Official Statement on COVID-19 Vaccine in Children Ages 5-11 Years

The National Association of Pediatric Nurse Practitioners (NAPNAP) applauds federal agencies for their extensive data review and emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine for all children ages 5-11 years. Making COVID-19 vaccines available to school-age children is a critical milestone in the pandemic and a strong step forward for public health in the U.S. and safeguarding our nation’s children. Vaccination optimization must be used in conjunction with other strategies, including universal masking, physical distancing and hand hygiene to reduce transmission risk and further protect our infants, toddlers and other vulnerable community members who cannot be immunized.

In preparing to immunize school-aged children, pediatric health care providers should become familiar with information specific to the vaccine for children ages 5-11 years.

  • Clinical trial data indicates that the authorized COVID-19 vaccine manufactured by Pfizer-BioNTech is 91% effective at preventing symptomatic infections in 5-11-year-olds.
  • The COVID-19 vaccine manufactured by Pfizer-BioNTech should be given to 5-11-year-olds in two 10-microgram (mcg) doses administered 21 days apart. The dosage is one-third of the adolescent and adult dose.
  • The vaccine vials for ages 5-11 years will have orange caps and borders to differentiate them from adolescent/adult vials.
  • The 30 mcg/dose Pfizer-BioNTech vaccine for adolescents/adults has not been studied in children under 12 years and therefore should not be used for this age group.
  • Similarly, the 10 mcg dose Pfizer-BioNTech vaccine for children has not been studied in children under 5 years and therefore should not be used for this age group.
  • Boosters are not currently recommended in children under 18 years of age.
  • There is a four day grace period meaning children are eligible for the vaccine four days prior to their fifth birthday.
  • Clinicians should monitor the CDC’s Clinical Considerations webpage for details.
  • Clinicians should report any concerns post-vaccination to the Vaccine Adverse Event Reporting System (VAERS) for ongoing safety monitoring.

NAPNAP’s community of experts in pediatrics and advocates for children are essential resources in addressing parent/caregiver concerns about disease transmission, vaccine safety and pediatric mental health. Dispelling misinformation with reliable information sources using clear and understandable language for families is critical. When educating families, pediatric health care providers should be clear that:

  • Vaccines are safe and effective in reducing transmission and severity of COVID disease.
  • Vaccines are free to all eligible individuals, regardless of insurance coverage, at all points of vaccine distribution.
  • Vaccination should be made widely available and administered to stop the spread of the virus for eligible people ages 5 and older.
  • COVID-19 vaccines may be safely co-administered with other vaccines (e.g. flu, other).
  • Being able to safely return to school and other activities with fewer restrictions improves children and adolescent’s mental health.
  • Parents are encouraged to enroll the children in the V-safe After Vaccination Health Checker program for ongoing safety monitoring.

NAPNAP calls on federal, state and local agencies and the manufacturer to work together with vaccination sites, including primary care offices, schools, health centers, pharmacies, pop-up vaccination sites and mobile units, to provide comprehensive, equitable vaccine delivery to every eligible child in the U.S. as quickly as possible.

Nov. 2, 2021

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