The COVID-19 booster shot for 5-11 year olds: 5 questions answered

In the USA, the number of COVID-19 cases is increasing again – including among children. In mid-May 2022, the Food and Drug Administration approved a booster shot of the COVID-19 vaccine for US children ages 5 to 11, and the Centers for Disease Control and Prevention subsequently recommended a booster shot for that age group.

Of course, many parents wonder about the importance and safety of booster vaccinations for their school-age children. For The Conversation, Debbie-Ann Shirley, a pediatric infectious disease specialist at UVA Health, answers some common questions she hears about COVID-19 and booster shots in children that she hears in her practice, and explains the research finding why booster shots are recommended for children of all ages 5 to 11

1. How important is a booster vaccination for children?

COVID-19 is generally milder in children than in adults, but serious illness can occur. By the end of May, more than 15,000 children aged 5 to 11 [nationwide] have been hospitalized with COVID-19 and 180 children have died. During the peak of the recent winter wave of the highly transmissible Omicron variant, 87% of children aged 5 to 11 hospitalized with COVID-19 were unvaccinated.

Additionally, the rare but serious condition that can occur in the weeks following COVID-19 infection, known as pediatric multisystem inflammatory syndrome or MIS-C, occurs most commonly in children aged 5 to 11 years. Over 3,800 cases of MIS-C have been reported in this age group, 5 to 11 years, and 93% of children who developed this complication were unvaccinated.

Some vaccines – including those for COVID-19 – become less effective over time. Booster shots help boost the immune response. Several childhood vaccinations, such as tetanus and diphtheria, require booster shots.

COVID-19 boosters have been shown to improve declining protection in adolescents and adults. The side effects are similar to those reported with the first series. The risk of myocarditis, or heart inflammation – a rare side effect that can occur after a COVID-19 vaccination – appears to be lower after a third dose than after the second.

2. How well does immunity hold up after the first COVID-19 vaccinations?

When administered to children ages 5 to 11, Pfizer-BioNTech’s vaccine produced an antibody response similar to that seen in October 16 to 25 year olds in a clinical study that formed the basis of the FDA’s original approval of the vaccine . However, studies after the vaccines were approved found that the vaccine’s effectiveness in the 5- to 11-year-old age group declined rapidly during the Omicron surge. Nevertheless, the syringes continued to protect against serious illnesses and hospital stays.

Vaccination has also been shown to provide high protection against multisystem inflammatory syndrome in children.

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