Frequently Asked Questions For All Children 6 Months and Older

What are mRNA COVID-19 vaccines, including the Pfizer-BioNTech and Moderna vaccines, that are authorized for children down to 6 months of age?

The Pfizer-BioNTech and Moderna mRNA vaccines help your child's body protect itself against future infection. Your child's body gains protection without getting seriously sick with COVID-19.

On the surface of the virus that causes COVID-19 is a "spike protein." When your little one gets vaccinated, the mRNA vaccine instructs your child's cells to make a harmless piece of this protein. The "spike protein" is then displayed by some of those cells. The mRNA in the vaccine degrades quickly.

Your child's immune system will recognize that this protein does not belong. It will then make antibodies against it. This is similar to what happens if you get naturally infected with the virus that causes COVID-19, but you don't get sick. In a natural infection the virus itself forces your cells to make the spike protein along with other viral proteins, but also causes you to be sick.

Learn more about mRNA COVID-19 vaccines by visiting the Centers for Disease Control and Prevention (CDC) webpage.

Which COVID-19 vaccines are my children eligible for?

Children 6 months and older are eligible for the Pfizer-BioNTech or Moderna COVID-19 vaccine.

Which vaccine should my child get?

All of the COVID-19 vaccines available for children 6 months and older are safe, effective, and recommended. Children are eligible for either the Pfizer-BioNTech or Moderna COVID-19 vaccine.

Parents and guardians can choose which brand vaccine they'd like their child to receive or consult with their child's healthcare provider or vaccine administrator (e.g., clinic where your child will be receiving the vaccine) if they have questions. NYSDOH recommends parents and guardians get their child vaccinated with whichever vaccine is available.

Where can I find COVID-19 vaccine for my child?

COVID-19 vaccines for children 6 months of age and older are free and widely available statewide, including through pediatricians, family physicians, local county health departments, federally qualified health centers, and pharmacies enrolled in the Federal Retail Pharmacy Program.

Parents and guardians are encouraged to contact their child's healthcare provider about scheduling a vaccine appointment for children under five years of age.

Parents and guardians can also visit vaccines.gov, text their ZIP code to 438829, or call 1-800-232-0233 to find nearby locations. Please note, due to federal regulation, some pharmacies are only able to vaccinate children three years and older.

Is the COVID-19 vaccine free?

All COVID-19 vaccines are free of charge for all ages. There is also no charge for the injection or administration of the vaccine. Healthcare providers who give COVID-19 vaccines must vaccinate everyone who requests vaccination – whether or not they have health insurance.

Can children really catch COVID-19?

Yes. Individuals of all ages, including babies, toddlers, children and teens can contract the virus that causes COVID-19 as well as spread it to others.

What are the risks of my child being unvaccinated?

Those who are unvaccinated have the greatest risk of infection and severe disease from COVID-19, including hospitalization and death. This is true for children of all ages, including babies and toddlers. Children are also at risk of a dangerous inflammatory condition called multisystem inflammatory syndrome in children (MIS-C) which can occur several weeks after COVID-19 infection.

Vaccination will help protect your little ones and reduce their risk of severe disease, hospitalizations, or developing long-term COVID-19 complications.

That's why NYSDOH, CDC, and pediatricians across New York and around the country, including the American Academy of Pediatrics, recommend that all eligible babies, toddlers, and children 6 months and older stay up to date with their COVID-19 vaccines.

What is MIS-C?

Multisystem inflammatory syndrome in children (MIS-C) is a rare condition associated with SARS-CoV-2. It typically occurs 2-6 weeks after infection and may lead to inflammation of various body parts including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal tract.

What is long COVID, and is my child at risk?

Children who contract COVID-19 may be at risk of long COVID. Symptoms associated with long COVID can vary widely, from cardiovascular symptoms like heart palpitations to difficulty breathing and excessive fatigue and can include difficulty concentrating or other psychological symptoms. Long COVID symptoms can occur even if the initial COVID illness is not severe and can last for months or even longer. Scientists are still working to understand long COVID.

What about immunocompromised children?

