Experts say children should get a COVID-19 bivalent booster. Here’s what you need to know – PBS NewsHour

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Newly formulated COVID-19 booster shots can help protect children and lower transmission of the coronavirus as the U.S. prepares for a possible spike in cases heading into the fall and winter.
The Centers for Disease Control and Prevention authorized bivalent COVID-19 booster shots for children ages 5 and above on Oct. 12. The new booster aims to target omicron subvariants, as well as the original strain of the virus.
“This is a critical step in our fight against COVID-19. An updated vaccine can help bolster protection for our children this winter,” CDC Director Dr. Rochelle Walensky said in a tweet.
The latest CDC data shows that less than a third of children ages 5-11 have been fully vaccinated with the initial two-dose vaccine series. For 12- to 15-year-olds, that figure is nearly 56 percent — still far below the 78 percent of people 18 and older who’ve received the two initial doses of the vaccine.
The bivalent booster was made available for adults in September.
READ MORE: U.S. approves omicron-specific boosters for kids as young as 5
The PBS NewsHour spoke with two physicians and an epidemiologist to answer your questions about COVID-19 boosters for children. Here’s what they had to say.
Children should get a bivalent booster if they’re in the recommended age range, physicians and public health researchers told the PBS NewsHour.
“These kids are in school in person with very, very few, if any at all, other mitigation measures. The booster will help them with severe disease, but also [will be] keeping them in school,” said Katelyn Jetelina, an epidemiologist and publisher of the Your Local Epidemiologist newsletter. “That is — I think as a parent — a big reason why I would be giving my kid a booster.”
The CDC recommends that children aged 5 and above get the new COVID-19 bivalent booster. The two boosters authorized by the Food and Drug Administration and the CDC are made by Moderna (for ages 6 and up) and Pfizer-BioNTech (for ages 5 and up).
Yes. Just like the bivalent booster for adults that the CDC and FDA authorized last month, the shot targets the original SARS-CoV-2 virus and the omicron variant. CDC data show that the BA.5 and BA.4.6 subvariants of Omicron accounted for more than 80 percent of cases in the U.S. as of Oct. 15.
The bivalent booster also provides greater immunity to the new subvariants, BQ.1 and BQ.1.1, which are derivatives of the BA.5 omicron subvariant. The bivalent boosters include “spike protein components” from BA.5 and BA.4 that provide this protection.
“The virus continues to evolve, but we’re not seeing completely new strains come out of nowhere,” said Dr. Steven L. Zeichner, a pediatric infectious disease specialist at the University of Virginia. “We’re seeing existing strains that then evolve from the strains … that are at large in the population.”
The CDC recommends that children ages 5 and up get a bivalent booster at least two months after their last vaccine dose, whether it was part of the primary series or a previous booster.
If your child had a COVID-19 infection, it’s best to check with their pediatrician on when to get their bivalent booster, said Zeichner.
Before children receive the bivalent booster, they should first complete their primary series of vaccines. According to the CDC, as of Oct.18, the primary vaccine series includes either:
And if a child is not feeling well before getting their shot, it’s best to check with their doctor before administering a COVID-19 vaccine, Zeichner said.
“The longer you prolong not getting the vaccine, the longer you’re not protected and you stand risks from not being protected,” he said. “I would certainly err on the side of giving the vaccine as opposed to not.”
This booster, like other vaccines, can result in some arm pain and fatigue, explains Dr. Sallie Permar, chair of pediatrics at Weill Cornell Medicine and NewYork-Presbyterian Komansky Children’s Hospital. She recommends timing it out if possible so it doesn’t interfere with your child’s activities.
READ MORE: Rural parents are less likely to say their pediatrician recommended COVID shots. Here’s why that matters
“Maybe they have a big sports event or maybe they have a big arts or musical event. Then you may want to plan your vaccine around those things so that they don’t feel crummy on their day to shine,” she said.
Both the primary series vaccines and the boosters are incredibly safe and effective, Zeichner told the NewsHour.
“I counsel parents a fair amount. And what I try to do is not to say ‘there is nothing,’ or ‘there’s no basis whatsoever for your fears.’ What I say is that everything has risks and benefits, and we have to balance the risks against the benefits,” he said. “And for all these vaccines, the benefits far, far, far outweigh the risk.”
READ MORE: Updated COVID boosters approved ahead of potential fall surge
Two rare risk factors that have gotten a lot of attention are myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the pericardium sac that surrounds the heart), especially in adolescent and young adult men who received the mRNA COVID-19 vaccines. That risk is minuscule compared to the risk of myocarditis and pericarditis caused by actual COVID infection, Zeichner said.
“If you’re not getting a vaccine and you don’t want your kid to get a vaccine because you’re worried about that risk, well, you’re not doing your child any favors,” he said, “because if the child does get COVID, they’re going to stand a much, much higher risk of developing that particular kind of complication.”
Yes. “Being exposed to two vaccines at the same time is fine, and there’s no evidence whatsoever that that’s going to be a problem,” Zeichner said.
Scheduling the two vaccines at the same time and location may prove to be challenging for some simply due to availability. Dr. Permar, a mother herself, suggests getting them together if possible.
“I would absolutely recommend it. We are very used to doing that in pediatrics, giving multiple immunizations at one time,” she said. “There’s not an immunologic downside. You will respond just as well to all those vaccines.”
The CDC is not recommending COVID-19 boosters for children in this age range at this point. They are eligible for a primary series of the COVID-19 vaccine, which is either:
That’s an open question because the course of the pandemic is unknown, according to Zeichner. “What we know is that the more the virus evolves, the worse the previous immune response functions to prevent disease,” he said.
Right now, the most important thing is getting vaccinated and boosted to prevent the spread of the virus.
COVID-19 is “not at all an innocuous disease and we have the tools to prevent it,” Zeichner said. If people had seen “what I’ve seen, they would not hesitate to get the vaccine for their children because it can be a devastating disease.”
Illustrations by Megan McGrew.
Left: The CDC recommends that children aged 5 and above get the new COVID-19 bivalent booster. Photo by Getty Images
By Dan Cooney, Matt Rasnic
By Prakash Nagarkatti, Mitzi Nagarkatti, The Conversation
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By Prakash Nagarkatti, Mitzi Nagarkatti, The Conversation

Dan Cooney is the PBS NewsHour’s Social Media Producer/Coordinator.

Matt Rasnic (he/him/they/them) is an associate producer and editor for social media at the PBS NewsHour.
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