YouWhen Pfizer and Moderna approved COVID-19 vaccines for children under six months of age, infant- or toddler-sized versions were made available. Some children may become infected after starting their vaccinations, as the extremely contagious BA.5 Omicron Subvariant has increased spread throughout the country.
This is particularly true for children ages six months to four years old who are receiving the Pfizer vaccine, which requires three doses—with the third dose coming two months after the second. Kids ages six months to five years old who get Moderna’s vaccine will complete their course much more quickly, with two doses in four weeks.
Here’s what pediatricians say to do if your child gets COVID-19 between doses.
Keep the dose up until your child is fully recovered.
Pediatricians say that getting COVID-19 in between doses should not significantly alter a child’s vaccination schedule, beyond waiting for the child to recover.
“If you get COVID in between your vaccine doses, you need to wait until you’ve completed your isolation before you get your second dose,” says Dr. Tina Tan, a pediatrician at Lurie Children’s Hospital in Chicago and professor at Northwestern University. COVID-19 may spread to others by going to a vaccination appointment.
But after a child’s isolation period has ended—typically ten days after they first tested positive or started showing symptoms—the child is clear to receive an additional shot, Tan says. “It doesn’t matter if it’s between the first and the second, or the second and the third. You do the same thing.”
Wait a few weeks if you want—but not too long
The U.S. Centers for Disease Control and Prevention (CDC) has provided guidance that a COVID-19-recovering child may need to wait for three months before being vaccinated. According to Dr. Ibukun C. Kalu (director of pediatric infection prevention at Duke University Medical Center), there’s no federal guidelines on how to deal with the ever-present scenario where a child gets infected in multiple doses. However, children should wait three months to get vaccinated if they become ill in more than one dose.
“If the child is either trying to complete their primary series or due for a booster, it is reasonable to use that three-month guideline,” Kalu says. A child’s age or the type of vaccine they received does not change this guidance.
The U.K.’s National Health Service recommends that children wait three months after recovering from COVID-19 before receiving a vaccine, while the New York State health department advises parents to talk to their pediatricians about this option if their child get sick between doses.
Learn More: Here are 5 Reasons Why Your Child Needs To Be Vaccinated Against CoviD-19
It is possible to delay the treatment for three months, but experts advise that patients should continue with their normal doses. “If that dose [appointment] is far enough out that they’ve recovered from COVID,” there’s no need to reschedule, Tan says.
Sticking to existing appointments may be especially helpful if a child is about to go back to school or other settings where they’re likely to encounter the coronavirus. BA.5 can easily infect people with COVID-19. Some reinfections occur in as little as one month.
Dr. Katelyn Jetelina, an epidemiologist and science communicator who writes the popular Your Local Epidemiologist newsletter, says that if one of her daughters—who both received the first dose of the Moderna vaccine in late June—got infected between doses, she would consider pushing their second shots out by a couple of weeks. “I wouldn’t delay it much more than that,” she says.
You must complete the course of vaccinations
Experts believe that children who have been infected will benefit from the vaccination series.
Here’s why vaccination after infection matters: since many children have mild cases of COVID-19, their immune systems may not “mount a very durable, strong response” to the infection, Jetelina says. The vaccines are designed to provide immune systems with more information about the virus and bolster that response, making kids more prepared “in case they come into contact with the virus again.”
The long-term protection from new variants can be increased by vaccination. “With Omicron and its subvariants, you can get infected again and again and again,” Tan says. “It’s really important that you get your antibody titers up there so that you are protected.”
Although COVID-19 is less common in children than it is in adults, some kids may still need to go to the hospital. Data from the Department of Health and Human Services shows that more than 70,000 American children were admitted to hospital with COVID-19 by 2022. 37,000 children were admitted to hospital during the Omicron surge of January and February.
According to a CDC Report, 9 out 10 children aged 5-11 who had to be hospitalized due to COVID-19 in the winter surge were not vaccinated. The risk of death and hospitalization for children who have not been vaccinated is reduced by vaccinating them. And while there’s scant research yet on whether it reduces the long-term effects of COVID-19 in kids—such as Long COVID and multisystem inflammatory syndrome in children (MIS-C)—studies have shown that vaccination reduces the risk of Long COVID among adults.
Get ready for the next doses
Experts recommend that parents consider COVID-19 as part of back-to-school planning.
Many schools will not have the same safety precautions as in the past, such as social distancing and masks, when they reopen to in-person instruction. “Kids are going to be exposed, probably on a more frequent basis than they are now, to people infected with COVID,” Tan says. It is important to ensure that your children receive routine vaccinations as soon as possible before semester begins.
The Omicron booster may also be available to children later in fall. Moderna is currently testing an Omicron booster for children under age five that’s similar to their Omicron booster for adults, which may be available as early as September. This could be a third dose for kids who received Moderna’s primary series, Jetelina says. It’s also currently unclear whether an Omicron-specific booster will be recommended for young kids who receive the Pfizer series, she says.
But parents shouldn’t wait for potential variant-specific vaccines when they can improve their children’s protection against COVID-19 now, experts recommend. “I think the relative unknown that we all face about upcoming variants has encouraged people to get their kids vaccinated as soon as they can,” Kalu says.
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