Parents of young kids finally have important news they have been waiting for: health authorities have authorized COVID-19 vaccines for kids six months to five years old.

This is welcome news for families and their younger children who have had to face the prospect of getting sick and have had to avoid many of their regular activities.

Federal health authorities have authorized the Moderna vaccine for children ages 6 months through 5 years, and the Pfizer-BioNTech vaccine for children ages 6 months through 4 years. The Pfizer vaccine requires three doses; the Moderna vaccine requires two doses. Pfizer’s vaccine was authorized for children ages 5 and over last November; the Moderna vaccine has now also been authorized for the  5-17 age group.

In this Q&A, Lindsey C. Douglas, MD, MSCR, a pediatrician at Mount Sinai Kravis Children’s Hospital, explains why parents should get their young kids vaccinated as soon as possible. Dr. Douglas is Medical Director, Children’s Quality and Safety, and Pediatric Hospital Medicine, and she is also Associate Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai.

Why should I get the vaccine for my child six months to five years of age? What are the benefits and risks?

We’re really excited that the vaccine has been approved for children six months to five years of age, so now nearly all children can get vaccinated. The vaccine does, in fact, reduce the chances that a child will get COVID-19. Many people who have looked at the data believe the reduction doesn’t seem to be that much. But we know that the vaccine reduces the chance that a child will get severe COVID, and that is really important. Children are being hospitalized with COVID-19, and that is something we worry about. Also, the vaccine will help us truly get back to normal, with children being able to be around other children, around their grandparents, and reducing the risks of transmission in general. We hope this will get us back to where we were before the pandemic, so that we can all gather together and not be as worried about COVID-19.

Two vaccines are recommended. What are the differences and does it matter which vaccine I get?

We have some information about both of them. There were studies that were done for the authorization by the Food and Drug Administration, and the two vaccines seem to have similar efficacy. However, the doses are different, and the timing is different. There are three doses for the Pfizer vaccine and two doses for the Moderna vaccine. My recommendation is to get the one that’s easiest for you to get, the one that’s available at your pediatrician. The differences are probably not as important as the difference between having the vaccine and not having the vaccine. You can talk with your pediatrician if you have other questions.

Will children experience any side effects?

Side effects have been quite minimal, and they’re similar to other vaccines, which include soreness at the site of the shot, and some children experienced fevers and body aches. I like to think of these as proof that the vaccine is working, that your immune system is actually activated and working.

What can I do about these side effects?

You can give your young child acetaminophen (Tylenol) or ibuprofen (Advil or Motrin). They can help with fever and muscle aches. Some medications, such as ibuprofen, work as anti-inflammatory medications, whereas acetaminophen does not. Some believe anti-inflammatory medications may also block the immune response. I have two children of my own who are between five and 11 and had the vaccine, and I tried to wait it out with them, so that they could have the most potent response. The symptoms typically last only about a day. If you need to use something, I suggest acetaminophen.

What does the data show about how effective the vaccine is?

The effectiveness of the vaccine was shown in how often a child would get COVID-19. But that’s not the only  thing that we worry about. The other thing that I worry about, as a pediatrician who takes care of hospitalized children, is preventing severe disease. There is not as much data on that, so it’s something that each parent should think about. Preventing severe disease in children is really important, and so is getting back to school and playgroups and all of the things that smaller children need for their development. Those to me are equally as important as not getting COVID-19 at all.

Are kids five and under at risk for serious disease?

People believe children don’t get COVID-19 as often or there are fewer cases of COVID-19 than in adults. That technically is true. More adults have been hospitalized. But there are children who have died from COVID-19. My opinion is this vaccine prevents both serious disease and hospitalization of a child, and that means it makes sense to get your child vaccinated.

Why is there no vaccine for kids under six months?

The studies for these vaccines were done in children over six months of age because the immune system is not fully formed in children under six months. We do start shots in infants as early as two months of age, but many vaccines can’t be given until kids are older, including the chickenpox shot. We tend to be much more careful with vaccines in children under six months of age.

If my child already had COVID-19, do they still need a vaccine?

Unfortunately, getting COVID-19 doesn’t prevent you from getting it again. I recommend that a child who has had COVID-19 be vaccinated. We know that vaccination is a strong way to prevent disease and prevent severe disease, and having some natural immunity from having the disease also provides some protection. The combination of the two is even better.

Is there anything else that patients and consumers should know?

The COVID-19 vaccines have been available for quite some time now. Kids under five are not that much different from those older than five. As a pediatrician, and as a parent myself, I’m thrilled that we can offer the vaccine to our most vulnerable and youngest children. This age group has been out of school the most of any age group because of not being eligible for the vaccine and not being able to wear masks easily. I urge parents to consider getting their children vaccinated today.

Until very recently, you probably never heard of the term omicron. If you did, it was as a letter in the Greek alphabet, like delta or pi. Now, Omicron dominates the news as the latest coronavirus variant that was first discovered in Southern Africa and is now being found around the world, including in the United States.

Although data on the Omicron variant is incomplete, a clearer picture is beginning to emerge, note two of Mount Sinai’s leading experts in infectious diseases Judith A. Aberg, MD, Dean of System Operations for Clinical Sciences and Chief of the Division of Infectious Diseases, and Bernard Camins, MD, Medical Director for Infection Prevention.

What do we know about the Omicron variant?

According to Drs. Aberg and Camins, the limited evidence we have suggests that while Omicron is more transmissible than earlier variants, it causes mainly mild disease—especially in people who are fully vaccinated and who have received their booster dose. Additionally, it appears to produce symptoms in line with those expected of COVID-19. This includes fatigue and headache as well as sore throat, runny nose, coughing, and fever. If you feel any of these symptoms, please get tested. 

