What to do if your child catches COVID-19 between injections

In June, children as young as six months finally became eligible for COVID-19 vaccines when infant and toddler options from Pfizer and Moderna were licensed. But now that the highly contagious BA.5 Omicron subvariant is causing increased transmission across the country, some children who have started their vaccination program may become infected before they can complete it.

This is especially true for children aged six months to four years who receive the Pfizer vaccine, which requires three doses, with the third dose coming two months after the second. Children aged six months to five years who receive Moderna’s vaccine will complete their course much faster, with two doses in four weeks.

Here’s what pediatricians say to do if your child catches COVID-19 between doses.

Wait for the next dose until the child recovers

Pediatricians say getting COVID-19 between doses shouldn’t significantly alter a child’s vaccination schedule, beyond waiting for the child to recover.

“If you get COVID between your vaccine doses, you should wait until you’ve completed your isolation before getting your second dose,” says Dr. Tina Tan, a pediatrician at Lurie Children’s Hospital in Chicago and a professor at Northwestern University. Going to a vaccination appointment while battling COVID-19 could spread the disease to others.

But after a child’s isolation period ends – usually ten days after they first tested positive or started showing symptoms – the child is clear to get an injection. extra, says Tan. “It doesn’t matter if it’s between first and second, or second and third. You do the same.

Wait a few weeks if you wish, but not too long

A child who has recently recovered from COVID-19 can wait up to three months to get vaccinated, according to guidelines from the US Centers for Disease Control and Prevention (CDC). There are no federal guidelines on how to navigate the increasingly common scenario of an infected child between doses, but waiting three months after recovery should also apply to children who become ill between doses. doses, explains Dr. Ibukun C. Kalu, director of the pediatric department. infection control at Duke University Medical Center.

“If the child is trying to complete their primary series or needs a booster, it’s reasonable to use that three-month guideline,” Kalu says. A child’s age or the type of vaccine they received does not change these guidelines.

The UK’s National Health Service recommends children wait three months after recovering from COVID-19 before getting a vaccine, while the New York State Department of Health advises parents to talk to their pediatrician of this option if their child becomes ill between doses.

Read more: 5 good reasons to have your young child vaccinated against COVID-19

However, a three-month delay is not necessary, and some experts say children should stick to the same dosing regimen they would have been on had they not been infected. “If this dose [appointment] is far enough away that they’ve recovered from COVID,” there’s no need to reschedule, Tan says.

Sticking to existing appointments can be particularly helpful if a child is about to return to school or in other settings where they are likely to encounter the coronavirus. BA.5 easily infects people who already had other versions of COVID-19, with some reinfections occurring within a month.

Dr Katelyn Jetelina, an epidemiologist and science communicator who writes the popular Your Local Epidemiologist newsletter, says if any of her daughters – who both received the first dose of the Moderna vaccine in late June – became infected between doses , she would plan to push their second shots in a few weeks. “I wouldn’t delay much more than that,” she said.

Be sure to complete the vaccination course

Completing the series of vaccines after a child has recovered from an infection will ensure they are broadly protected against future infections and hopefully against future variants, experts say.

Here’s why vaccination after infection is important: Because many children have mild cases of COVID-19, their immune systems may not “mount a very durable and strong response” to infection, Jetelina says. Vaccines are designed to give the immune system more information about the virus and boost that response, making children better prepared “in case they come into contact with the virus again.”

Vaccination can also provide longer-term protection against new variants. “With Omicron and its subvariants, you can get infected over and over and over again,” says Tan. “It’s really important that you get your antibody titers there so that you are protected.”

Although COVID-19 tends to be less severe in children than in adults, the disease can still put children in hospital. More than 70,000 children in the United States have been admitted to hospitals with COVID-19 in 2022 so far, according to data from the Department of Health and Human Services. During Omicron’s first surge in January and February, 37,000 children were hospitalized.

During this winter surge, nine out of ten children ages 5 to 11 who were hospitalized with COVID-19 were not vaccinated, according to a CDC report. Immunizing children reduces their risk of hospitalization and death. And while there is still little research on reducing the long-term effects of COVID-19 in children – such as long COVID and multisystem inflammatory syndrome in children (MIS-C) – studies have shown that vaccination reduces the risk of long COVID among adults.

Prepare for future doses

Experts are also encouraging parents to consider vaccination against COVID-19 as part of their back-to-school preparations.

When schools reopen for in-person instruction, many will have fewer safety measures in place, such as masks and social distancing, than in the past. “Children are going to be exposed, probably more frequently than they are now, to people infected with COVID,” Tan says. She recommends making sure children are also up to date on other routine vaccinations before the start of the semester.

Later in the fall, children may have the option of receiving booster shots tailored to the Omicron variant. Moderna is currently testing an Omicron booster for children under five, similar to their Omicron booster for adults, which could be available as early as September. This could be a third dose for children who received Moderna’s main series, Jetelina says. It’s also currently unclear whether an Omicron-specific booster will be recommended for young children who receive the Pfizer series, she says.

But parents shouldn’t wait for potential variant-specific vaccines when they can improve their children’s protection against COVID-19 now, experts recommend. “I think the relative unknown we all face about upcoming variants has encouraged people to get their children vaccinated as soon as they can,” Kalu says.

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