Should I Get My Child the New Bivalent Booster Shot?

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UPDATE: December 9, 2022

The Food and Drug Administration (FDA) approved the bivalent booster shots from Pfizer and Moderna for children ages 6 months and older on December 8. The Centers for Disease Control and Prevention (CDC) signed off on the approval one day later, making the shots available at your local pharmacy or healthcare provider.

This article has been updated with the latest information.

Key Takeaways

  • The Centers for Disease Control and Prevention has recommended COVID-19 booster shots targeting the Omicron COVID-19 variant.
  • As of December 2022, the bivalent booster is available for children ages 6 months and older.
  • Both Pfizer and Moderna have bivalent boosters available, with different parameters for each.

There's a new weapon in the battle against COVID-19. On September 1, 2022, the director of the Centers for Disease Control and Prevention (CDC) signed off on its advisory panel's recommended use of COVID-19 vaccine boosters.

It came just weeks after Pfizer and Moderna both applied for emergency use authorizations (EUA) for their boosters, which target the BA.4/BA.5 variants. Originally, Moderna's bivalent booster was targeted for use in people 18 and older, while Pfizer-BioNTech's shot was made available for people 12 and up. Tweens and teens were among the first children eligible for the updated booster. But those ages have since been expanded.

In a statement, CDC Director Rochelle Walensky, MD, MPH, said, "the updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant." She goes on to add, "if you are eligible, there is no bad time to get your COVID-19 booster and I strongly encourage you to receive it.”

With this news, parents understandably have lots of questions. With kids in school and germs circulating, parents want to know how to time their kids’ boosters.

Is My Child Eligible for the Bivalent Booster?

Pfizer’s vaccine for kids aged 12 and up was rolled out in the days and weeks after Labor Day 2022, just in time for many children to head back to school. Moderna soon followed with its vaccine for that age group.

By October, the FDA authorized the updated bivalent boosters from Pfizer and Moderna for everyone ages 5 and older. The Pfizer booster was made available for kids 5 and up, and the Moderna booster was for kids 6 and up. Kids can get these boosters two months after completing their primary series or last booster.

Then in December, officials added parameters for those over 6 months old. The updated Moderna bivalent booster can be given to any child over 6 months old who completed their primary series of the original vaccine at least two months ago.

“More children now have the opportunity to update their protection against COVID-19 with a bivalent COVID-19 vaccine, and we encourage parents and caregivers of those eligible to consider doing so—especially as we head into the holidays and winter months where more time will be spent indoors,” FDA Commissioner Robert M. Califf, MD, says in a statement.

For Pfizer, children between 6 months and 4 years old that have not yet had any COVID vaccinations—or have not yet gotten a third dose—will receive the bivalent booster as part of their primary series. But, this is important: Children between 6 months and 4 years old who have already had three doses of the original vaccine will not be eligible to get a bivalent booster dose at this time. The FDA says they expect more data for this group in January and will evaluate it then.

What to Know About the Omicron-Specific Boosters

The bivalent booster combines the BA.4/BA.5 variants with the original vaccine formula. For kids 12 and up, the dose is the same for this booster as it was for other Pfizer boosters: a 30-µg dose. As such, experts expect any potential side effects of this vaccine will be similar to the original.

“The expected side effect profile would be very similar to the original vaccine because the mRNA vaccine technology is the same for both,” explains Kari Simonsen, MD, MBA, senior vice president, pediatrician-in-chief, and chair of pediatrics at Children’s Hospital & Medical Center in Omaha, Nebraska.

According to the FDA, in a clinical study of the original Moderna booster, common side effects for those ages 17 through 36 months included irritability/crying, sleepiness, and loss of appetite. For those between 37 months and 5 years, other side effects were fatigue, headache, muscle pain, joint pain, chills, and nausea.

What Are the Benefits of the New Booster for Kids?

Experts agree this new bivalent vaccine will have many benefits for kids who are eligible to receive it. First of all, vaccines and boosters generally protect kids from the most serious effects of a COVID-19 infection.

“The vaccines reduce the risk of death and serious illness from COVID-19,” says Ali Alhassani, MD, MSc, head of clinical at Summer Health. “While it is true that death due to COVID-19 is extremely rare in children, the risk is not zero.”

