The American Academy of Pediatrics (AAP) released its annual update to childhood vaccine recommendations, ahead of respiratory virus season and kids going back to school. The AAP has created guidance on vaccination for decades, and in previous years, it partnered with the Centers for Disease Control and Prevention (CDC) to share a unified list of vaccine recommendations. But this year’s schedule differs from the CDC, including the guidance on the COVID vaccine for children.

“The main difference in the AAP guidance for COVID is that it explicitly recommends the vaccine for all children at high risk of serious illness, and that includes ages 6 months to 23 months,” says Dr. Irene Frantzis, a pediatric infectious diseases doctor at NewYork-Presbyterian Morgan Stanley Children’s Hospital of Children’s Hospital of New York.

The AAP’s latest recommendations are also coinciding with an uptick of COVID infections in the U.S., prompting many parents to have questions about vaccine protection. “It is important for parents to remember that COVID is here to stay, and it can cause really severe symptoms,” says Dr. Frantzis. “The COVID vaccine is a safe and effective way to prevent your child from getting sick and needing hospital care.”

To learn more about new COVID vaccine guidance, side effects and the increase in cases, Health Matters spoke to Dr. Frantzis.

What is the current recommendation for COVID vaccinations for children?

The AAP guidance focuses on vaccinating children at high risk of severe COVID. This includes:

• Young children under the age of 2.
• Children who are immunocompromised, have heart or lung conditions, diabetes, sickle cell disease, obesity, or other specific risk factors.
• Children who are living in long-term care facilities or with people who might be at high risk of COVID.
• Children who have never received a COVID vaccine.

For kids who are not in these groups, the AAP recommends the vaccine be available for any parent who wants their child protected.

There are nuances on the number of doses, but talking to the primary care pediatrician is a great way to make sure your child gets the right vaccine dose.

How is this different from the CDC guidance?

While the CDC guidance also emphasizes that COVID vaccines help keep children safe, and recommends vaccination for high-risk groups, it does not include children under 2 years old as high risk. The CDC is now advising parents to have a conversation with a provider before deciding to vaccinate.

How effective is the COVID vaccine at protecting children?

If your child already had their first two initial doses, they should have good immunity with one annual booster dose (similar to an annual flu shot).

This year’s vaccine, like the previous ones, will reduce your child’s susceptibility to COVID and prevent emergency room visits, hospitalizations in children, and post-COVID conditions like long COVID. It is an updated, seasonal vaccine, so it encompasses the strain of the virus that is now circulating (called LP 8.1) and causing an increase in infections.

If my child had COVID, do they need to be vaccinated?

A previous infection may not protect your child from getting COVID, because the virus is unpredictable and has mutated to make it more transmissible. That’s why an annual vaccine is recommended.

What do we know about the COVID vaccine side effects, specifically for kids?

Many children will not experience any side effects, and if they do occur, it’s usually the day after vaccination, especially if they receive two doses. Side effects may include:

• Tenderness, swelling, or redness around the vaccination area
• Feeling tired, sleepy, and fussy
• Having a low appetite
• Mild fever

Symptoms usually last one to two days and can be managed with over-the-counter pain relief such as acetaminophen or a warm compress. In rare cases, adolescents and young adults may experience a condition called myocarditis which is an inflammation in the heart that can happen after the COVID vaccine or a COVID infection.

Can my child be vaccinated for COVID and the flu at the same time?

Yes, children can receive the COVID and flu vaccines at the same time, as well as with other routine vaccines.

Where can I get my child the COVID vaccine?

Your primary care pediatrician is the best place to get vaccinated. Pediatricians are committed to providing the COVID vaccine and working to make sure they have an adequate supply.

When is the best time of year to get vaccinated for COVID?

Unlike the flu, COVID comes in waves throughout the year, so there’s no specific COVID season. However, COVID has become more and more a part of our typical winter viruses and will be ingrained in our community going forward. Vaccines and basic hygiene like washing hands are the best ways to protect your children.