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A vial of the Pfizer-BioNTech COVID-19 vaccine for children five to 11 years old is shown at the Viral Solutions vaccination and testing site in Decatur, Georgia. The U.S. has entered a new phase in its COVID-19 vaccination campaign, with shots now available to millions of elementary-age children in what health officials hailed as a major breakthrough after more than 18 months of illness, hospitalizations, deaths, and disrupted education. (AP Photo/Ben Gray)

This photo provided by Pfizer shows kid-size doses of its COVID-19 vaccine. About 1.9 million kids between 5 and 11 years old in the U.S. have been diagnosed with COVID-19. Some 8,300 have been hospitalized and about a third needed intensive care. (Pfizer via AP)

Explainer: What to know about vaccines for kids 5 to 11 years old

By Lauran Neergaard

The Associated Press

Vaccinations finally are available to U.S. children as young as five, to the relief of some parents even as others have questions or fears.

The Centers for Disease Control and Prevention (CDC) last week gave the final OK for youngsters between 5 and 11 years old to get kid-size doses of the vaccine made by Pfizer and its partner BioNTech. Pediatricians and other doctorsí groups praised the move and are gearing up to help families decide whether to vaccinate their children.

Like COVID-19 vaccines for adults and teens, they are free.

Here are some things to know:

SHOULD ELEMENTARY SCHOOL-AGED CHILDREN GET VACCINATED?

Yes, according to U.S. health authorities and leading doctorsí groups. Even though the virus tends to be more severe in adults than children, COVID-19 is causing plenty of preventable suffering among youngsters. About 1.9 million kids ages 5 to 11 have been diagnosed with COVID-19. Some 8,300 have been hospitalized, about a third needed intensive care, and at least 94 deaths have been verified.

Thatís not counting the risk of a serious complication called multisystem inflammatory syndrome that can hit kids several weeks after theyíve recovered from even a mild infection.

Vaccination also promises to help kids more safely resume school and social activities.

ARE KID DOSES THE SAME SIZE AS ADULT ONES?

No. Children between 5 and 11 years old receive a third of the dose given to teens and adults. Thatís 10 micrograms per shot for youngsters, compared to 30 micrograms per shot for everyone age 12 and older. Like everybody else, the younger kids will get two shots, three weeks apart.

HOW WELL DO THE SHOTS WORK?

In a study, Pfizerís pediatric vaccine proved nearly 91% effective at preventing symptomatic infection. Vaccinated youngsters developed levels of virus-fighting antibodies as strong as teens and young adults whoíd received the full-strength dose.

ARE THERE SIDE EFFECTS?

In the trial, the 5- to 11-year-olds had some annoying post-shot reactions, including sore arms and fatigue, similar to teens and young adults, but were less likely to have fevers. Altogether, the study includes 4,600 youngsters, 3,100 of them given the vaccine and the rest dummy shots. The FDA found no safety concerns.

WHAT ABOUT RARE PROBLEMS?

Tens of millions of the larger doses have been given safely to Americans age 12 and older. One very rare serious side effect has come to light: heart inflammation.

These rare reactions have occurred mostly in young men or teens boys, usually after the second dose, and they tend to recover quickly. To put the risk in context, doctors say COVID-19 infection can cause more serious heart inflammation. One theory is that testosterone and puberty play a role, which is partly why experts expect any risk to younger kids would be even lower.

WHERE ARE THE SHOTS AVAILABLE?

The shots are being offered at pediatriciansí offices, health clinics, and pharmacies. Some school systems also plan to host vaccination clinics, too.

CAN MY CHILD GET A FLU SHOT AT THE SAME TIME?

Yes, the CDC says COVID-19 shots can be given at the same visit as vaccines for the flu, or other routine vaccinations a child ó or anyone else ó may require.

WHAT IF MY CHILD IS ABOUT TO TURN 12?

CDC said children should get the dose thatís right for their age on the day of vaccination. So if a child gets the 10-microgram dose for the first shot and then turns 12, the second shot should be the 30-microgram dose.

SHOULD I JUST WAIT UNTIL THEIR 12TH BIRTHDAY SO BOTH SHOTS ARE THE BIGGER DOSE?

Pediatricians say not to postpone vaccination because the kid-size dose is effective in that age group.

IS THE CDCíS MOVE A MANDATE?

No. The CDC has not mandated vaccinations for youngsters, but recommended them.

ARENíT ONLY SOME KIDS AT HIGH RISK OF SERIOUS COVID-19?

Nearly 70% of 5- to 11-year-olds hospitalized for COVID-19 have had other medical problems, including obesity and asthma. But sometimes the otherwise healthy get seriously ill, too. And given the profound social, mental health, and educational impact the pandemic has had on youngsters, health authorities made clear that all children should be vaccinated. There also are equity concerns, as more than two-thirds of youngsters whoíve been hospitalized are Black or Hispanic.

WHAT IF MY CHILD ALREADY HAD COVID-19?

They still should be vaccinated once theyíve recovered, according the CDC. Itís clear that prior infection does provide some protection against another bout but that immunity can vary depending on how seriously ill someone was, and how long ago. Studies of adults have found that vaccination after infection can dramatically boost protection.

IS PFIZERíS VACCINE THE ONLY CHOICE FOR CHILDREN?

In the U.S., for now, it is. Modernaís similar vaccine is used by teens in some other countries and is being tested in younger children but isnít yet available for Americans under age 18. A few other countries have used other kinds of COVID-19 vaccines in young children, including China, which just began vaccinations for 3-year-olds.

WHAT ABOUT VACCINATIONS FOR U.S. CHILDREN YOUNGER THAN 5?

Stay tuned: Pfizer and Moderna are testing low doses in babies and preschoolers.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Instituteís Department of Science Education. The AP is solely responsible for all content.

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