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Should your child get the updated Covid-19 booster?


Last week, the U.S. Centers for Disease Control and Prevention released guidance recommending the updated Covid-19 booster for children ages 5 to 11. Now the Pfizer/BioNTech booster is available for children ages 5 and up, and the Moderna booster can be given to kids ages 6 and up.

What should parents consider when deciding whether to buy the updated booster for their child? Are there situations that may cause families to wait? Are there any downsides? What about kids just turning 5 – should they get the new booster? If a child has not yet been vaccinated, is he eligible for the updated booster?

To guide us through these questions, CNN Medical Analyst Dr. I spoke to Leana Wen. She is also the author of “Lifelines: A Doctor’s Journey in the Struggle for Public Health” and is the mother of two young children.

CNN: Who is now eligible to receive the updated Covid-19 booster? Does it matter how many vaccinations they’ve had before?

Dr.Leana Wen: Essentially, anyone aged 5 years and older can receive the new bivalent Covid-19 booster as long as they complete their primary vaccine series. It doesn’t matter how many boosters they have. This means that a child who has only received the first two doses of Pfizer or Moderna can also receive support for a child who has already received a booster dose, provided it has been at least two months since the last dose of vaccine.

CNN: What should parents and caregivers consider before choosing the updated booster for their child?

Wen: There are two important questions to ask. First, is your child at high risk of serious illness due to Covid-19? The most important reason to get vaccinated is to reduce hospitalization and other serious consequences. The first two doses of the vaccine are very good at achieving this for most children. Some may still be at higher risk for worse outcomes – if a child has serious underlying medical conditions, such as receiving chemotherapy or a transplant recipient. In these cases, a booster dose is recommended.

Second, is it very important for you to protect your children from Covid-19 infection? Many families, once their child has been vaccinated, have made the decision not to prioritize eradicating the Covid-19 infection if the risk of serious illness is very low.

On the other hand, others remain very alert and cautious. Maybe they’re worried about the unknown around prolonged Covid. Maybe they want to prevent their children from getting sick, which causes caregivers to miss school days and work days. Or it could be another household member who needs protection, such as an elderly grandparent or someone else with chronic underlying illnesses. All of these are reasonable considerations to get the kids on the booster later.

The CDC said that those aged 5 years and older can receive the bivalent Covid-19 booster if they receive the primary vaccine series.

One thing I will note is that we do not know how effective the booster will be in reducing symptomatic infection. Some studies have shown that the efficacy of the primary vaccine against symptomatic infection may decrease within a few months. However, a lot can happen with Covid-19. We may see increased cases this fall and winter. There may be a new variant that has become dominant. Many parents may want to provide the best protection for their child in case of another surge and then decide again next year whether another booster is needed.

CNN: Are there situations that might make parents wait to raise their children?

Wen: If a child has just contracted Covid-19, it is recommended to wait at least three months as the CDC recommends before boosting. Re-infection is unlikely during this time frame and it may be helpful to allow time for the body to develop its own immune response.

The same goes for a previous vaccine. The CDC says children and adults can receive the updated booster as long as at least two months have passed since their last shot of the vaccine.

I think both of these are minimum ranges. Many experts, myself included, believe it is beneficial to wait longer—perhaps four to six months—after infection or the last vaccination. This longer period may allow the body to develop enhanced immunity before another supplement, as some studies suggest. However, I also understand and appreciate the CDC’s need to have facilitated guidance and it makes sense to follow their guidelines as stated.

CNN: Is there a downside to giving boosters to kids?

Wen: This is an important question to ask. The way I would answer is to clarify that there are pros and cons to every intervention, including vaccines. Parents and families will weigh the pros and cons differently. The evidence is very clear that for first vaccines, the positive aspects far outweigh any potential risks. The evidence is less clear to reinforcers.

For example, in the case of a child with serious underlying medical problems, there is a significant advantage to receiving supplements to prevent serious consequences due to Covid-19. For other children, particularly those younger than 12, initial vaccinations are probably still very protective, and it is not yet clear what the additional benefit of the vaccine in reducing the risk of hospitalization is.

Covid-19 vaccines have some common side effects. The vast majority are benign and self-resolving; Symptoms such as body aches, fatigue, fever, and pain in the strengthening jab area usually disappear within a few days. (There are very rare cases of myocarditis, an inflammation of the heart muscle that occurs most often in adolescent boys. These also tend to resolve on their own and do not cause long-term effects.) In general, they should not. This is an important consideration for parents.

The CDC recommended the booster, and I think it’s reasonable for parents who want to follow guidance to do so. For those on the fence, having a candid talk with your pediatrician about your family’s particular circumstances can also guide your decision.

CNN: What about kids who just turned 5 – should they get the new booster?

Wen: I have a son who recently turned 5 and got his first series when he was 4 years old. His last hit was in July. I don’t plan on giving him a booster yet. I’ve been waiting for at least six months for the reasons I listed above.

CNN: Can parents and caregivers choose to give their child a dose of the original booster?

Wen: No. The U.S. Food and Drug Administration has withdrawn its authorization for the original monovalent vaccine and replaced it with an updated bivalent booster. That means you can only get the updated booster. This applies to adults as well as children.

CNN: If a child has not yet been vaccinated, is he eligible for updated support?

Wen: No. Children who have not yet been vaccinated can only receive the original vaccine for their primary series. Parents wishing to have their child receive the updated bivalent vaccine should complete the primary series (two doses of Pfizer or Moderna) and then receive the updated booster.

I want to stress the importance of the primary series. Numerous studies have found that the first two doses are highly protective against serious illness, including in children. In a New England Journal of Medicine study, the first two doses of the Pfizer or Moderna vaccines reduced hospitalization time among children by more than 80%. This should be a call to action for families who have not yet had their children vaccinated against any Covid-19 vaccines to get the first one.