Coronavirus vaccination for children between six months and four years of age.
The experts of the Standing Commission on Vaccination (STIKO) recommend vaccinating young children (6 months to 4 years) at increased risk of severe covid 19. The risk exists especially if the children are chronically ill and have a weak immune system.
Exactly how the basic immunization (= building up of immune protection) of children between six months and four years takes place depends on the vaccine used:
- Comirnaty vaccine (preferred recommended): Infants receive three vaccination doses. The first is given at six months of age at the earliest, the second three weeks after the first, and the third after another eight weeks.
- Spikevax vaccine: Here, two shots are given at least four weeks apart.
The Standing Committee on Vaccination (STIKO) recommends that all children aged at least five years receive a Covid vaccination. However, the vaccination process is not the same for everyone. How children between the ages of five and eleven should be vaccinated depends on certain risk factors:
- Accordingly, children with pre-existing conditions receive two doses of vaccine.
- This also applies to children with people at particular risk in their closest environment and in the case of individual wishes of the child and his or her legal guardian.
If children receive two vaccinations, there are three to six weeks between them for the Comirnaty vaccine and four to six for Spikevax.
Coronavirus vaccination for children 12 and older.
Children and adolescents who are at least twelve years old are also advised by vaccination experts to receive a vaccination against Covid-19. According to the recommendation, they should always receive two vaccinations to build up immune protection (basic immunization).
The Spikevax vaccine would also be approved in this age group (vaccination interval four weeks). However, due to possible, albeit rare, side effects such as myocarditis, vaccination experts do not recommend the vaccine for this age group.
When is vaccination particularly important for children and adolescents?
Pre-existing conditions that increase the risk for severe disease progression of Covid-19 include:
- severe overweight (obesity)
- Premature babies younger than two years of age
- severe heart disease and heart defects
- Congenital or acquired immune deficiency or therapies that suppress the immune system (immunosuppression)
- severe diseases of the nervous system
- chronic lung disease with impaired lung function; including severe or inadequately treated asthma
- chronic kidney weakness
- poorly controlled diabetes
- trisomy 21 and other rare diseases
- cancers
In addition, vaccination experts especially advise vaccination when children have close contact with people who cannot be vaccinated themselves or who are unlikely to build up adequate vaccine protection.
Do children and adolescents need a booster vaccination?
The Standing Committee on Vaccination recommends that the following children receive a first booster vaccination (third vaccine dose in total):
- children between five and eleven years of age, if they have been previously vaccinated
- all children and adolescents 12 years and older
The decisive factor here is whether the children became infected with the coronavirus after basic immunization and possibly contracted Covid-19. This counts as a so-called “immunological event” and also refreshes an immune protection. Booster vaccination is then not necessary.
Further booster vaccination
For the remaining children, six months are recommended, although in individual cases vaccination can be repeated after four months. It is best to talk to the pediatrician treating you about whether and when a booster vaccination makes sense.
Booster vaccination is not currently scheduled for children under five years of age.
Which coronavirus vaccine do children and adolescents receive?
- Children from six months to eleven years: Comirnaty by BioNTech/Pfizer and Spikevax by Moderna.
- Children and adolescents 12 years and older: Comirnaty from BioNTech/Pfizer and Nuvaxovid from Novavax. Spikevax is also approved for this age group, but vaccination with it is not recommended by STIKO (due to side effects such as heart muscle inflammation).
Booster vaccine for children
Vaccination experts recommend boosting vaccine protection in children and adolescents 12 years of age and older with the adapted Comirnaty vaccines. In addition to the blueprint of the first Sars-CoV-2 spike protein (wild type), these also contain that of the omicron variants BA.1 and BA.4/5, respectively.
Children at risk between five and eleven years of age, on the other hand, should receive another dose of the Comirnaty original vaccine alone. Spikevax is also available for boosters after three months in immunocompromised children six years and older.
What dose of vaccine do children receive?
Younger children do not receive the same amount of vaccine as adolescents and adults. The exact dosage for the basic first vaccinations depends on the vaccine and age:
Children five years and older receive ten micrograms of vaccine dose with Comirnaty and 50 micrograms with Spikevax. This applies to both single (healthy children without risk) and double vaccination (children at risk).
Children and adolescents 12 years and older receive the same vaccine dose as adults.
The respective doses have been tested in studies in children and adolescents to ensure that the vaccination works and is safe at the same time.
Doctors inject the Covid 19 vaccine into a muscle (intramuscularly) like most other vaccines. Babies usually get the vaccine in a thigh muscle (vastus lateralis muscle). Older children and adolescents prefer to be vaccinated in the deltoid muscle of the upper arm.
Children with impaired blood clotting are best to press on the injection site for a few minutes. Inform the vaccinator in advance if your child has a bleeding tendency.
What are the vaccination reactions and side effects in children and adolescents?
Vaccination deliberately sets the immune system in motion. In many cases, the vaccinated children and adolescents feel this in the days after the vaccination. Experts speak of so-called vaccination reactions. They mainly affect the injection site and are manifested by:
- pain, especially when the injection site is pressed on
- Redness @
- swelling
- Fever
- Fatigue, tiredness
- Loss of appetite
- Irritability, increased crying (in infants)
- Headache and aching limbs
- Nausea, vomiting and diarrhea
Usually, such vaccine reactions subside after a few days. If the symptoms persist longer or you are unsure, it is best to talk to your pediatrician.
Side effects and risks
Vaccinated persons should take it easy and avoid physical exertion in the days following vaccination. If symptoms such as heart palpitations, chest pain and/or shortness of breath occur, seek medical help immediately.
Children and adolescents may also have an allergic reaction to the vaccination. The reaction usually occurs immediately after vaccination. In very rare cases, the allergic reaction assumes life-threatening proportions (anaphylactic shock). Known allergic persons (to other substances) should therefore be observed for at least half an hour after vaccination in order to be able to act quickly if necessary.
No 100 percent safety
Regulatory and vaccination authorities therefore continuously record and review reported adverse events and adjust their recommendations as appropriate.
Decision between vaccination and infection
Therefore, adolescents and their parents should choose independently in consultation with their doctor. The decision cannot be handed over. The wishes of the young vaccinees should also play a decisive role.
However, by all accounts, not only Sars-CoV-2 infection but also vaccination itself is associated with a very low risk for children and adolescents.
