Children and COVID vaccination

By Dr. William Li
Published Monday, December 13, 2021

By now you are probably well aware that there are vaccines available for COVID-19. These products have been tested rigorously and are safe and effective to protect against COVID-19. Currently there is one COVID-19 vaccine (Pfizer-BioNTech) approved for use in ages 5-11 and two products (Pfizer-BioNTech and Moderna) approved for 12 years and older.

The vaccines are available at many locations including physician offices, local pharmacies, and at provincial and regional vaccine clinics. Your child's school may also be hosting a COVID-19 vaccine clinic. Pick the location that will work the best for your child and your family's needs. For example, consider whether your child needs a smaller, more intimate setting or whether they would prefer to have their parent(s) beside them during their immunization. You can find out where to get the vaccine through this handy website the province created.

You may be worried about side effects. The good news is that the majority of kids have none or mild side effects. Most commonly, children may experience a sore arm, and they may have swelling or redness around the vaccine site usually lasting for a couple days. Headache, fever, feeling tired or muscle pain are also common for the first couple of days, although less common in younger children. Serious side effects are rare in children. For more information see the province's factsheets:

• COVID-19 mRNA Vaccine for Children 5 to 11 years old
• COVID-19 mRNA Vaccines for Individuals Aged 12 Years and Older

Your child may have some fears about getting the vaccine. This is really common! Approximately two in every three children experience needle fear. Fortunately, there are many strategies to help! Firstly, speak to your child before their appointment and let them know they are getting a vaccine. Preparing your child is important, but depending on your child, it may be better to let them know on the day of rather than several days before. Either way, it should never be a surprise. Talk to your child about what they can expect. Be honest, answer any questions they may have, and help them to not focus on their worries or fears. For example, if your child tells you that they are scared, you can say "That's normal. Most kids are scared, but we're going to do some things to help you." It may help your child to compare what the needle will feel like with something they are familiar with. I often tell my patients that it feels like a mosquito bite.

On the day of the appointment, you can bring something your child finds comfort in like a favourite stuffed animal or a video to watch. There may be some waiting time before it is your child's turn and they will need to stay at least 15 minutes after they have received their vaccine. It is a good idea to bring something for your child to do while waiting. Some children may benefit from putting a numbing cream on their arm. This does not take away the pain completely, rather it dulls the sensation of the needle. If this is something of interest to you, I encourage you to speak to your doctor about whether this would be the right option for your child. Some of these creams are available over-the-counter at your local pharmacy while others require a prescription. Your child can also use an icepack to help numb their arm by placing it on and off their arm for a few minutes before their vaccine.

During the vaccine, try to have your child keep their arm loose as much as possible and have them focus on something other than the needle like a distraction toy, a book, or having a conversation with them. Make note of which strategies worked best so you can use them again for your child's second dose. A helpful video on some of these pain prevention strategies can be found below. Immunize Canada also has great resources for parents at immunize.ca/card-parents.

Do not forget to get your flu vaccine and other routine vaccines as well! All children six months of age and older can receive the flu vaccine. Children 12 years and older can get the flu vaccine and routine vaccines at the same time as their COVID-19 vaccine; while 5-11 years old are generally recommended to wait two weeks before or after their COVID-19 immunization to get any other vaccine. If you have any questions about timing of vaccines, talk to your child's doctor.

Dr. William Li (MD, FRCPC) is a community pediatrician practicing at Manitoba Clinic.