Vaccine side effects, such as headaches, fevers and chills, are a sign our immune system is building protection against the virus we are being vaccinated against.

When we receive an mRNA vaccine (Moderna or Pfizer), the vaccine tells our cells to build copies of the spike protein found on the surface of the virus that causes COVID-19. It’s impossible for these spike protein copies to infect us with COVID-19. But our body sees a protein it doesn’t recognize and launches an immune response to build antibodies. Even if those antibodies do not prevent infection, they, along with memory –B and –T cells, can respond immediately and reduce the length and severity of illness. People who are not vaccinated were 17 times more likely to die from COVID-19 in March than those who received a primary vaccine series plus a booster dose.

Severe adverse events from vaccination are rare.

Anaphylaxis is a severe allergic reaction that may occur within minutes after receiving any vaccination. For COVID-19 vaccinations, it has occurred at a rate of about five cases per 1 million vaccinations.

Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of the heart. These reactions are rare and happen most often in teenagers or young adult males, usually within one week of receiving an mRNA COVID-19 vaccination (Pfizer or Moderna). CDC data show myocarditis occurs less often after a booster dose than the second dose in a primary vaccine series. Symptoms include chest pain, shortness of breath and a fast-beating, fluttering or pounding heart. Most patients respond well to treatment of their symptoms and feel better within a few days.

This week, the U.S. Food and Drug Administration amended the Emergency Use Authorization for the Pfizer-BioNTech COVID-19 vaccine, authorizing a single booster dose for children 5 through 11 years old, whose last dose was at least five months prior. The Center for Disease Control and Prevention’s Committee on Immunization Practices forwarded a recommendation to the CDC director, which was approved, and the Western States Scientific Safety Review Workgroup reviewed the recommendation, Thursday evening.

The decision goes into effect today, May 20, and states:

• Children ages 5 through 11 who are not immunocompromised should get a booster dose at least five months after receiving the second dose in their primary vaccine series.
• Children ages 5 through 11 who are immunocompromised (and who have received a third primary series dose) should get a booster dose at least three months after receiving the third dose in their primary vaccine series.

Oregon Health Authority (OHA) estimates that there are more than 337,000 Oregon children ages 5 through 11. As of Thursday, 36.5% of children in this group had completed their vaccination series.

“Boosters are especially likely to benefit children who are at high risk for severe disease,” said Paul Cieslak, medical director for communicable diseases and immunizations at OHA. “Boosters may also prevent children from spreading the virus to loved ones who are at high risk.”

Since the start of the pandemic, 15,000 children ages 5 through 11 have been hospitalized with COVID-19 in the U.S., and more than 180 have died. Booster doses restore the immune system and extend protection from COVID-19 infection and severe illness.

“With over 18 million doses administered in this age group, we know that these vaccines are safe, and we must continue to increase the number of children who are protected,” said CDC Director Dr. Rochelle P. Walensky.  

Changes to second booster guidelines

The CDC this week also strengthened its guidelines for getting a second COVID-19 booster dose.

• People age 12 and up who are moderately to severely immunocompromised should receive a second booster dose at least four months after their first booster dose.
• Adults age 50 and up should receive a second booster dose at least four months after their first booster dose.
• When the CDC initially approved a second booster dose for the above groups, the agency said people “may” choose to get a second booster dose. Now the agency says people in the above groups “should” get a second booster dose. The agency cited rising case numbers and a substantial increase in COVID-19-related hospitalizations for older Americans in this change.

COVID-19 vaccines and boosters are safe and effective for children

The effectiveness of the two-dose series in preventing infection by the Omicron variant wanes over a few months. Boosters were shown to increase antibodies against Omicron in children 5–11 years of age to 36 times the level they had after the second dose.

“Most important, though, is to get that primary series into kids who haven’t had it yet,” said Cieslak.

Vaccination is the best way to protect children from severe illness and the long-term effects of COVID-19 that are still not fully understood.

You can find a vaccine provider by visiting Get Vaccinated Oregon, the CDC’s Vaccines.gov site or by visiting your local pharmacy. You can also call 211, text ORCOVID to 898211 or email ORCOVID@211info.org.

If you have any questions about COVID-19 vaccines or boosters for children ages 5 through 11, please submit them here. We are unable to answer every question we receive, but we try to answer those that could inform a wide audience. Additionally, the FDA is expected to meet next month to review requests from Moderna and Pfizer to authorize their COVID-19 vaccines for children as young as 6 months old. Feel free to submit questions about that as well.

Contact your child’s pediatrician to discuss a booster dose, or go to a local pharmacy. People wanting booster doses for their 5-11-year-olds can also come to the Malheur County Health Department, 1108 SW 4th St., Ontario, Ore., any Wednesday between 9 a.m. and noon, and 1 p.m. to 4:30 p.m., and walk-in to the vaccination clinic.