Frequently Asked Questions

Although severe illness due to acute COVID-19 infection is less frequent in children compared to adults, children can still be hospitalized and even require admission to an intensive care unit (ICU) due to COVID-19. Some children can also develop other complications from COVID-19 beyond the infection itself, including a condition called multisystem inflammatory syndrome (MIS-C). While highly treatable and rare, approximately one in three children hospitalized with MIS-C will require ICU care. Further studies will be needed to assess how well the vaccines protect against such complications from COVID-19.

Clinical trial data show that the Pfizer vaccine is well tolerated in children aged five to 11 years old, with side-effects generally comparable to side-effects your child may have experienced after other childhood vaccinations. These may include feeling tired, chills, muscle aches and pains and a sore or red arm. The majority of children had very mild side-effects or none at all. Typically these side-effects will go away after a few days and there are no long-term side-effects reported.

No. There is no way you can get COVID-19 from any of the vaccines. None of the vaccines contain the SARS-CoV-2 virus, which causes COVID-19.

Yes. There is no reason a child with a food allergy of any kind should not be vaccinated. Children with a history of allergy to foods, oral drugs, insect venom or environmental allergies can receive COVID-19 vaccines without any special precautions. If you are concerned about the possibility of an allergic reaction to any of the vaccine ingredients or a previous dose of the vaccine, please consult your child’s primary health-care provider.

Vaccination helps prevent severe disease and hospitalization due to COVID-19. Children and youth who previously had COVID-19 have some protection, but this protection will be much stronger if they're also vaccinated.

Another reason for vaccination combined with other public health measures is to get the virus under control. Omicron may be less severe, but its high transmissibility means many more will be affected. This puts our health and our health-care system at risk. The more resources we have to direct toward caring for patients with COVID-19, the more challenging it is to provide life-changing surgeries and procedures for patients who don't have COVID-19 who are also in need of care.

Natural immunity refers to the immune responses that are developed following exposure to an infection. When contracting an infection, most individuals will develop antibodies that are key to recognizing and fighting the same infection, if encountered again. 

Natural immunity can decrease with time, and the antibodies may not last in your immune system for a very long time. Developing natural immunity also implies that you need to contract the infection, meaning that you could experience very serious health complications as a result.

Immunity against COVID-19 can also be achieved by getting vaccinated. The difference, in this case, is that the vaccine instructs your immune system on how to develop the antibodies that protect against COVID-19 without having to contract the infection and get sick. Because additional vaccine doses are given to help build the immune responses, the antibodies continue to circulate in the body for a longer period than when contracting the infection a single time.

Work on coronavirus vaccines has been ongoing for more than 10 years, due in part to the SARS-CoV-1 outbreak in 2003. It was important to develop the COVID-19 vaccine quickly because of how many people were dying and getting sick, and because of the disruptions to everyday life as a result of the pandemic. Even though the vaccines were developed quickly, all the usual steps for the approval of vaccines occurred, including clinical trials with the appropriate number of participants. Because of the large amount of resources that were made available to develop a COVID-19 vaccine and the large number of COVID-19 cases, the clinical trials were accelerated. This made it easier to tell quickly whether or not the vaccines worked to prevent cases of COVID-19. The vaccine was rapidly shown to be safe and effective in protecting against COVID-19.

Myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the heart’s outer lining) are rare and most commonly experienced by older adolescents and young adults. Both are extremely rare in relation to the COVID-19 vaccine. More than 10 million children in the U.S. and Canada have received the vaccine with very few reports of these conditions. Myocarditis and pericarditis actually occur far more often after COVID-19 infection than after being vaccinated against COVID-19, as noted by Health Canada and the Centers for Disease Control and Prevention. There are multiple surveillance mechanisms in place in order to monitor any potential post-vaccination risk of these conditions over time. 

There is no evidence or scientific reason to believe that the COVID-19 vaccine can affect puberty and fertility in children. Clinical trials of those who have been vaccinated in the general population have shown that the vaccine is very safe.

Yes. It is recommended that anyone who has had COVID-19 should still get the vaccine.

The clinical trials included people who previously had COVID-19, and the vaccine was found to be safe for them. Because it is not known how long antibodies against COVID-19 last after infection and it is possible to get the infection again (sometimes more severely), the vaccine is recommended as it can be helpful in boosting a person's existing immunity to COVID-19.

There is no specific amount of time required to wait between infection and vaccination. As long as you no longer have symptoms, completed the self-isolation period as per your local public health guidelines and are fully recovered from the virus, vaccination is recommended.

