All children age 6 months and older should be vaccinated against COVID-19 with at least one dose of the current 2024–2025 formulation mRNA vaccine. COVID-19 vaccination of children in this age group has been demonstrated to be safe and to prevent hospitalization and severe complications of COVID-19 illness. Both Pfizer-BioNTech and Moderna mRNA products are authorized for use in children down to 6 months of age. Novavax adjuvanted protein subunit vaccine is authorized for use beginning at age 12 years.
Children age 6 months through 4 years initially require a primary series of two (Moderna) or three (Pfizer-BioNTech) doses of the same brand. The primary series may include doses of previously authorized formulations. CDC recommends use of the same brand for all recommended doses given to children younger than age 5 years. If it is not possible to do so because the brand is unavailable at the vaccination visit, the brand of a previous dose is unknown, or because the child would not or should not be vaccinated with the previous brand for any reason, then administer the age-appropriate formulation of the available brand. A 3-dose primary series is required for children age 6 months through 4 years who have a mixed-brand primary series. A 3-dose primary series is also required for all children and adults who have moderate or severe immunocompromise.
Last reviewed:
November 16, 2024
This child should receive the dose recommended for his age at the time of the vaccination visit. At age 11 years, an age-appropriate single dose of either Pfizer-BioNTech or Moderna mRNA vaccine is recommended. If the patient arrives in your clinic after turning 12 years old, the 2024–2025 Formula Novavax protein subunit vaccine is also an option. If using the Novavax product, a previously unvaccinated person requires two doses, given 3 to 8 weeks apart, as a primary series.
Last reviewed:
November 16, 2024
CDC states that a person who moves to an older age group between vaccine doses should receive the vaccine product and dosage for the older age group for all subsequent doses.
Children who transition from age 4 years to age 5 years during the initial vaccination series should receive 1 dose of the 2024–2025 vaccine from the same manufacturer at the dosage authorized for children age 5–11 years on or after turning age 5 years.
Last reviewed:
November 16, 2024
Children who transition from age 4 years to age 5 years during the initial vaccination series should receive 1 dose of vaccine from the same manufacturer at the dosage for children ages 5–11 years on or after turning age 5 years. This child should receive one dose of the 2024–2025 Moderna vaccine (no dose change is needed).
Last reviewed:
November 16, 2024
CDC states that if a person moves to an older age group between vaccine doses, they should receive the vaccine product and dosage for the older age group for all subsequent doses.
Children who transition from age 11 years to age 12 years during the initial vaccination series should complete the 3-dose series using the dosage for people ages 12 years and older for all doses received on or after turning age 12 years:
Moderna series: 2024–2025 Moderna, 0.5 mL/50ug
Pfizer-BioNTech series: 2024–2025 Pfizer-BioNTech, 0.3 mL/30 ug
See www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#table-02 for additional details.
Last reviewed:
November 16, 2024
Both vaccines have been demonstrated to be safe, with side effects typical of those in older age groups. The most common local reaction in this age group is pain at the injection site; the most common systemic symptom in older children was fatigue and in younger children (6 through 23 months) irritability/crying and sleepiness were most common. Fever may occur after either vaccination. Febrile seizures can occur in infants and young children ages 6 months through 5 years as a result of any condition that causes a fever (most common with high fevers). Febrile seizures are uncommon after vaccination. Febrile seizures were rare after mRNA COVID-19 vaccine clinical trials in this age group, and CDC continues to monitor for this adverse event following vaccination in infants and young children.
No cases of myocarditis were reported during the clinical trials for either vaccine. To date, post-authorization surveillance has not detected an increased risk for myocarditis and pericarditis following mRNA COVID-19 vaccination in children ages 6 months–4 years (Pfizer-BioNTech) and ages 6 months–5 years (Moderna).
Last reviewed:
November 16, 2024
Last reviewed:
June 22, 2023