Additionally, Dr. Alhassani says COVID vaccines and boosters have shown protection against serious COVID complications such as MIS-C (multisystem inflammatory syndrome in children). Vaccines also make kids less likely to contract COVID and spread the infection to vulnerable people, he adds.

The fact that these new boosters are updated with the currently circulating variants means they will likely have broader protection than the boosters based on the original formula, says Dr. Alhassani.

“These new boosters are targeted for the Omicron BA.4/BA.5 variant, the dominant strains in the U.S.,” he explains. “That fact suggests that they would offer broader protection than the first Pfizer-BioNTech vaccine that targeted the initial COVID-19 strain alone.”

Children who have recovered from MIS-C should make sure to stay on top of their COVID vaccinations. Research published in January 2023 showed patients with a history of MIS-C had no adverse reactions to the vaccine. One caveat—if your child has had MIS-C, they should wait 90 days after diagnosis to receive the vaccine.

When Should I Get My Child Boosted?

Vaccination rates for children in the younger age groups are relatively low. As of November 30, 2022, less than 5% of kids between the ages of 2 and 4 years old have completed their primary series, according to the CDC. That number is even lower for those under 2 years old, at just under 3%. Only 2% of children ages 5 to 11 have gotten their bivalent booster.

Given these numbers, health officials are hoping to encourage more parents to not only get their children boosted but also vaccinated if they haven't already—and do it as soon as possible.

“Parents and caregivers can be assured that the FDA has taken a great deal of care in our review, and we encourage parents of children of any age who are eligible for primary vaccination or a bivalent COVID-19 vaccine booster dose to consider seeking vaccination now as it can potentially help protect them from COVID-19 during a time when cases are increasing,” says Peter Marks, MD, PhD, director of the FDA’s Center for Biologics Evaluation and Research.

Behnoosh Afghani, MD, a pediatric infectious diseases specialist at UCI Health, doesn’t think parents should wait on boosting their kids, noting that booster doses of COVID vaccines have been shown to decrease disease severity in kids.  “Because of the high prevalence of circulating COVID-19, it is important for the kids who qualify for the booster dose to get it as soon as possible.” Dr. Afghani adds.

If you have any questions about COVID vaccinations or boosters, make sure to discuss the decision with your child's pediatrician or another healthcare provider, especially if your child has any underlying medical conditions.

What This Means for You

Navigating the world of COVID booster shots as a parent can be confusing—especially as different kids got different vaccines and at different points in time! The main thing to know is that completing your child’s primary series is vital, and boosting them also has important health benefits. The bivalent booster shots offer a new tool for parents to help protect their children from COVID. If you are still unsure about how to time your booster, please reach out to your child's pediatrician or healthcare provider, who can give you advice based on your particular situation.

9 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. CDC Recommends the First Updated COVID-19 Booster

  2. U.S. Food and Drug Administration. Coronavirus (COVID-19) update: FDA authorizes updated (bivalent) COVID-19 vaccines for children down to 6 months of age.

  3. Pfizer Inc. Pfizer and BioNTech submit application to U.S. FDA for emergency use authorization of Omicron BA.4/BA.5-adapted bivalent COVID-19 vaccine.

  4. Moderna, Inc. Moderna completes application to U.S. Food and Drug Administration for emergency use authorization of Omicron-targeting bivalent COVID-19 booster vaccine, Mrna-1273.222.

  5. Centers for Disease Control and Prevention. COVID-19 vaccines for children and teens.

  6. Zambrano LD, Newhams MM, Olson SM, et al. Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA vaccination against multisystem inflammatory syndrome in children among persons aged 12–18 years — United States, July–December 2021. MMWR Morb Mortal Wkly Rep. 2022;71(2):52-58. doi:10.15585/mmwr.mm7102e1

  7. Elias MD, Truong DT, Oster ME, et al. Examination of adverse reactions after covid-19 vaccination among patients with a history of multisystem inflammatory syndrome in children. JAMA Netw Open. 2023;6(1):e2248987. doi:10.1001/jamanetworkopen.2022.48987

  8. Centers for Disease Control and Prevention (CDC). Trends in demographic characteristics of people receiving COVID-19 vaccinations in the United States.

  9. Centers for Disease Control and Prevention. CDC strengthens recommendations and expands eligibility for COVID-19 booster shots.

By Wendy Wisner
Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. She has worked with breastfeeding parents for over a decade, and is a mom to two boys.