COVID-19 vaccination for children and young people

The Joint Committee on Vaccination and Immunisation and the Chief Medical Officers have been advising whether COVID-19 vaccinations should be offered to children and young people.

Updated: 22 December 2021

Who will be offered COVID-19 vaccinations?

Since July, the Joint Committee on Vaccination and Immunisation (JCVI) and the UK Chief Medical Officers (CMOs) have been advising on how the COVID-19 vaccination programme may be applied to children and young people. This advice covers primary doses and booster doses. 

What is the advice on primary doses?

The JCVI’s advice on primary doses is as follows:

5-11 year olds at higher clinical risk*

Two 10mcg doses of Pfizer-BioNTech, at least 8 weeks

5-11 year olds who are household contacts of someone who is immunosuppressed

Two 10mcg doses of Pfizer-BioNTech at least 8 weeks apart 

NB – For 5-11 year olds above, JCVI advise that there should be a minimum 4 week interval between any vaccine dose and recent COVID-19 infection.

12-15 year olds at higher clinical risk*

Two 30mcg doses of Pfizer-BioNTech, at least 8 weeks apart 

12-17 year olds who are household contacts of someone who is immunosuppressed

Two 30mcg doses of Pfizer-BioNTech, at least 12 weeks apart

12-17 year olds who are severely immunosuppressed**

Three 30mcg doses of Pfizer-BioNTech, at least 8 weeks apart

A specialist paediatrician should advise whether the child or young person meets the eligibility criteria and on the timing of the third dose.

12-17 year olds not in groups specified above

Two 30 mcg doses of Pfizer-BioNTech, at least 12 weeks apart

NB –the Green Book provides advice on dosing intervals following recent COVID-19 infection.

* clinical risk as defined in Table 4 of the Green Book chapter on Covid-19

** criteria for a third primary dose are listed the Green Book chapter on Covid-19

What about booster doses for children and young people? 

On 22 December 2021, JCVI advised that booster doses of 30mcg of Pfizer-BioNTech should be offered no sooner than 3 months after completing the primary doses to: 

  • 16 & 17 year olds
  • 12-15 year olds in a clinical risk group
  • 12-15 year olds who are household contacts of someone who is immunosuppressed
  • 12-15 year olds who are severely immunosuppressed and have had a third primary dose

When will those who are now eligible be able to get their vaccinations?

The four health services across the UK are now developing and rolling out their plans. Different approaches will be taken across the country. We anticipate that children aged 5-11 years who are now eligible will be invited for vaccination from mid January 2022.

The Governments and NHS vaccine programmes should provide clear and consistent information for children and young people, families and clinicians about these next steps.

In England further information has been published on nhs.uk

Details of the Northern Ireland vaccination programme is available on the nidirect government services website.  

In Scotland, further information has been provided by NHS Inform.

Further details of the Welsh Government’s vaccination programme is available on the GOV.WALES website.

What information will be provided to children, young people and their families about this?

The JCVI and CMOs have noted that the risks and benefits around COVID-19 vaccination for children and young people are more finely balanced than for older age groups. Information provided should cover all the details needed to ensure informed consent can be given by the 12-17 year old. For those aged 5-11, a parent or carer will need to provide that informed consent

For those who are household contacts of a person who is immunosuppressed - vaccination should be offered on the understanding that the main benefits are related to the potential for indirect protection of that household contact.

Information about the vaccine, its safety and side effects has been published by the UK Health Security Agency.

What information will be available to support healthcare professionals?

The Green Book has been updated with the clinical criteria included in this phase of the vaccination programme, the evidence base, potential safety and side effects, and recommended dosing intervals (which vary according to age, risk profile and time since a confirmed COVID-19 infection). This information should support clinicians discuss risks and benefits of vaccination with children, young people and their families.

Product information about individual vaccines is available from the MHRA. Two formulations of the Pfizer BioNTech vaccine have been authorised for use: a paediatric formulation for 5-11 year olds and an adult formulation for those aged 12 and over. The Moderna vaccine are authorised for use in 12-17 year olds. Other vaccines have yet to be authorised for under 18s in the UK.

Is the paediatric formulation available in the UK?

The paediatric formulation of the vaccination for 5-11 year olds is not yet available in the UK. Using a smaller dose of adult vaccine, or medicine, for children off-licence in the way described by the JCVI is not unusual. This will be done by a qualified practitioner with the right training and safeguards in place. It would be perfectly reasonable, however, to delay vaccination until the paediatric formulation arrives in the UK, if parents wish to do so.
 

What about COVID-19 vaccination for healthy 5 - 11 year olds?

Any advice on whether COVID-19 vaccinations should be offered to all 5-11 year olds would follow the same decision-making process, starting from trials, through authorisation by MHRA, advice from JCVI, and then agreement from Ministers. We are aware of the many hours of intense scrutiny the JCVI has given to the issue of assessing the health benefits and risks of healthy 12-15 year olds being offered the vaccine. JCVI will be reviewing evidence and data and applying the same level of scrutiny to younger age groups. 

RCPCH does not yet have a view on COVID-19 vaccinations for healthy 5-11 year olds and we are awaiting advice from JCVI. We will also be actively reflecting on the ethical questions that arise from considering the risks and benefits to children receiving COVID-19 vaccinations. 

What’s the College’s view on myocarditis?

We don’t know the long-term issues from vaccination, but nor do we have a full understanding of the long-term issues from COVID-19. All suspected side effects to COVID-19 vaccines should be reported to the MHRA through the Yellow Card Scheme. The College looks to JCVI to review the evidence and data and provide advice on risk.

What about other routine childhood vaccinations?

JCVI has stressed the importance of ensuring that other routine immunisations for children and young people are maintained given the benefits they offer. National immunisation programmes are proven to be highly effective at preventing disease, reducing serious and sometimes life-threatening diseases such as meningitis and measles.

As we note in our position statement on vaccinations, paediatricians and child health professionals can support national vaccination programmes through their work by making every contact count. Some groups are at greater risk of low vaccine uptake, including children in large families, children in lone parent families, looked after children, children in mobile families including the travelling community, children in some ethnic minority groups, children with chronic conditions or disability. Children’s immunisation status should form part of any assessment. If vaccines are not up to date, the reason should be established. Parents may have delayed or refused vaccines for a variety of reasons and parents should be offered the opportunity to discuss their concerns.

What’s the College’s response to the new Omicron variant?

We are keeping a watching brief on the developing situation and will update our FAQs as soon as we know more.

Latest updates to this page

  • Update in this version (22 December) to reflect JCVI’s advice on 22 December
  • Update in version (8 December) to note our watching brief on the new Omicron variant
  • Update in version (2 December) reflecting updated JCVI advice on 29 November 2021
  • Update in version (22 November) on vaccinations for under 12s
  • Update in version (18 November) to reflect JCVI advice on second doses for 16 & 17 year olds not in at-risk groups
  • Update in version (14 September) to reflect CMOs advice on vaccinations for healthy 12-15 year olds 
  • Update in version (3 September) to reflect JCVI advice on expanded list of 12-15 year olds with specific health conditions that are eligible for COVID-19 vaccination