COVID-19 vaccination for children with a high risk of severe COVID-19

Most children who have a SARS-CoV-2 infection do not develop severe symptoms if they become ill. That is why the COVID-19 vaccination is not offered to all children. Is your child being treated by a paediatrician, and in a medical risk group with a higher risk of severe illness from a SARS-CoV-2 infection? Then it is important for your child to get the COVID-19 vaccination to prevent severe illness and hospital admission.

Children who have had the COVID-19 vaccination can still get a SARS-CoV-2 infection. However, after vaccination, it is much less likely that your child will become seriously ill or end up in hospital due to COVID-19.

How long does the COVID-19 vaccination keep working?

Vaccination probably offers 6 to 12 months of protection against severe illness due to COVID-19. That may vary from one person to another, for example if a child is using medication that suppresses their immune system. A person may also be less resistant to infection if the virus has changed.

Most common side effects

In children aged 6 months to 4 years:

• Pain at the injection site
• Drowsiness
• Irritability
• Fever
• Reddened skin at the injection site
• Decreased appetite

In children and adolescents aged 5 to 17 years:

• Pain at the injection site
• Tiredness
• Headache
• Muscle aches
• Fever
• Reddened skin at the injection site
• Cold chills

The side effects usually occur in the first two days after the vaccination. Most side effects are gone within 1-2 days. 

In very rare cases, myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the outer lining of the heart) may occur after vaccination. This very rare side-effect has been observed more often among young adult males (aged 16-24 years). No cases of myocarditis or pericarditis following vaccination have been reported among young children at this time.  

Children aged 6 months to 4 years who are at higher risk of a serious course of illness resulting from COVID-19 can get the COVID-19 vaccination. The COVID-19 vaccination is not required. 

Children who have a high risk of severe COVID-19 (and their parents or caregivers) will not receive an invitation letter. If relevant, the medical specialist will inform and advise them during their appointment to get the vaccination from the Municipal Public Health Services (GGDs).

Children under 5 years of age will receive an age-appropriate dose of the COVID-19 vaccine made by Pfizer/BioNTech.

How many vaccinations do children need?

Children under 5 years of age will usually have one COVID-19 vaccination (once a year). 

Sometimes one vaccine dose is not enough. For example, this applies if your child has probably never had COVID-19 before, and has never received a COVID-19 vaccination before. Or if your child’s immune system is compromised after a bone marrow transplant. 

The treating paediatrician will tell you if one vaccine dose is not sufficient. If that is the case, you will receive a referral letter with more information. Then your child will receive three COVID-19 vaccinations. The second vaccination can be given three to four weeks after the first vaccination. There must be at least eight weeks between the second and third vaccinations. 

Children and adolescents aged 5-17 years who are at higher risk of a serious course of illness resulting from COVID-19 can get the COVID-19 vaccination. The COVID-19 vaccination is not required. Children who have a high risk of severe COVID-19 (and their parents or caregivers) will not receive an invitation letter. If relevant, the medical specialist will inform and advise them during their appointment to get the vaccination from the Municipal Public Health Services (GGDs).
Other children in this age group do not need to get a COVID-19 vaccination. The variant of the coronavirus SARS-CoV-2 which is currently circulating is less likely to cause severe illness. In addition, almost all children have built up some immunity due to a previous SARS-CoV-2 infection or a COVID-19 vaccination.

COVID-19 vaccination for children aged 5 years and older

Children will receive an age-appropriate dose of the COVID-19 vaccine made by Pfizer/BioNTech. Children aged 5 to 11 years receive a dose of 10 mcg. Children aged 12 and older receive a 30 mcg dose of the Pfizer vaccine.

Children in medical high-risk groups aged 5–11 years will usually have one COVID-19 vaccination (once a year). The treating paediatrician will tell you if one vaccine dose is not sufficient. If that is the case, you will be notified in the referral letter for vaccination by the Municipal Public Health Services (GGDs). 

Who will give the vaccination?
The COVID-19 vaccinations are administered by the Municipal Public Health Services (GGDs). 

My child has a fever. Can my child still get the COVID-19 vaccination?
If the fever is higher than 38.5 C, wait to get the vaccination until your child is feeling better.

My child has also received a notice or already scheduled an appointment for another vaccination at the well-baby clinic (through the National Immunisation Programme). What should I do with the invitation for the COVID-19 vaccination?
There does not need to be any interval between the vaccinations. You can keep the appointment for the other vaccinations as well as the appointment for the COVID-19 vaccinations. 

My child is not in a medical high-risk group. Can my child still get the COVID-19 vaccination?
Most children do not need a COVID-19 vaccination at this point, because they will not become very ill if they get COVID-19. If you would like your child to be vaccinated against COVID-19 anyway, for example because a family member is in vulnerable health, that is a possibility. To discuss your options, contact the Municipal Public Health Services (GGDs) on telephone number: 0800-7040.

My child has already had one COVID-19 vaccination, but is not in a medical risk group. Is it necessary for my child to get a COVID-19 vaccination now?
If the fever is higher than 38.5 C, wait to get the vaccination until your child is feeling better. No, your child does not need a COVID-19 vaccination at this time.

My child has also received a notice or already scheduled an appointment for another vaccination, such as the immunisations for HPV or for DTaP and MMR. Can I also schedule an appointment for my child to get the COVID-19 vaccination?
Yes. Your child can get the COVID-19 vaccination on the same day as the other vaccinations. There does not need to be any specific interval between the vaccinations. Please note: the COVID-19 vaccination is administered by the Municipal Public Health Services (GGDs), not at the well-baby clinic.