Michigan Association of Health Plans

10 things to know about the bivalent COVID booster for kids under 5

This story appeared in University of Michigan Medicine’s Health Blog. Read the rest here.  

With the bivalent COVID booster recently authorized for children as young as six months, the updated coronavirus vaccine is now available to almost all age groups.

But as parents make decisions about vaccinating their child, some questions may be unclear: Which children are eligible? Should kids get the shot if they already had COVID? What are the side effects? Can you choose between vaccines?

Debra Langlois, M.D., a pediatrician at University of Michigan Health C.S. Mott Children’s Hospital and mother of two, helps answer these questions and more – and explains why she is choosing to get her own four-year-old daughter the bivalent booster.

1. Bivalent booster shots are the best protection against the predominant COVID-19 strain

These booster shots target both the original COVID-19 strain as well as subvariants of the omicron variant – which is the predominant circulating COVID-19 strain – providing the strongest protection to young children against what they’re most likely to be exposed to this season.

“These vaccines have been well studied, proven to be safe and effective and are responding to the current trends in COVID,” Langlois said. “The technology is there to provide us, and now almost all children, better protection against the predominant circulating Omicron variant strain.”

2. Eligibility depends on how many vaccinations a child has already had, and which kind

The COVID-19 vaccine only became available to young children in June, with Moderna offering a two-dose series for ages six months to six years and Pfizer offering a three-dose series for kids six months to under age five.

The United States Food and Drug Administration decided that children under age six who’ve already gotten two original doses of Moderna’s vaccine can get a single booster of Moderna’s bivalent vaccine if it’s been at least two months since their last shot.

Kids under age five who have started but not finished Pfizer’s vaccination series will get Pfizer’s original doses for the first two shots and Pfizer’s bivalent version for their third shot. However, those who have completed Pfizer’s three doses currently aren’t eligible for the bivalent booster. This may change after further reviews, Langlois says.

“The thought is that these children may already have some protection because when Pfizer was doing efficacy studies for their third dose, we were seeing Omicron as the predominant strain,” Langlois said, noting that data to support giving an updated bivalent booster dose for these children is expected in early 2023.

All COVID-19 series doses should be from the same manufacturer in this age group, and the bivalent booster is now the only option available as the third shot.

3. Side effects are minor and temporary

No safety concerns have come up in either trial and reported side effects are comparable to routine vaccines, including potential swelling or redness or pain at the injection site, temporary elevated temperature, fatigue, or irritability for a day or two for younger kids. Some kids have no side effects.

Ibuprofen or acetaminophen can reduce pain, fever and discomfort, Langlois says.

  back to blog