Children who are moderately to severely immunocompromised should receive an additional dose of COVID-19 vaccine.

Why should immunocompromised children be vaccinated?

It is important that immunocompromised children are vaccinated to ensure that the immune system better protects them against a COVID-19 infection.

What immunocompromising conditions currently qualify children 6 months – 11-years-old to be eligible for an additional dose of the COVID-19 vaccine?

Consistent with CDC's guidance, this includes moderately or severely immunocompromised people due to a medical condition or receipt of immunosuppressive medications or treatments. Specifically, immunocompromising conditions may include:

• Active treatment for solid tumor and hematologic malignancies
• Receipt of solid-organ transplant and taking immunosuppressive therapy
• Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppression therapy)
• Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
• Advanced or untreated HIV infection
• Active treatment with high-dose corticosteroids (i.e., ≥20mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.

Because of the risk of COVID-19 infection in this population, immunocompromised people should continue to be counseled regarding the potential for a reduced immune response after vaccination and the importance of additional protective measures, regardless of the decision to receive an additional dose of the COVID-19 vaccine. Prevention measures include wearing a well-fitting mask, staying six feet apart from others they don't live with, and avoiding crowds and poorly ventilated indoor spaces until advised otherwise by their healthcare provider particularly in areas of increased transmission. Close contacts of immunocompromised people should be strongly encouraged to be vaccinated against COVID-19.

Parents or guardians with questions are encouraged to consult with their child's healthcare provider.

Is the COVID-19 vaccine safe for children?

Yes. COVID-19 vaccines have undergone – and will continue to undergo – the most intensive safety monitoring in U.S. history. The U.S. Food and Drug Administration's (FDA) evaluation and analysis of the safety and effectiveness of these vaccines was rigorous and comprehensive, supporting the authorizations for administering the COVID-19 vaccine down to children 6 months of age.

The CDC Director and its Advisory Committee on Immunization Practices' (ACIP) recommend that all children 6 months and older should receive a COVID-19 vaccine. Additional information can also be found on www.cdc.gov.

Is the vaccine effective for children?

Yes, the COVID-19 vaccines authorized for children down to 6 months of age are safe, effective, and the best way for you to protect your child from the virus. Parents and guardians can learn more about the safety and effectiveness of the COVID-19 vaccines for children on the FDA's website.

What are the side effects my child may experience after being vaccinated?

Your child may not notice any changes in how they feel after getting the vaccine. But it's also possible to feel a little "under the weather." This can happen after any vaccine. It's also important to know that children 6 months – 11 years of age receive a smaller dose of the COVID-19 vaccine than adolescents and adults 12 and older.

After the COVID-19 vaccine, your child may have:

• A sore arm where they got the shot
• A headache
• Chills
• Fever
• Tiredness
• Nausea and vomiting

These side effects are not dangerous and just a sign of your child's immune system doing its job. Parents and guardians are encouraged to speak with their child's pediatrician or primary healthcare provider if they have questions.

Will the vaccine give my child COVID?

No. None of the COVID-19 vaccines—including the mRNA Pfizer-BioNTech and Moderna vaccines authorized for children down to 6 months of age—can give your child COVID-19.

None of the vaccines are made up of materials that can cause disease. For example, the vaccines authorized for emergency use by the FDA use a small, harmless part of the virus' genetic material called 'mRNA'. This is not the virus. mRNA vaccines teach your or your child's body to create a virus protein. Your or your child's immune system develops antibodies against these proteins to fight the virus that causes COVID-19 if you or your child are exposed to it. That is called an immune response.

If my child is 11, should I wait for them to turn 12 so they can receive a larger dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine?

No. Parents and guardians should get their children ages 6 months – 11 years vaccinated as soon as possible with the appropriate dosage, which is based on their age at the time each vaccine dose is administered. Our nation's best medical and health experts have worked to ensure that the vaccine doses for 5 – 11-year-olds are safe and effective – offering our children excellent protection against COVID-19 and generating a strong immune response.

If my child turns 12 in between their first and second doses, what should they get for their second dose?

