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Vaccines for children: COVID-19

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Making the decision to vaccinate

As a parent or guardian, you want what's best for your child. It's normal to ask questions about COVID-19 vaccination before making a decision.

If you need more specific information, or have questions, consult a health care provider. You can also find information on your provincial, territorial or local public health authority's website.

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Impacts of COVID-19 on children and youth

Vaccines offer good protection against the most severe outcomes of COVID-19.

Most children and youth who get COVID-19 have mild or no symptoms but some:

You can increase protection against severe COVID-19 outcomes and illness by:

Children and youth at higher risk

Children and youth with certain underlying medical conditions may have a higher risk of severe illness from COVID-19. It's especially important for children who are at higher risk for severe COVID-19 illness to stay up to date with their vaccines.

Underlying medical conditions that may put children at higher risk for severe COVID-19 illness include:

Children who have multiple (2 or more) long-lasting conditions are also at higher risk for severe COVID-19. If you don't know if your child is at increased risk of severe outcomes because of an underlying medical condition, ask a health care provider.

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Importance of vaccines

Vaccines help lower your child's risk of getting seriously sick from COVID-19. They work with the body's natural defences to develop protection against disease. The COVID-19 vaccine makes the immune system create antibodies and immune memory. This allows the body to remember the virus and react quickly to fight infection before children can get really sick.

When to vaccinate children and youth

The primary series of COVID-19 vaccines is approved for children and youth aged 6 months to 17 years of age. A booster dose is approved for children 5 to 17 years of age following their primary series.

Only mRNA vaccines are approved for use in children and youth in Canada. The bivalent mRNA vaccine is preferred for the booster dose. Only the Pfizer-BioNTech bivalent mRNA vaccine is currently approved for those 5 to 17 years of age.

Children and youth who aren’t immunocompromised

The number of doses in the primary series varies by age and product. Before beginning or continuing the primary vaccine series, it’s recommended that children and youth wait 8 weeks after:

  • a positive COVID-19 test or
  • the start of COVID-19 symptoms

If booster doses are recommended, they should be offered at least:

  • 6 months from completing the primary series or
  • 6 months from a COVID-19 infection, whichever is later

Children 6 months to 4 years of age

Children 6 months to 4 years of age may be offered an mRNA COVID-19 vaccine for the primary series. It’s recommended that doses be at least 8 weeks apart.

  • Moderna Spikevax is approved as a 2-dose primary series for children 6 months to 5 years of age.
  • Pfizer-BioNTech Comirnaty is approved as a 3-dose primary series for children 6 months to 4 years of age.

A booster dose isn’t currently recommended for children 6 months to 4 years of age.

Children 5 to 11 years of age

Children 5 to 11 years of age should be offered an mRNA COVID-19 vaccine primary series. Two vaccine doses at least 8 weeks apart are recommended for the primary series.

Children who turn 12 before their second dose in a primary series should receive the higher dose approved for youth 12 to 17 years of age to complete their primary series.

A booster dose should be offered to children 5 to 11 years of age with underlying medical conditions that place them at high risk for severe COVID-19 disease. A booster may also be offered to other children 5 to 11 years of age.

The bivalent mRNA booster is preferred. Only 1 booster is currently recommended for children 5 to 11 years of age.

In certain cases, a health care provider may recommend a bivalent booster for children who:

  • are at high risk of severe COVID-19 and
  • have previously received a monovalent booster dose

Youth 12 to 17 years of age

Youth 12 to 17 years of age should be offered an mRNA COVID-19 vaccine primary series. Two vaccine doses 8 weeks apart are recommended for youth.

For fall 2022, it’s recommended that a booster dose be offered to youth 12 to 17 years of age at increased risk for severe COVID-19 disease. A booster may also be offered to other youth 12 to 17 years of age.

To stay up to date, a booster dose should be offered to youth who were recommended to get one this past fall but have not received one.

Children and youth who are immunocompromised

A primary series includes an additional dose for children and adolescents who are moderately to severely immunocompromised. This is because people who are immunocompromised may have a lower immune response to COVID-19 vaccines.

The number of doses in the primary series varies by age and product. Before beginning or continuing the primary vaccine series, it’s recommended that children and youth who are immunocompromised wait 4 to 8 weeks after:

  • a positive COVID-19 test or
  • the start of COVID-19 symptoms

If booster doses are recommended, they should be offered at least:

  • 6 months from completing the primary series or
  • 6 months from a COVID-19 infection, whichever is later

Parents and caregivers of moderately to severely immunocompromised children and youth are encouraged to speak with a health care provider. They’ll be able to inform you about vaccination and other ways to protect children and youth against COVID-19.