It will take more time for researchers and clinicians to fully assess how effective existing COVID-19 vaccines are against the Omicron variant. But if you have not yet been vaccinated, or are eligible and have not yet received a booster shot, you should do so as soon as possible. Vaccine makers are assessing the need to reformulate their vaccines against the new variant, but that may take months; Drs. Aberg and Camins say it is better to get some additional protection now rather than waiting for the potential for better protection later.

How do we protect ourselves against a more transmissible variant?

Drs. Aberg and Camins say that it is more important than ever to follow current guidelines from the Centers for Disease Control and Prevention (CDC) for avoiding infection, such as wearing masks in public indoor settings, staying home if you feel sick, getting vaccinated, and getting your booster shot when you are eligible. This is especially important as we enter the holiday season and as rates of infection rise in the New York metropolitan region and around the country, although there is no evidence that Omicron is the cause.

In addition, Drs. Aberg and Camins say you should be vigilant about following the CDC’s detailed guidelines on gathering for the holidays, which emphasize keeping your gatherings small and outdoors if possible. For traveling, the CDC says you should avoid travel if you have been exposed to COVID-19 unless you are fully vaccinated or recovered from COVID-19 in the past 90 days. You should avoid international travel until you are fully vaccinated. Some international travel is already being curtailed because of the new variant.

What else should be taken into consideration as this global pandemic continues?

Viruses constantly change through mutation.

These variants do not necessarily present a significant new risk. Last summer, the Delta variant was found to be more easily transmitted, but people who were vaccinated did not face a significantly increased risk of serious illness or hospitalization. Many other variants were initially thought important enough to be assigned a Greek-letter name but later turned out not to have a widespread or significant effect.

Scientists and researchers are hard at work to fully assess this variant.

Currently, scientists are working in labs to assess how effective the existing COVID-19 vaccines are against Omicron. The testing involves taking blood samples from those who have been fully vaccinated and seeing if their antibodies neutralize the new variant. Results are expected in a few weeks. Additionally, Mount Sinai researchers are continually analyzing the positive SARS-CoV-2 samples for variants, including Omicron, to see if these variants are circulating among the local population.

We are keeping an eye on the effectiveness of monoclonal antibody treatments.

One of the main concerns with the Omicron variant is that the number and type of mutations it contains may make some monoclonal antibody treatments less effective. Monoclonal antibody treatments are given to non-hospitalized people diagnosed with COVID-19 who are at high risk of developing more severe symptoms. Scientists are working to learn which treatments will be most effective against Omicron.

In another step to strengthen the public health defense against the COVID-19 pandemic, federal regulators have authorized “booster” shots for all adults.

The Food and Drug Administration (FDA) has authorized a booster dose for the Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines, and the Centers for Disease Control and Prevention (CDC) is recommending booster shots for all adults over age 16. Health experts are encouraging all those eligible to consider getting the booster shot.

“The most important thing is to get vaccinated, and get a booster shot” if you over 16, says Waleed Javaid, MD, Professor of Medicine at the Icahn School of Medicine at Mount Sinai and an expert on infectious diseases. “We at Mount Sinai are closely monitoring reports on various variants including Omicron and Delta.  At this time, we encourage everyone to get vaccines and boosters, and continue to wear masks in public and follow guidance provided by the public health officials.”

Waleed Javaid, MD

In this Q&A, Dr. Javaid answers other frequently asked questions about COVID-19 booster shots.

When should I get a booster shot?

If you were fully vaccinated with the Pfizer or the Moderna vaccine, you should get the booster at least six months after getting the two vaccine doses. If you received the Johnson & Johnson vaccine, you should get the booster at least two months after completing the primary vaccination.

What do we know about side effects from the booster shot?

I received my booster, and I had pretty much the same reaction as my second dose. Most of those around me also experienced very similar reactions as their second dose. The short-term side effects include pain in the arm where you got your shot, tiredness, and headache. There is nothing in the literature or in our experience at Mount Sinai to suggest the reaction will be any different from the first and second doses.

Does it matter which booster shot I get?

The most recent recommendation from the FDA and the CDC is that we can use these vaccines interchangeably, and they have not found one is better than the other. Right now, they are considered equal.

What if I got the J&J vaccine?

People who have received a single dose of the Johnson & Johnson vaccine can get a booster using the Johnson & Johnson vaccine, or they can get a Pfizer or Moderna dose as a booster. However, as of Thursday, December 16, the CDC recommends that patients receive an mRNA COVID-19 vaccine over Johnson & Johnson’s COVID-19 vaccine due to the increased effectiveness of mRNA vaccines.

What is the difference between a booster shot and a third dose?

A third shot is considered part of the original series and is considered necessary to provide full protection to a group of people who have reduced ability to fight infections, which includes patients being treated for some cancers or those with an organ transplant. Boosters are shots that have now been authorized for all adults after a certain time period has passed since they were fully vaccinated in order to boost their immune system to ensure they can continue to fight the infection. Right now, a booster shot is not required to be considered fully vaccinated if you are not among the special group specifically recommended for a third shot.

I’ve had COVID-19 and two doses of the vaccine, should I get the booster shot?

People who have had COVID-19 and got two doses of vaccine can certainly get their booster shot. There seem to be questions about this. The data shared by the CDC and other agencies is that getting the booster shot after being infected with COVID-19 offers you additional protection against infection. To all adults, I would say, definitely consider a booster as an option to protect yourself and your loved ones around you. I encourage everybody to reach out to their providers or to Mount Sinai for any advice we can provide.