Eligible children ages 6 months – 11 years should get vaccinated as soon as possible with the appropriate dosage, which is based on their age at the time each vaccine dose is administered. This means if a child who is 11 turns 12 between their first and second vaccine dose, then that child should receive the dosage amount for a 12-year-old for their second dose.

Do the Pfizer-BioNTech or Moderna COVID-19 vaccines contain animal-based ingredients?

No! The Pfizer-BioNTech and Moderna COVID-19 vaccines contain no human or animal products, preservatives, or adjuvants and use no ingredients of human or animal origin.

Do COVID-19 vaccines contain mercury/thimerosal?

No! There are no preservatives such as mercury/thimerosal in any of the currently available COVID-19 vaccines, including the Pfizer-BioNTech and Moderna vaccines available for children down to 6 months of age.

Can my children receive the COVID-19 vaccine at the same time they receive other vaccines?

Yes. According to the CDC, no particular spacing is needed between the COVID-19 vaccine and other vaccines. This means your child can get the COVID-19 and other vaccines—such as their seasonal flu shot—at the same time or at any time. This includes together, before, or after other vaccines.

My child tested positive for COVID-19 and/or COVID-19 antibodies. Do they still need the vaccine?

Yes! The CDC recommends that individuals get vaccinated even if they have already had COVID-19, because they can be infected more than once. While your child may have some immunity after recovering from COVID-19, we don't know how long this protection will last. Vaccination is safe in a child who has already been infected. Children who get COVID-19 are at risk of serious illnesses, and some have debilitating symptoms that persist for months.

Is it better for my child to get natural immunity to COVID-19, rather than immunity from a vaccine?

No! All children, including children who have already had COVID-19, should get vaccinated. Unvaccinated children are at higher risk of complications of COVID-19 infections.

Children who get COVID-19 are at risk of serious illness, and some have debilitating symptoms that persist for months. While your child may have some immunity after recovering from COVID-19, we don't know how long this protection lasts. Getting vaccinated against COVID-19 is safe and effective and will protect your child against the virus.

Can my child get the COVID-19 vaccine if they are sick?

If your child is sick with COVID-19, they should wait to be vaccinated until they have recovered and are no longer isolated. The next vaccine dose can be delayed by 3 months from the onset of symptoms or when you first received a positive test. If your child is sick with an illness other than COVID-19, you can check with your child's pediatrician or primary healthcare provider for advice on when your child should be vaccinated.

Can my child attend preschool/school while they have side effects from getting the COVID-19 vaccine?

Children can attend school following COVID-19 vaccination if they feel well enough to attend school and do not have a fever or other COVID-19 symptoms. If your child experiences the following symptoms, they should not attend school. These symptoms would not be expected from the COVID-19 vaccine, but might be seen with COVID-19 illness or other viral illnesses:

• Runny nose
• Cough
• Shortness of breath
• Sore throat
• Loss of taste
• Loss of smell

Side effects from the COVID-19 vaccine are not severe or dangerous, and it is not likely that they would cause a child to miss school.

What if my child is exposed to COVID-19 before a dose of COVID-19 vaccine?

If your child is exposed to COVID-19 before vaccination, they should take certain precautions per CDC before starting the vaccination series. If your child is exposed to COVID-19 after receiving a vaccine dose but before finishing the series, they should follow CDC precautions before getting their next COVID-19 dose. It's okay to delay the next dose beyond the recommended interval for this reason.

Please let your child's healthcare provider or vaccine administrator (e.g., clinic where your child will be receiving the vaccine) know if you need to reschedule their vaccine appointment due to a recent exposure.

What if my child is infected with the virus that causes COVID-19 before vaccination or between doses?

If your child has a COVID-19 infection, whether symptomatic or not, before any dose in the vaccination series, they should complete their isolation before getting the dose. Additionally, you should talk with your child's healthcare provider about the possibility of delaying the dose for 3 months from the date your child's symptoms started or (if your child didn't have symptoms) the date of the positive test.

