Your Next Family Outing: Getting the COVID-19 Vaccine or Booster

This has been a cold and flu season like no other, and parents have been feeling the brunt of it. RSV, flu, and a host of other icky cold viruses have been circulating at exceptionally high levels this fall. COVID-19 is starting to make a comeback too. Parents of young children have been dealing with one illness after another, and with the holiday season coming in full swing, we are desperate for a respite.

The good news is that there are vaccines to help protect your child's health over the next few months. Annual flu shots are available for children aged 6 months and up. COVID-19 vaccines are now available for all children 6 months and older, including an updated bivalent vaccine that is tailored to more closely match the currently circulating COVID variants. Now would be a great time to take the whole family to get either their booster shots, or even initial vaccine series.

We caught up with Peter Marks, MD, the director of the Food and Drug Administration's (FDA) Center for Biologics Evaluation and Research, to help parents understand what went into approving the COVID vaccines for kids, how the new updated bivalent booster can protect your kids this season, and what to know in general about this current cold, flu, and COVID season.

What Should Parents Know About The Updated Bivalent Vaccines For Kids?

In early December, the bivalent COVID vaccine was approved for children 6 months through 4 years, after previously being approved for kids aged 5 and up. This means most children now have the option of being further protected from COVID. The bivalent vaccines contain both the original strain of COVID, along with the BA.4/BA.5 variants, which are sublineages of omicron. Children can get the updated boosters after completing their primary series, of either Pfizer or Moderna.

Dr. Marks emphasizes that these updated vaccines have been thoroughly studied and vetted, just like all the other COVID vaccines. “We took the same care that we've taken with all of our authorizations to make sure that the data—both supporting the potential efficacy and the safety of the vaccine—are there,” he said. “We're very comfortable that the safety profile with this bivalent booster and in this youngest age group is essentially the same or very similar to what we saw with the original vaccine in this age group.”

Moreover, Dr. Marks says he expects the vaccines to work well for kids in the real world, and he anticipates the updated vaccine will provide improved protection against the currently circulating strains. There are new studies coming out—including one published by the Centers for Disease Control and Prevention (CDC) in early December—showing the bivalent booster is more effective at preventing both COVID infections and serious disease in adults. Dr. Marks expects the vaccines will work similarly for children.

Addressing Parents’ Concerns About The Vaccines and Booster

While the arrival of the bivalent booster for kids is exciting to many parents, it’s clear that many have reservations. Vaccine uptake has lagged in young children, especially among children 4 and under. For example, only 4.7% of 2-4 year-olds and 2.9% of children 6 months through 2 years have completed their primary COVID vaccine series.

Dr. Marks says parents should know that COVID vaccines really aren’t much different than other standard vaccines that children receive. “There's no magic behind these vaccines that makes them fundamentally different than other vaccines,” he explains. “They work by ultimately leading the body to make a protein against which antibodies are generated and a cellular immune response is generated that helps protect one from what is a potentially life-threatening illness, even in young kids.”

Not only that, but he thinks some parents may not fully understand the primary purpose of COVID vaccines. While they are not perfect at preventing infection, they do offer children needed protection against severe disease and hospitalization. There’s a myth that COVID is mild in children, says Dr. Marks. But while children usually fare better than adults, COVID can be severe for children, and children can die of it.

As Dr. Marks points out, COVID is actually more deadly to children than the flu. For example, in even a bad flu season, such as the 2019-2020 flu season, there were 188 pediatric deaths. On the other hand, during the almost three years of the COVID pandemic, a total of 1,575 children have died, according to the latest CDC data.

The take-home message here is that the COVID vaccines have been shown to protect your children against the worst outcomes of the virus, such as severe disease, hospitalization, and death.

“Parents may say, ‘Well, these, these vaccines aren't so good, I still got COVID-19 even though I was vaccinated,’" Dr. Marks says. "Yes, you may have gotten COVID-19. But did you end up in the hospital? You know, did you end up on a ventilator? Or did you end up worse even?”

What About Kids Who Have Already Gotten COVID?

Some parents might wonder if they need to get their child vaccinated even if their child has previously had COVID. This is an understandable concern, but Dr. Marks recommends all eligible children get the updated bivalent booster for added protection, whether or not they’ve had COVID.

The COVID virus is constantly evolving, says Dr. Marks. So the virus circulating now is not the same one circulating two years ago, or even one year ago. “It's a different enough virus that the immunity [your child] might have gotten back when they had COVID last January, may not protect them against serious outcomes in quite the same way if they get COVID now,” Dr. Marks said.

“Yes, the child may have a little bit of a sore arm. It's possible they might have a fever, be a little cranky for a day after vaccination, just like adults saw after they get COVID vaccination,” Dr. Marks notes. “But there’s a tiny inconvenience of the vaccine compared to the giant problem if you get issues with COVID.”

What Are the Next Steps for Vaccines As New Variants Continue to Emerge?

Nothing is finalized as of yet, but Dr. Marks expects COVID vaccines to be updated as the virus shifts and changes, and for there to be an updated mRNA COVID vaccine every fall, similar to the flu shot. At the same time, Dr. Marks says that “second generation” vaccines are in the works, and we might see these start to come out a few years down the road.

“I think we'll start to see efforts to make better vaccines, which will hopefully provide longer-term protection against a broad array of different variants,” Dr. Marks said. “But those are probably a few years away.”

What to Expect This Winter With COVID

After a bit of a lull this fall, COVID cases have started to pick up again. According to the most recent CDC data, cases have increased 49.6% over the past week; hospitalizations for COVID have ticked up 13.8% in this same time period.

Dr. Marks’ advice for parents as this new winter wave of COVID begins? Right now is a great time to get vaccinated. “If your child’s never been vaccinated, now’s a good time to start,” he said. “It's not too late!” Within 7 days after the first dose of vaccine, children are already starting to develop some protection against COVID, Dr. Marks noted. “After they get their second dose—which will be either in three or four weeks—they will have additional protection.”

Additionally, if your child has already had the primary series, this winter and holiday season is a great time for a bivalent booster. As Dr. Marks points out, the currently circulating omicron variants are quite immune evasive, and the original vaccine formula just doesn’t offer the same level of protection as the updated vaccines do.

And what about the flu shot? Dr. Marks urges parents to get that one too, if you haven’t already, and points out that you can get your child’s flu and COVID shots at the same time.