The Omicron variant is known to be much more transmissible than previous strains of COVID-19 but vaccination still protects against serious illness and hospitalization. The more people who are vaccinated against COVID-19, the more we can protect ourselves and prevent new variants from emerging and spreading in the community.

Seeking out culturally relevant resources is key to making decisions about vaccination. The National Collaborating Centre for Indigenous Health has a webpage on COVID-19 updates, including information on COVID-19 vaccines. The Indigenous Education Network and Ontario Institute for Studies in Education (OISE) Library have put together an Indigenous COVID-19 Information and Resource page, which contains information on vaccine resources and Indigenous COVID-19 vaccination centres.

Children aged five to 11 receive a two-dose schedule of a smaller Pfizer vaccine dose than the one used in people 12 and older (10 µg instead of 30µg). The National Advisory Committee on Immunization (NACI) recommends that the second dose should be given at least eight weeks after the first dose. Children who turn 12 before their second dose may receive an adult dose.

The COVID-19 vaccine is currently a two-dose series for children aged five to 11. While one dose provides partial protection in young individuals, it takes both doses to be considered fully vaccinated and optimize the protection provided by vaccination.

Canada’s National Advisory Committee on Immunization (NACI) recommends children aged five to 11 receive first and second doses eight weeks apart as this interval is expected to be more beneficial for children in terms of producing longer-lasting immunity and fewer side-effects. While this is NACI’s recommendation, in some cases, the second dose may be administered with a minimum of 21 days between the two doses, as per Health Canada approval. This shorter interval may be considered if informed consent is provided by the child’s caregiver, recognizing the risks and benefits of receiving the second dose earlier than the recommended eight weeks.

The first COVID-19 vaccine that is available for your child will be the best vaccine to get, as it will provide protection against COVID-19 to your child as soon as possible. Vaccine doses are based on age and the maturity of the immune system. The clinical trials showed the paediatric dose given to children aged five to 11 (a third of the dose given to people aged 12 and up), was effective and also resulted in fewer side-effects. 

Vaccine doses are based on age and the maturity of the immune system, not weight. The clinical trials showed the paediatric dose given to children aged five to 11 (a third of the dose given to people aged 12 and up), was effective and also resulted in fewer side-effects, including in children with above average weight. Therefore, children who are almost 12 or weigh more than average would not benefit from receiving the adult dose.

Some children have a very strong reaction to needles. If your child is worried about getting a needle, you can ask for special ways to support their vaccination, such as a longer appointment time or a private space for the injection. The CARD system (Comfort, Ask, Relax, Distract) may also help. It provides groups of strategies to reduce the pain, stress and worries associated with vaccinations to make the experience a positive one. More information can be found at AboutKidsHealth.ca/card. For children worried about pain, there are numbing creams and patches available at many pharmacies to help minimize needle discomfort. 

Sensory-sensitive vaccination clinics use some of the CARD strategies listed above to offer a calmer environment for each child, giving them as much time as they need and their own room to get the vaccine. Some clinics also offer sensory-sensitive appointments, offering dimmed lights, less noise and a slower pace, as well as privacy.

Current evidence suggests that children with disabilities or medical complexity may be at an increased risk for severe illness or complications from COVID-19 based on their underlying condition making vaccination and prevention of COVID-19 especially important. The Pfizer COVID-19 vaccine is safe and effective for children with a wide variety of different medical conditions and complexities. Unexpected or severe side-effects to the vaccine are very rare. If you have specific questions about your child’s medical condition and the COVID-19 vaccine, talk with your child’s doctor or book an appointment with the SickKids COVID-19 Vaccine Consult Service.

Families should consider different strategies that have worked well with previous immunizations and create a plan to set their child up for success. Some questions to consider when scheduling your child’s vaccination appointment include:

- Does my child require a calmer environment? (i.e., privacy, quiet)

- If applicable, is the vaccination clinic wheelchair accessible?

- Which distraction techniques are typically most effective for my child (i.e., deep breathing, counting, watching a favourite video, stress balls)

- What position will be most comfortable for my child during their vaccination (i.e., comfort holding, sitting with caregiver, lying down)

If family caregivers have questions related to vaccinating their child with disabilities or medical complexity, you should first reach out to your child’s primary care physician. For additional questions after speaking with your child’s physician, you can book an appointment with the SickKids COVID-19 Vaccine Consult Service.

Contact your child’s primary care provider or the SickKids COVID-19 Vaccine Consult Service, a by-appointment phone service for Ontario residents that provides a safe, judgment-free space to have an open conversation about the COVID-19 vaccine with a pediatric registered nurse. Book an appointment online at www.sickkids.ca/vaccineconsult or by calling 1-888-304-6558.

For general information on COVID-19, please visit the COVID-19 Learning Hub.