Please let your child's healthcare provider or vaccine administrator (e.g., clinic where your child will be receiving the vaccine) know if you need to reschedule their vaccine appointment due to isolation. Completing isolation before getting the COVID-19 will help protect those around your child from infection.

What's in the Pfizer-BioNTech COVID-19 vaccine?

The Pfizer-BioNTech COVID-19 vaccine includes the following ingredients:

• mRNA: mRNA is not the virus itself. The mRNA vaccines (like the Pfizer-BioNTech and Moderna vaccines) teach your body to create proteins. Your body recognizes these proteins and jumps into action, making antibodies that help you fight the virus, which is called an immune response. It reproduces the same immune response that happens in a natural infection without actually infecting your body.
• Lipids: fat-like substances that protect the mRNA and provide a bit of greasy exterior that helps the mRNA enter the cells.
• Salts: help balance the acidity in your body.
• Sugar: helps the molecules keep their shape during freezing.

For a simple breakdown of the ingredients in the Pfizer-BioNTech COVID-19 vaccine, see this infographic here.

For Moderna check here

How were the vaccines developed so quickly?

There are many factors that allowed the COVID-19 vaccines to be developed quickly and safely.

• Researchers got a head start on developing a vaccine because the virus that causes COVID-19 is similar to other existing viruses.
• Research about the new virus was shared almost immediately with scientists all over the world, which allowed work to begin on a vaccine right away.
• Some researchers were able to run phase one and two trials at the same time.
• The studies on COVID-19 included a larger number of people than other recent vaccine trials, meaning there were a larger number of people in the trials over a shorter period of time.

The federal government allowed manufacturing of the most promising vaccines to begin while the studies were ongoing. That means that when it was authorized it could be offered to the public almost immediately.

In addition, any side effects were studied very carefully during the clinical trials. No serious side effects were identified in the thousands of people who were enrolled. The COVID-19 vaccine is safe and effective and will protect your child against the virus.

How can I be sure that the COVID-19 vaccine does not change my child's DNA?

The COVID-19 vaccines do not change or interact with your or your child's DNA in any way. mRNA (Pfizer-BioNTech and Moderna) COVID-19 vaccines deliver instructions to our cells. However, the instructions never enter the nucleus of the cell, where DNA is located.

They tell our cells to start building protection against the virus that causes COVID-19. The vaccine itself breaks down and falls apart in the body right away.

Who should not get the Pfizer-BioNTech or Moderna COVID-19 vaccine?

According to the FDA, children should not get the Pfizer-BioNTech or Moderna COVID-19 vaccine if they:

• had a severe allergic reaction after a previous dose of the vaccine
• had a severe allergic reaction to any ingredient of the vaccine.

Is it possible for my child to have an allergic reaction?

There is a remote chance that the Pfizer-BioNTech COVID-19 or Moderna COVID-19 vaccine could cause an allergic reaction. People can have allergic reactions to any medication or biological product, including vaccines. Most allergic reactions occur shortly after a vaccine is administered, which is why the CDC recommends that people with a history of anaphylaxis or an immediate non-severe allergic reaction after a COVID vaccine within 4 hours of administration are observed for 30 minutes after vaccination, while all other people are observed for 15 minutes after vaccination. All vaccination sites must be equipped to ensure appropriate medical treatment is available in the event of an unlikely allergic reaction. The CDC recommends anyone with an allergy to "any component" of the vaccine not get the vaccine.

What are the signs of a severe allergic reaction to the Pfizer-BioNTech or Moderna COVID-19 vaccine?

The chance of a severe allergic reaction is remote. Severe allergic reactions usually occur within minutes after getting a dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine. Signs of a severe allergic reaction can include:

• Difficulty breathing
• Swelling of your face and throat
• A fast heartbeat
• A rash all over your body such as hives
• Dizziness and weakness

What are the risks of my child having myocarditis and pericarditis from the Pfizer-BioNTech COVID-19 vaccine?

