This page contains frequently asked questions about COVID-19 vaccination for children aged 6 months to 4 years with serious medical conditions who are at higher risk of becoming seriously ill after a SARS-CoV-2 infection.  It also provides links to the advisory reports of the Health Council of the Netherlands (in Dutch) and decisions by the Ministry of Health, Welfare and Sport (VWS) (in Dutch) regarding vaccination of children aged 6 months to 5 years, including children in medical high-risk groups.

FAQ about vaccination of children aged 6 months to 4 years

Children aged 6 months to 4 years with serious medical conditions who are at higher risk of a serious course of illness resulting from COVID-19 will receive an invitation letter from their treating paediatrician, starting from 12 January 2023. This may include children who have serious heart or lung problems or severely impaired immunity. 

Children will receive an age-appropriate dose of the COVID-19 vaccine made by Pfizer/BioNTech. This vaccine dose is made specifically for children and approved by the European Medicines Agency (EMA). Children aged 6 months to 4 years receive a lower amount of the active substance (3 micrograms) than children aged 5 years and older. 

This lower dose is sufficient to produce an effective immune response in young children. However, these children will receive 3 injections to complete the basic series (rather than the 2 injections in the basic series for older children and adults). Even if young children are larger or smaller than other children the same age, this child dose of the vaccine is suitable to produce an effective immune response.

The package leaflet for the vaccine lists the following side-effects that may occur in infants and young children:

  • Pain or swelling at the injection site
  • Drowsiness
  • Irritability
  • Fever
  • Decreased appetite

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. No cases of myocarditis or pericarditis following vaccination have been reported among young children at this time.  

At this time, it is unknown how long the vaccine will offer protection.

Children aged 5 years and under with serious medical conditions will be offered 3 vaccinations for effective protection against COVID-19.

The package leaflet for the vaccine states that the second vaccination should be given three to four weeks after the first vaccination. There must be at least eight weeks between the second and third vaccinations. 

The vaccinations will be administered at special locations provided by the Municipal Public Health Services (GGDs). 

The recommendation here is to wait 2 weeks between the COVID-19 vaccination and other vaccinations. Please keep that in mind when making an appointment for the COVID-19 vaccination.  

If the fever is below 38.5 C, your child can be vaccinated. This applies even if the fever was above 38.5 C the day before. If the fever is higher than 38.5 C, wait to get the vaccination until your child is feeling better. 

No, vaccination is a voluntary choice, but it is recommended for children between 6 months and 4 years old with serious medical conditions who are at higher risk for serious illness from COVID-19.