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Information for parents and carers of children aged six months to four years who are at greater risk from COVID-19 infection



― What is COVID-19 or coronavirus?
Can my child have the COVID-19 vaccine?
― Is my child at risk from COVID-19 infection?
― My child has a severely weakened immune system. Will they need a third dose of the first COVID-19 vaccine?
― Is the COVID-19 vaccine safe for infants and children?
― Protection
― What happens next?
― What about giving consent?
― Are there any reasons why my child should not have the vaccine?
― Side effects
― Are there other, more serious side effects?
― What to do if you are concerned about symptoms
― Can my child catch COVID-19 from the vaccine?
― More information



What is COVID-19 or coronavirus?

COVID-19 is a very infectious respiratory disease caused by the SARS-CoV-2 virus. Very few infants and children with COVID-19 infection go on to be seriously ill. For most children, COVID-19 infection causes mild or no symptoms, but for a small number of children with health conditions the risk of serious illness is greater. Young children with certain health conditions are seven times more likely to be admitted to intensive care. 


Can my child have the COVID-19 vaccine?

Children aged six months to four years with health conditions that may put them at greater risk from COVID-19 will be offered the vaccination from May 2023. They will be offered two vaccines, with a gap of eight weeks between the first and second doses.

The vaccination will help to protect your child against COVID-19. They will be offered the Pfizer (Comirnaty 3 micrograms) vaccine, at a lower dose compared with that given to children aged five and above. The vaccine is safe and recommended for use in children.

Getting vaccinated is a safe and effective way to protect your child against serious illness and being admitted to hospital. 


Is my child at risk from COVID-19 infection? 

Coronavirus can affect anyone. For most children COVID-19 is a mild illness that rarely leads to complications. Some children are at greater risk, including those living with conditions such as: 

  • cancers (such as leukaemia or lymphoma);
  • diabetes;
  • serious heart problems;
  • chest problems or breathing difficulties, including poorly controlled asthma;
  • disease of the kidney, liver or gut;
  • a weakened immune system due to disease or treatment (for example, steroids, chemotherapy or radiotherapy);
  • an organ transplant;
  • a neurodisability or neuromuscular condition;
  • a severe learning disability;
  • Down’s syndrome;
  • a problem with their spleen, for example sickle cell disease, or if they have had their spleen removed;
  • epilepsy;
  • serious genetic problems; or
  • other serious medical conditions as advised by the doctor or specialist. 

For more information, go to:


My child has a severely weakened immune system. Will they need a third dose of the first COVID-19 vaccine?

Some children who have a severely weakened immune system may need an extra (third) dose of COVID-19 vaccine to make sure that they have better protection. This dose should be given at least eight weeks after their second dose. You can discuss this with your child’s medical specialist.


Is the COVID-19 vaccine safe for infants and children? 

All medicines and vaccines in the UK are closely monitored by the Medicines and Healthcare products Regulatory Agency (MHRA). They have approved the Pfizer vaccine for infants and children as it is safe and effective. For more information on the vaccine, see the patient information leaflet at:



The vaccine provides good protection against serious illness from COVID-19.

It may take a few weeks to build up protection from the vaccine. Like all medicines, no vaccine is completely effective – some children may still get COVID-19 despite having a vaccination, but the effects should be less severe. 

Children with a weakened immune system may not make a strong immune response to the vaccine, but it should offer them protection against serious illness.


What happens next? 

  • The NHS will give you information about when and where your child can have the vaccination. 
  • Babies aged from six to 12 months will have the vaccine in their thigh. Children older than 12 months will usually have it in the top of their arm or in their thigh.
  • On the day of the appointment your child should wear clothing which can be removed easily. Wearing loose clothing makes it easier to get to the top of the arm or the thigh.
  • Children may like to bring a favourite toy with them to play with while they wait. There are some ideas on how to reduce a child’s anxiety during vaccination at:


What about giving consent? 

As a parent or a carer with parental responsibility, you will be asked to give informed consent (permission) for your child to have the vaccine.

It is important that you understand the benefits and risks of vaccination. The nurse or person giving the vaccination will be able to discuss the vaccine and answer any questions at the appointment.


Are there any reasons why my child should not have the vaccine? 

There are very few children who cannot have the COVID-19 vaccine.

The vaccine should not be given to anyone who has had:

  • a confirmed serious allergic reaction (anaphylaxis) to any of the ingredients of the vaccine; or
  • a confirmed serious allergic reaction (anaphylaxis) to a previous dose of the same COVID-19 vaccine.

It is important that you tell the person giving your child the vaccine if they have ever had a serious allergic reaction.


Side effects 

Like all medicines, vaccines can cause side effects. Most of these are mild and don’t last long, and not everyone gets them. The most common side effects should only last a day or two. 

The most common side effects in the first day or two are: 

  • soreness and redness at the injection site; 
  • tiredness; and
  • fever.

Babies under two years old may also be irritable, sleepy and lose their appetite. 

Your child may have a mild fever for two to three days after the vaccination. However, a high temperature is unusual and may be because your child has another infection or illness. If you are worried, speak to your doctor or nurse. You can give your child liquid paracetamol, at the correct dose for their age, to help them feel better. It’s important to read the instructions on the bottle or speak to your pharmacist.

Remember – babies and children under 16 should not take medicines that contain aspirin.


Are there other, more serious side effects? 

Cases of inflammation of the heart (called myocarditis or pericarditis) have been reported very rarely after the Pfizer vaccine. 

Most children recover from these and feel better following rest and simple treatment.

Get medical advice urgently if you notice your child has the following side effects.
  • Chest pain
  • Shortness of breath
  • A fast-beating, fluttering or pounding heart


What to do if you are concerned about symptoms 

Symptoms following vaccination normally last less than a week.

If the symptoms seem to get worse or if you are concerned, you can visit online, call NHS 111 Wales by dialling 111, or contact your GP surgery.

If you get advice from a doctor or nurse, make sure you tell them about the vaccination (if possible, show them the vaccine record card) so that they can carry out a proper assessment.

Make sure you keep the vaccine record card safe.

You can report any side effects online at or on the Yellow Card app.


Can my child catch COVID-19 from the vaccine? 

No, they cannot catch COVID-19 from the vaccine. The vaccination will reduce the chance of your child suffering from COVID-19. 

If you need more information on symptoms, visit


More information

You can find more information and patient leaflets at:

You can find more information on vaccines offered in Wales at:

To find out how the NHS uses your information, visit:

If you have any questions or want more information, you can visit, talk to your doctor or nurse, or call NHS 111 Wales.

The leaflet this information is taken from was published in May 2023.
© Public Health Wales
Version 1. ISBN 978-1-83766-155-8