In December 2022, the FDA extended the authorization for these boosters to kids between 6 months and 4 years old.
If your child completed the Moderna primary series (two shots) at least two months ago, they can get a Moderna bivalent booster. If they are still in the process of getting their three Pfizer primary series shots, the third one will be a bivalent booster. If they have completed the three-shot Pfizer series, they do not need a booster yet.
What Omicron Looks Like in Kids
So far, most of what we know about Omicron comes from data from infected adults. “[The data] indicates that Omicron is less severe than Delta but still more than ‘just a cold’ for unvaccinated adults,” says Kelly Fradin, MD, pediatrician and author of Parenting in a Pandemic: How to Help Your Family Through COVID-19. For kids, symptoms of Omicron appear similar to that of other COVID-19 variants. “Omicron tends to attack the upper airways more than the lower airways,” says Eric Ball, MD, a pediatrician with Providence Mission Hospital in Orange County, California, and past president of the American Academy of Pediatrics. “We are seeing a lot of children present with a very bad sore throat, coughing, nasal congestion, and fever.” In some children, the symptoms of the Omicron variant are similar to cold symptoms, Dr. Ball says, but adds that COVID-19 symptoms are typically more severe than the usual stuffiness, runny nose, cough, and sore throat. “We are seeing high fevers and difficulty breathing due to COVID-19 infection,” Dr. Ball says. Many pediatric COVID-19 patients have croup-like symptoms, Dr. Ball adds. “They have swelling of the upper airway, which makes breathing difficult. Some of these children need to go to the hospital or receive special medication to help them breathe more comfortably.” Dr. Fradin’s pediatric Omicron patients have been more likely to present with a sore throat, croupy cough (barking in nature), and headache. “Notably, we continue to see many asymptomatic children who test positive for Omicron,” she adds. “I haven’t seen children becoming more sick with Omicron than with prior variants. "
Preventing Omicron in Kids
Dr. Fradin encourages parents to test early and often to identify cases early and prevent exposure in the community. The sooner you detect COVID-19, the sooner your child can return to school or daycare, as the quarantine period begins when the test is positive, she adds. Dr. Fradin acknowledges that most parents are struggling—tired of living through a pandemic and frustrated with constant negative news and fluctuating guidelines, but urges those who remain unvaccinated to consider full COVID-19 vaccination, including a booster dose if eligible. The COVID-19 vaccine provides robust protection from hospitalization and severe cases of infection, Dr. Fradin says. “We have data that vaccination reduces the risk of COVID-19 complications like MIS-C and it’s likely that vaccination also decreases the risk of long COVID and the possibility of COVID-19-triggering autoimmune diseases such as type 1 diabetes,” she explains. Kids 6 months old and up can be vaccinated against COVID-19. “I’d encourage parents to take reasonable precautions to protect their children—following quarantine guidelines, testing, masking, and vaccination. But then try to relax and remember you’ve done your best,” Dr. Fradin says. “Your child may still get sick given how contagious Omicron is, but the likelihood is that they will be OK.”
When to See a Pediatrician
If you suspect your child might be infected with Omicron, it’s best to confirm with a test, either at home or at a doctor’s office, says Dr. Ball. “Unless your child is an imminent danger or severely ill, it’s best to avoid the emergency department so that people who need it for actual emergencies can have access,” he adds. For a mild infection, you can use a fever-reducing medication like acetaminophen (Tylenol). If your child is 6 months or older, you can also give them ibuprofen (Advil or Motrin). Aside from that, it’s all about fluids and rest, says Dr. Ball. If your child tests positive, you’ll need to isolate with your child to make sure they don’t spread the disease to other people. If you have questions about any symptoms your child may have, call your pediatrician.
