Children aged 6 months to 4 years who are at higher risk of severe illness from COVID-19 can get a free COVID-19 vaccination.
Young children get a children’s (paediatric) version of the Pfizer vaccine. It has a lower dose and smaller volume. It is also given using a smaller needle.
To be protected, young children need 3 doses of the Pfizer vaccine. It is recommended the second dose is given 3 weeks after the first. Followed by a third dose given at least 8 weeks after the second dose.
Children are not eligible for a booster.
Even if your tamariki has had COVID-19, they should still get any COVID-19 vaccinations they are eligible for.
It is recommended you wait 3 months after testing positive before getting any COVID-19 vaccination.
A gap of 3 months gives your immune system time to recover from the infection and get the most benefit from a vaccination. Getting vaccinated sooner than 3 months might mean your immune response is not as strong.
Eligibility criteria for young children
Tamariki aged 6 months to 4 years can get the paediatric Pfizer vaccine if they are at higher risk of severe illness from COVID-19. It is a 3-dose course. The second dose should be 3 weeks after the first dose, followed by a third dose given at least 8 weeks after the second dose.
Eligible children include those who are severely immunocompromised, or who have complex or multiple health conditions.
Health conditions include:
- chronic lung disease
- serious heart conditions such as congestive heart failure or congenital heart disease
- chronic kidney disease
- chronic neurological or neuromuscular disease such as cerebral palsy
- Down syndrome
- a weakened immune system or are on an immunosuppressive treatment such as chemotherapy
- severe haematological disorders
- a transplant in the last 24 months.
Children aged 6 months to 4 years who do not have these health conditions have a very low likelihood of severe illness from COVID-19. They are not eligible for the vaccine. If you are unsure if your child is eligible, contact your healthcare provider.
Safety of the Pfizer vaccine
Medsafe is responsible for approving the use of all medicines and vaccines in New Zealand. They only approve a vaccine in Aotearoa once they are satisfied it has met strict standards for safety, efficacy and quality.
The trials in children aged 6 months to 4 years showed the vaccine continues to have an excellent safety profile and that side effects are generally mild. The vaccine has been used in this age group worldwide since the second half of 2022.
As with all medicines, there is a risk of an allergic response after this vaccine. This is why everyone should wait for at least 20 minutes after their vaccination.
The Pfizer COVID-19 vaccine is safe for people with food allergies. Unlike some other vaccines, there is no food, gelatin or latex in the Pfizer vaccine, and it is not grown in eggs.
The only reason that someone may not be able to have this vaccine due to allergy is if they have had a severe allergic response (anaphylaxis) to a previous dose of the Pfizer vaccine or an ingredient in the vaccine.
If a child has a history of an immediate allergic reaction to other products, including food, medicines or other vaccines, they can still have this vaccine but will need to stay a little longer (at least 30 minutes) for monitoring. Vaccinators have training to recognise these symptoms and have the appropriate equipment to treat people on site.
Tips before vaccination
Before your child’s vaccination appointment:
- provide encouragement and keep them relaxed
- consider scheduling the vaccine appointment for the start of the day to avoid anxiety building up
- make sure they have had something to eat and drink
- check they are wearing clothes that make it easy to see and access their upper arm or thigh.
If they are a little nervous, they are welcome to take something to the appointment that will distract them, like a soft toy, phone or some music.
A responsible adult needs to go with the child to their appointment. This can be a parent, an adult family member, trusted family friend, legal power of attorney, or whanaungatanga carer.
A legal guardian needs to give consent for the vaccination of the child.
If the adult who accompanies the child to the appointment is not the child’s legal guardian:
- the vaccinator will need to verbally confirm by phone with a legal guardian that they consent to the child being vaccinated, or
- the responsible adult can bring a signed copy of the COVID-19 vaccination consent form completed by a guardian.
This is standard consenting process.
Side effects of the COVID-19 vaccine are similar in children to those seen in adults. These side effects are generally mild and should only last 1 or 2 days.
Common side effects
The most common side effects are:
- a sore arm from the injection — you can put a cold cloth or ice pack on it
- a headache
- feeling tired
- feeling feverish or sweaty
- aching muscles.
After vaccination, they will need to stay for at least 20 minutes so that a health professional can check for any immediate adverse reactions.
Vaccinators have the training to recognise these symptoms and have the appropriate equipment to treat people on-site. Young children cannot always express how they feel, so if they seem unwell or miserable get them to rest and drink plenty of fluids.
They should avoid vigorous exercise, like running around or swimming. You can give your child paracetamol after their vaccination if they seem miserable or in pain. Follow the instructions on the packet, or as given by your doctor or pharmacist.
If you have any concerns, contact Healthline on 0800 358 5453 or take your child to seek medical attention.
Myocarditis and pericarditis
Myocarditis is an inflammation of the heart muscle. Pericarditis is inflammation of the tissue forming a sac around the heart. Both can be mild or serious. They are usually caused by viruses, such as COVID-19, but are also very rare side effects of the Pfizer vaccine.
These conditions are most commonly seen in adolescents and young adults and are very rare in children under 12 years of age. Myocarditis and pericarditis were not identified as side effects of the Pfizer vaccine in the 6 months to 4 years age group in trials. It is important to be aware of the symptoms for all ages who are vaccinated.
Symptoms of myocarditis and pericarditis linked to the Pfizer vaccine generally appear within a few days, and mostly within the first few weeks after having the vaccine. If anyone gets these symptoms after vaccination, you should seek medical help, especially if these symptoms do not go away:
- seems pale, lethargic or floppy
- have tightness, heaviness, discomfort or pain in the chest or neck from the heart beating too quickly or skipping beats
- have difficulty breathing or catching their breath or faster breathing than normal
- gets breathless or sweaty while trying to breast or bottle feed
- feel faint, dizzy or light-headed.
If the child or young person experiences any of these symptoms in the days or weeks after the vaccine, they should see a doctor — there will be no charge for the consultation. You can also call Healthline on 0800 358 5453 any time to get advice.
If you have an immediate concern about their health, call 111, and make sure you tell them they have had a Pfizer COVID-19 vaccine.
Medsafe and the National Immunisation Programme continue to track reported side effects for this vaccine, including myocarditits and pericarditis.
Make a booking and find a vaccination centre
Not every vaccination site stocks the vaccines for the 6-month to 4-year age group, but there are lots of ways to find a site convenient for you. Book online or over the phone, or visit a walk-in or drive-through vaccination centre.
Book online using BookMyVaccine.nz. Choose the 6 months to 4 years age band from the dropdown menu.
Book over the phone by calling the COVID Vaccination Healthline on 0800 28 29 26. It is free to book over the phone, and the team is available from 8am to 8pm, 7 days a week.
You can ask for an interpreter if you need one. Translation services are available in over 40 languages, and there is the option to use NZ Relay Services.
It is a good idea to have your child’s NHI (National Health Index) number ready. This will make the booking process quicker. You can also make whānau group bookings when you call.
Not all COVID-19 vaccination sites offer vaccinations to young children. Your local doctor or pharmacy may be able to vaccinate your child. There may also be walk-in or drive-through centres.
If you have questions or concerns
If you would like to talk through any questions or worries, you can call the COVID Vaccination Healthline on 0800 28 29 26 from 8am to 8pm, 7 days a week.
The team can chat through your concerns and, if needed, can refer you to a medical professional.