The Centers for Disease Control and Prevention (CDC) recently updated its COVID-19 vaccine guidance for children. Instead of a universal recommendation, the agency now advises a “shared clinical decision-making” approach, leaving the choice up to families and their healthcare providers. This shift follows an announcement from health officials that COVID vaccines would no longer be routinely recommended for healthy children.
So, what does this mean for your child’s health? A pediatric infectious disease specialist offers some clarity on the issue.
Are Children Still Getting Sick from COVID-19?
Yes, children continue to be affected by COVID-19, especially those between 6 months and 5 years old. Antibodies transferred from the mother during pregnancy tend to fade around six months of age, leaving young children more vulnerable to infection. Vaccination for this age group was previously recommended starting at six months for this reason.
Currently, vaccination rates in children remain low, which means many remain as susceptible to COVID as they were in the early stages of the pandemic. The number of children under five dying from COVID remains roughly the same as before vaccines were available, largely because many remain unvaccinated. Although the pandemic phase has passed, the virus continues to circulate and will likely remain a concern for many years to come.
Are Healthy Kids Safe from COVID-19?
Not necessarily. While severe COVID illness is less common in children than adults, healthy kids can still become seriously ill or even die from the virus. In the past year, approximately 150 children have died from COVID, and 40% of those had no underlying health conditions. Data also shows that among hospitalized children eligible for vaccination, 95% had not received the most recent COVID shot.
Are Yearly Boosters Necessary for Children?
Whether your child needs yearly boosters is a decision to make with your pediatrician. The primary goal of the vaccine is to prevent hospitalization, intensive care, and death. For children with risk factors such as obesity, asthma, or heart conditions, doctors may recommend annual boosters.
For healthy children without these risk factors, the benefits of boosters are more modest. A booster shot may provide four to six months of protection against mild to moderate infection. This means your child might experience symptoms and need to stay home from school but would likely avoid severe illness or hospitalization.
What About Side Effects?
The COVID vaccines, especially mRNA vaccines, are generally very safe. Common side effects include headache, fever, and fatigue, which are usually mild and short-lived.
One rare side effect that has received much attention is myocarditis, or inflammation of the heart muscle. This tends to occur in 16- to 29-year-old males, most often after the second dose, but it is very rare happening in about 1 to 4 per 100,000 people. Most cases resolve on their own without lasting problems. Importantly, myocarditis caused by COVID infection itself is more common and more dangerous than vaccine-related myocarditis.
Can Kids Get Long COVID, and Does Vaccination Help?
Children can develop long COVID, a condition where symptoms persist for three months or more after infection. In infants and toddlers, about 14% who get infected experience long COVID, showing symptoms like trouble sleeping, fussiness, poor appetite, congestion, and coughing. Preschoolers can also be affected, with symptoms such as dry cough, daytime sleepiness, and low energy. Older children are susceptible as well.
Vaccination reduces the risk of long COVID in children by about 42%, making it an important preventive tool.
Will Insurance Cover COVID Vaccines for Kids?
Yes, despite the change in recommendations, health insurers will still cover COVID vaccines for children. The CDC’s “shared clinical decision-making” approach ensures that families can access the vaccine without financial barriers.
Bottom Line
The decision about COVID vaccination for children can feel complicated, but the expert advice is clear: vaccinating your child against COVID is a wise and straightforward choice. The vaccine protects children from severe illness, hospitalization, death, and long COVID. After completing the initial vaccine series, consult with your pediatrician about whether boosters are appropriate for your child’s individual health needs.