The chance of having either occur is very low. Cases of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining outside the heart) have been reported both in adolescents and young adults who contracted the COVID-19 virus and in those receiving one of these two mRNA COVID-19 vaccines. These reports are rare, and the known and potential benefits of COVID-19 vaccination outweigh the known and potential risks, including the possible risk of myocarditis or pericarditis. The FDA advises that you tell the vaccination provider about your child's medical conditions, including if your child has had myocarditis or pericarditis in the past. You should seek medical attention right away if your child has any of the following symptoms after receiving the Pfizer-BioNTech or Moderna COVID-19 Vaccine:

• Chest pain
• Shortness of breath
• Feelings of having a fast-beating, fluttering, or pounding heart

My child has allergies. Can they be vaccinated?

If your child has an allergy to any ingredient in the Pfizer-BioNTech or Moderna vaccine, or to a previous dose of the Pfizer-BioNTech or Moderna vaccine, they should not receive this vaccine. Here are ingredients for the Pfizer-BioNTech vaccine. Here are the ingredients for the Moderna vaccine.

If your child has had an immediate allergic reaction of any severity to another vaccine or injectable therapy, it is a precaution to getting a COVID-19 vaccine. This does not mean that your child cannot get the Pfizer-BioNTech or Moderna vaccine. You should talk with your child's healthcare provider about the risks and benefits of your child getting the Pfizer-BioNTech or Moderna COVID-19 vaccine.

People with other allergies not related to a vaccine or other injectable therapy may get a COVID-19 vaccine. This includes allergies to food, pets, venom, environmental allergies, or allergies to medications taken by mouth. Children with these types of allergies may get the Pfizer-BioNTech COVID-19 vaccine. If you have any questions or concerns about the risks and benefits of the Pfizer-BioNTech COVID-19 vaccine for your child, you should speak with your child's healthcare provider.

Can COVID-19 vaccines affect puberty and/or the future fertility of my child?

No. There is no evidence that any vaccine, including COVID-19 vaccines, affect fertility. Additionally, the vaccine does not affect puberty. For more information, visit ny.gov/getthevaxfacts.

Parents, guardians, and community members should all be aware of good sources of information from trusted, credible organizations regarding the COVID-19 vaccine and children. New York State recommends the following links for those seeking more information, as well as resources that can help explain and guide conversations with their children.

Where can I find more information about the COVID-19 vaccines?

It is very important to know that the sources of COVID-19 vaccine information that you use are trusted sources of accurate information – so you can make informed decisions about your health and the health of your child.

In addition to this dedicated website for New York parents and guardians of children 5 – 11 years-old, visit New York State's #GetTheVaxFacts page for credible, accurate information New York parents and guardians can trust: ny.gov/getthevaxfacts.

The Centers for Disease Control and Prevention is one of these trusted sources. Information on COVID-19 vaccines can be found on this CDC webpage.

• Here's information on COVID-19 vaccines for children and teens.
• CDC's "Frequently Asked Questions about COVID-19 Vaccination" webpage is also very helpful.

The Children's Hospital of Philadelphia (CHOP) has a Vaccine Education Center. On this website you can find trusted information about COVID-19 and COVID-19 vaccines.

• The CHOP Vaccine Education Center also has a mobile app, "Vaccines on the Go: What You Should Know." It offers helpful information about vaccines, including COVID-19 vaccines.

The American Academy of Pediatrics (AAP) is another source of trusted information. Pediatricians provide information on AAP's COVID-19 webpage. They cover many topics related to COVID-19 and children. The following are some of the topics related to COVID-19 vaccines:

• "The Science Behind COVID-19 Vaccines: Parent FAQs"
• "Getting Your Child Ready for the COVID-19 Vaccine"
• "State report of pediatric cases, hospitalizations and deaths"
• The "healthychildren.org" website has a FAQ webpage about the COVID-19 vaccines. The answers are from the Academy of Pediatrics.

For general resources and information:

• KidsHealth's "Resources to Help Explain COVID-19 to Children"

For helpful videos that can help parents and guardians explain the COVID-19 vaccine to children:

• University of Michigan's "All About Coronavirus: A Video for Kids and Their Families"
• Unicef's "COVID-19 Vaccines Explained in 4 Levels of Difficulty"