Information for parents and carers of children aged 6 months to four years at higher risk of COVID-19

About COVID-19

COVID-19 is a respiratory infection caused by a coronavirus, known as SARS-CoV-2. It’s highly infectious and spreads through the air when people cough or sneeze, or when people touch surfaces where it has landed, then touch their eyes, nose or mouth.

COVID-19 and children

Although most children who get COVID-19 have a mild illness, some children can become very unwell. Children with certain conditions are at higher risk of serious illness from COVID-19, which may lead them to being very poorly and having to go to hospital.

The COVID-19 vaccine is recommended for children aged 6 months to 4 years who are at higher risk of serious illness from COVID-19. To be invited for vaccination this spring/summer, your child must have turned 6 months old by 1 April 2023. Your child may have been identified for vaccination when they were aged 4, but may turn 5 years old before they receive their vaccine.

Why your child is being offered the COVID-19 vaccine

The vaccine helps to build up immunity to COVID-19, so the body can fight it off more easily.

If your child is vaccinated, they are much less likely to get seriously ill from COVID-19 or need to go to hospital.

Getting the vaccine will help to protect your child against COVID-19. Infants and young children with underlying health conditions are seven times more likely to be admitted to paediatric intensive care units with severe COVID-19 compared to those without underlying health conditions.

Some children are at higher risk from COVID-19, including those living with certain conditions such as:

a neurodisability or neuromuscular condition such as cerebral palsy
severe or profound learning disability
Down's syndrome
serious genetic conditions
serious heart conditions
lowered immunity due to disease or treatment
endocrine disorders
asplenia or dysfunction of the spleen

The vaccine will help to protect your child from getting seriously ill or having complications from COVID-19.

Amount of doses your child will be offered

As with other vaccines, the COVID-19 vaccine is given more than once to boost your child's immunity and to provide longer-term protection.

Your child will be offered two infant doses of the COVID-19 vaccine. The second dose will be offered at least 8 weeks after the first.

If your child has already had COVID-19

Even if your child has already had COVID-19, they could still get it again. If your child is vaccinated, and they get COVID-19 again, the vaccine will reduce the risk of your child getting seriously ill with COVID-19 and having to go to hospital.

COVID-19 vaccine safety

All medicines (including vaccines) are tested for safety and effectiveness before they are allowed to be used. Once they are in use, the safety of vaccines continues to be carefully monitored.

Over 1 million COVID-19 vaccine doses have been given to children aged 6 months to 5 years in the United States of America since June 2022, with no new or unexpected concerns.*

Please visit the Patient Information Leaflet for more information on the vaccine, including ingredients and side effects

*There is limited data from clinical trials regarding vaccine efficacy against severe COVID-19 in persons aged 6 months to 4 years due to the relative infrequency of severe COVID-19 in this age group. In combined analyses from clinical trials performed by Pfizer-BioNTech, the preliminary, descriptive vaccine efficacy against COVID-19 was 73.2% (95% CI: 43.8% to 87.6%) after dose 3 in persons aged 6 months to 4 years, at a time when Omicron variants were the dominant circulating strains. Further trial data continues to accrue.

Preparing your child for vaccination

On the day of the vaccine:

Make sure your child wears practical clothing that's easy to get off and on
It might be useful to take your child's favourite toy or blanket with you
If you feel anxious yourself, or if you have a fear of needles, try to stay calm and show your child there's nothing to fear
Let the person giving the vaccine know if you or your child feel nervous. They'll be very understanding and can provide support

It's important to let the vaccinator know if your child is receiving any medicines, treatment or therapy at a hospital or specialist clinic. If you have questions about the timing of your child's vaccine, speak to their health professional or specialist.

On the day of your child's appointment

At the appointment, the vaccinator will check parent/carer consent. They’ll give you information and explain anything that you’re unsure about or do not understand.

The COVID-19 vaccine is given as an injection in the upper arm or thigh. The needles used are small and your child should only feel a tiny pinprick.

Getting other vaccines on the same day as the COVID-19 vaccine

Children can safely get other vaccines on the same day they get their COVID-19 vaccine. Routine immunisations give your child the best possible protection from serious diseases and should not be delayed.

If your child is ill on the day of the COVID-19 vaccine

Your child can still have the COVID-19 vaccine if they have a minor illness as long as they do not have a fever. If your child feels very unwell, their COVID-19 vaccine appointment may be postponed until they have fully recovered. You should not attend an appointment if you or your child have a fever or think you might be infectious to others.

If your child is unable to leave your home, or if they need additional support at their appointment, call 111 to discuss your requirements.

Common side effects

It's normal for your child to experience side effects after a vaccine. It shows the vaccine is teaching their body's immune system how to protect itself from COVID-19. Side effects are usually mild, only last a day or two and should not last longer than a week.

Your child might:

get a little redness, swelling or tenderness where the injection was given. This tends to be worst around 1 to 2 days after the vaccine
appear to feel more tired
have general aches or mild flu-like symptoms
have a fever or be a bit irritable

If your child's side effects seem to get worse, or if you're concerned, contact your GP or health care professional, make sure you tell them about your child's vaccine so they can assess you properly.

Rare side effects

An uncommon side effect is swollen glands in the armpit or neck on the same side as the arm where your child had the vaccine. This can last for around 10 days, but if it lasts longer see your doctor.

Cases of inflammation of the heart (called myocarditis or pericarditis) have been reported rarely after the COVID-19 vaccines. Among children, the risk of myocarditis following vaccination decreases with decreasing age. No myocarditis events were reported to the US Vaccine Adverse Event Reporting System after vaccination of over 1 million children aged 6 months to 5 years (as of 21 August 2022).

You should seek medical advice urgently if your child experiences any of the following side effects after vaccination:

symptoms of severe allergic reaction such as difficult breathing, wheezing or reduced level of consciousness
shortness of breath or chest pain
feelings of having a fast-beating, fluttering or pounding heart

Fever after the COVID-19 vaccine

It's quite common to develop a fever (temperature above 37.8ºC) after a vaccination, but developing a fever is more common after the second dose of the COVID-19 vaccine. The fever is a normal response to the vaccine.

Fevers are usually mild, so you only need to give a dose of infant paracetamol if your child is not comfortable or is unwell. Read the instructions on the product packaging and patient information leaflet very carefully and never give medicines that contain aspirin to children under 16 years of age.

If your child's fever starts more than 48 hours after the vaccine, lasts longer than 48 hours, or is above 39ºC, your child may have another infection and you should seek medical advice. Call your GP.

If you think your child may be seriously ill, trust your instincts and seek urgent medical advice.

Reporting side effects

Millions of people have had a COVID-19 vaccine and the safety of the vaccines continues to be carefully monitored.

You can report suspected side effects of vaccines and medicines through the Yellow Card Scheme online, or by using the Yellow Card app, or by calling 0800 731 6789.

For more general information about the COVID-19 vaccine, visit
gov.im/vaccinations