Children 6 months to 4 years of age

Children 6 months to 4 years of age who are immunocompromised may be offered an mRNA COVID-19 vaccine for the primary series. A 3-dose primary series of the Moderna Spikevax vaccine is preferred, with an interval of 4 to 8 weeks between each dose.

If Moderna Spikevax is unavailable, a 4-dose series of the Pfizer-BioNTech Comirnaty vaccine may be offered. The recommended interval is 4 to 8 weeks between each dose.

A booster dose is not currently recommended for children 6 months to 4 years of age.

Children and youth 5 to 11 years of age

Children 5 to 11 years of age who are immunocompromised should be offered an mRNA COVID-19 vaccine primary series. A 3-dose primary series is recommended for both mRNA vaccines. The recommended interval is 4 to 8 weeks between each dose.

Children who turn 12 before completing their primary series should receive the higher dose approved for youth 12 to 17 years of age to complete their primary series.

A booster dose should be offered to children 5 to 11 years of age who are immunocompromised. The bivalent mRNA booster is preferred. Only one booster is currently recommended for children 5 to 11 years of age.

In certain cases, a health care provider may recommend a bivalent booster for children who:

  • are at high risk of severe COVID-19 and
  • have previously received a monovalent booster dose

Youth 12 to 17 years of age

Youth 12 to 17 years of age who are immunocompromised should be offered an mRNA COVID-19 vaccine primary series. A 3-dose primary series is recommended for both mRNA vaccines. The recommended interval is 4 to 8 weeks between each dose.

Youth 12 to 17 years of age who are immunocompromised should have been offered a fall 2022 booster dose. To stay up to date, a bivalent booster dose should be offered to youth who were recommended to get one this past fall but have not received one.

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Vaccination after being infected with COVID-19

Vaccination is important, even if you’ve had COVID-19. While infection alone provides some protection, vaccination after infection:

Children and youth who are not immunocompromised and who experienced COVID-19 before any primary series dose should wait:

Children and youth who are immunocompromised are recommended to wait 4 to 8 weeks after having COVID-19 to receive the next dose in a primary series.

Children and youth 5 to 17 years of age who are due for a booster based on the above recommendations can be offered a booster dose:

In some circumstances, they may be eligible to receive a booster dose after 3 months.

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Possible side effects

Side effects can be expected as your body responds to a vaccine. Side effects for children and youth are similar to those for adults.

Some people have no side effects while others may have some type of reaction. Reactions are most often mild and go away by themselves within hours or days. The COVID-19 vaccine ingredients are no longer in the body after a few days. Only the immune response to protect against COVID-19 remains.

Common vaccine side effects may include:
Symptoms at the injection site, such as: More general symptoms, such as:
  • redness
  • soreness
  • swelling
  • chills
  • fatigue
  • joint pain
  • headache
  • mild fever
  • muscle aches

Rare reactions that have been reported

As with all vaccines, there's a very small chance that there will be a serious side effect.

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Safety and monitoring

Millions of children in Canada and around the world have safely received COVID-19 vaccines. Some rare reactions have been reported.

Only vaccines that meet the safety, effectiveness and quality standards of Health Canada are approved for use in Canada. COVID-19 vaccines are tested during their development according to international standards and then carefully reviewed by Health Canada. The benefits of all COVID-19 vaccines continue to outweigh the risks of the disease.

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Ongoing monitoring for safety

Vaccine safety monitoring doesn't stop after approval of a COVID-19 vaccine.

Canada has a strong vaccine safety monitoring system that continually works to detect rare side effects that didn't appear in clinical trials.

Canada also has a safety surveillance system in place that's specifically designed for monitoring pediatric vaccinations. The Immunization Monitoring Program ACTive (IMPACT) is a pediatric, hospital-based network administered by the Canadian Paediatric Society. It has been used to monitor childhood vaccination for more than 20 years.

In addition, monitoring is also done by:

These organizations continue to monitor the safety of COVID-19 vaccines as they’re rolled out in vaccination programs in Canada and around the world.

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Have a positive vaccination experience

Children, youth and their families may have concerns about vaccination. Knowing what to expect can help ease worries and make vaccination a positive experience for your family.

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Have a family discussion about vaccination

Talk to children and youth about the importance of getting vaccinated.

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Individual public health measures

Regardless of your vaccination status, continue to:

It's important to respect choices made by caregivers. We'll continue to provide updates as more data emerges. We aim to help caregivers make informed decisions about COVID-19 vaccination for their children.

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