Vaccination of 6 months-4 years: answering parents’ questions

2023-07-03 16:22:44

On October 19, 2022, the European Medicines Agency issued a positive opinion concerning the use of the pediatric form of the COMIRNATY vaccine from Pfizer-BioNTech laboratories for children aged 6 months to 4 years. This is a form of the vaccine specifically adapted to this age group, with a dosage of 3 µg of mRNA per dose, different from the form of the vaccine adapted to children aged 5 to 11 (10 µg of mRNA per dose).

The Haute Autorité de santé recommends, in its opinion of December 15, 2022, to open vaccination to children aged 6 months to 4 years at risk of a severe form of Covid-19 as well as to children in this same age group. living in the entourage of an immunocompromised person, with the aforementioned vaccine.

The education and support of children and their parents by health professionals is essential to the success of this vaccination.

Find below the main information to help you answer parents’ questions.

Which children from 6 months to 4 years are concerned?

The vaccination campaign concerns children aged 6 months to 4 years with at least one comorbidity identified by HAS.

The list of comorbidities brings together all the comorbidities previously identified in adults as potentially carrying a risk of developing a serious form of the disease, as well as certain pathologies particularly at risk for this age group, the list of which is as follows: :

congenital heart disease; Chronic liver diseases; Chronic heart and respiratory diseases (including severe asthma requiring ongoing treatment); Neurological diseases; Primary or drug-induced immunodeficiency; Obesity; Diabetes ; Hematological malignancies; sickle cell disease; Trisomy 21.

To these pathologies can be added situations where, on a case-by-case basis, on the basis of a strict assessment of the individual benefit/risk ratio, doctors specializing in organs and rare diseases can offer vaccination to children because a vulnerability conferring a major risk of a severe form of Covid-19.

The vaccination campaign also concerns children aged 6 months to 4 years living with an immunocompromised person as part of the cocooning strategy.

What vaccine is given to children 6 months to 4 years old?

Children from 6 months to 4 years old receive a specific form of the Pfizer vaccine, dosed at 3µg per dose and therefore adapted to their age group. This therefore differs from the pediatric form of the Pfizer vaccine suitable for children aged 5 to 11 (10µg/dose).

How many doses do children 6 months to 4 years old need?

Children aged 6 months to 4 years eligible for vaccination once morest Covid-19 must receive 3 doses of the specific form of the Pfizer vaccine in order to complete their initial vaccination schedule (primo-vaccination).

Because the protection provided by the first two doses of vaccine is not enough, it is very important to complete any vaccination schedule started in order to obtain optimal protection.

What are the time limits between each injection?

The first two doses should be given 3 weeks apart, and the third dose should be given 8 weeks following the second.

Who can vaccinate children from 6 months to 4 years old?

This vaccination concerns very young children suffering from serious pathologies, only doctors are authorized to prescribe and administer the vaccine. The time of the prescription thus constitutes a privileged moment to explain the act and its importance to the parents, to answer their questions and to support them as best as possible in the process of vaccinating their child.

Midwives and state-qualified nurses (IDE), in particular child care nurses, who are used to vaccinating children in this age group, are authorized to administer the vaccine to them as soon as the child it was prescribed by a doctor.

As for the vaccination of other minors, the vaccination of children aged 6 months to 4 years requires the authorization of both parents, unless it is impossible for one of the two parents to obtain the agreement of the other parent. On the other hand, it is not necessary for the child to be accompanied by one of his parents. The person accompanying him must be able to establish that he has parental consent and present a parental authorization form duly signed by both parents.

The parental consent form is available here, and should be given to staff at the vaccination site. Parental consent forms should be kept for 3 months following vaccination.

How many doses should a child aged 6 months to 4 years who has already been infected with Covid-19 receive?

The primary vaccination of children aged 6 months to 4 years includes the injection, intramuscularly, of 3 doses of the form of the vaccine specific to this age group (3 µg/dose). The first two doses should be given 3 weeks apart. The third injection must be performed 8 weeks following the second.

Even in the event of Covid-19 infection occurring before the start of the vaccination schedule or between the different injections (example: infection occurring before the 1st injection, or between the 1st and 2nd injection or between the 2nd and 3rd injection), the three doses must ultimately be carried out, to guarantee optimal protection.

In the event of infection with Covid-19, a period of 3 months must be respected between the infection and the injection. Thus, a child who receives his first dose on February 1, and who should therefore have received his second dose on February 22, but contracts Covid on February 8, will have to perform his second injection 3 months later, therefore on April 1. The same logic applies for infections occurring between the second dose and the third dose.

It is important to complete a vaccination schedule that has been initiated. Indeed, the protection provided by only two doses of vaccine for this age group is insufficient. Protection is optimal following the third injection.

It is also possible to receive another vaccine from the vaccination schedule concomitantly with the COMIRNATY 6 months – 4 years vaccine. If these are not administered on the same day, there is no specific delay between the two injections.

Does the vaccination once morest Covid-19 of children aged 6 months to 4 years conflict with the other vaccinations that they must receive during their childhood?

It is perfectly possible for a child to receive another vaccine from the vaccination schedule at the same time as the vaccine once morest Covid-19. If these are not administered on the same day, there is no specific delay between the two injections.

What are the rules for vaccinating a child?

As for the vaccination of other minors, the vaccination of children aged 6 months to 4 years requires the authorization of both parents, unless it is impossible for one of the two parents to obtain the agreement of the other parent. On the other hand, it is not necessary for the child to be accompanied by one of his parents. The person accompanying him must be able to establish that he has parental consent and present a parental authorization form duly signed by both parents.

The parental consent form is available here, and should be given to staff at the vaccination site.

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