed choice.

COVID-19 Vaccine Benefits for Kids 

In clinical trials, the Pfizer-BioNTech COVID-19 vaccine was 100% effective in preventing infection with SARS-CoV-2 (the virus that causes COVID-19) in children ages 12 to 15.

The trial for younger children ran during a time the Delta variant began circulating. Because the Delta variant is stronger than the virus variant (Alpha) circulating during the vaccine trial with adolescents, researchers measured vaccine effectiveness by the ability to prevent COVID-19. This is virus infection causing symptoms. The Pfizer-BioNTech vaccine was 90% effective in preventing COVID-19 in children ages 5 to 11. The vaccine also triggered a strong immune response with a good safety profile.

A lot of people think COVID-19 is a mild illness in children, but that’s not necessarily true. Although most kids experience mild cases, others become severely ill. Children younger than 18 make up 16% of total confirmed COVID-19 cases, and 691 children have died of COVID-19, according to the American Academy of Pediatrics (based on Centers for Disease Control and Prevention [CDC] reporting through October 17).

Preventing COVID-19 via vaccination can also prevent complications of COVID-19 in children like MIS-C and post-COVID syndrome (also called “long-haul COVID”), which can cause lingering fatigue, shortness of breath, joint, and chest pain that can interfere with a child’s ability to participate in daily activities. COVID-19 vaccination can help children resume and avoid missing activities, such as school and sports, due to COVID-19.

COVID-19 Vaccine Side Effects 

All vaccines have side effects. Most are harmless and resolve within a few days. The side effects most often experienced by children who receive the COVID-19 vaccine are:

Some people don’t experience any side effects. Some only experience pain or redness at the injection site. Other people feel lousy for a day or so after vaccination. According to the Mayo Clinic, side effects in children typically resolve in 1 to 3 days. Side effects are more likely to occur after the second dose of COVID-19 vaccine than the first. However, some children develop side effects after the first dose, and some people experience side effects after both doses.

COVID-19 Vaccine Risks for Kids

Serious health problems following COVID-19 vaccination are rare in all age groups. A few people have experienced anaphylaxis, or a serious allergic reaction, after vaccination. In the clinical trials that tested the Pfizer-BioNTech vaccine in children ages 5 to 11 and 12 to 15, there were no reports of anaphylaxis or serious allergic reactions. According to the Asthma and Allergy Network, children who have an allergy to polyethylene glycol (PEG) or any other ingredient in the Pfizer-BioNTech vaccine should not get the vaccine. However, it is safe for children with food, insect, medication, latex and environmental allergies to receive the Pfizer-BioNTech COVID-19 vaccine.

Some people who have previously received dermal filler injections have experienced swelling in the area that received the filler after getting a COVID-19 vaccination. If your child has ever had a filler injected into their face (to treat a scar, for instance), they may experience swelling a day or so after receiving a COVID-19 vaccine. This side effect is rare and can be managed with medicine.

COVID-19 Vaccine Myocarditis 

Inflammation of the heart muscle (myocarditis) or the tissue surrounding the heart (pericarditis) is another rare side effect of COVID-19 vaccination. Again, there were no adverse events in the trials involving children, but there have been reports in adolescents and adults after millions of people were vaccinated.

Approximately 1,000 cases of myocarditis and pericarditis after COVID-19 vaccination with the Pfizer-BioNTech or Moderna vaccines have been reported. These cases most commonly occurred in adolescent and young adult males, at a rate that is higher than expected for these age groups.

Most of the cases of vaccine-related heart inflammation have been mild; however, some people required hospitalization. To date, there have not been any confirmed deaths due to COVID-19 vaccination.

Researchers at the FDA, CDC and other organizations use benefit-risk assessment models to determine if the risk of a certain adverse event occurring is greater than the benefit of the vaccine (for example, the expected number of hospitalizations the vaccine would prevent). The FDA's own benefit-to-risk model predicts that the benefits of the vaccine outweigh the risks in children, including those ages 5 to 11. Healthcare professionals also note that the risk of heart damage from COVID-19 infection is greater than the risk of heart damage from vaccination.

It's notable that the Pfizer-BioNTech vaccine received full FDA approval in August 2021 for ages 16 and older. Children ages 5 to 15 can still get the vaccine under its emergency use authorization. Your healthcare provider can help you weigh the potential benefits and risks of COVID-19 vaccination for children.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jul 15
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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