Your coronavirus questions, answered: Which dose of the vaccine will be right for ‘cusp kids’?

By — Becky in Illinois,

If my daughter will turn 12 in January but the vaccine for 5- to 11-year-olds comes out in early November, should she get the 5-11 vaccine even though within two months her age would make her eligible for a much higher dose? For example, I heard that the vaccine for 5-11 is one-third the dosage as that used for 12-17. What do you recommend for “cusp” kids?

— Becky in Illinois

This is one of the most common questions we’re getting right now.

Recently, we answered a question about whether weight should make a difference for “cusp kids.” But what about kids like your daughter — should they wait a short time for a higher dose? Especially when kids have already waited for a vaccine for so long?

Pediatricians’ advice is to wait for official recommendations from federal health authorities. That said, some pediatricians do not anticipate that the guidelines for the coronavirus vaccine will be much different from many other vaccines given to children on the cusp of an age dividing line.

For instance, the dose of vaccines like the influenza vaccine vary depending on the age of the child, said Suzanne Berman, a pediatrician in Crossville, Tenn. “Different volumes for different aged people is not new to pediatrics. Basically, whatever age you are on the date you are ready for that dose, that’s what you get,” she explained.

Indeed, it may seem strange, particularly for children who are, say, 11 when they get the first dose of the coronavirus vaccine and have turned 12 in time for the second — placing them in two different age categories with different dose recommendations. It’s unclear how federal health authorities will advise pediatricians and parents to handle such situations. But Berman said if the guidance is similar to that of other vaccines, the child would get the lower dose at 11 and then the higher dose at 12.

One thing Berman said she would not advise is waiting for the child’s birthday before getting her vaccinated.

“Waiting is perilous,” she said, explaining it is not worth risking covid-19 to wait for a higher dose of the vaccine. “My strongest advice is to get the dose that’s appropriate for whatever age kid you have at the time when you can get it.”

In the end, whether your 11-year-old gets the 10-microgram dose of the Pfizer-BioNTech vaccine or, at age 12, gets the 30-microgram dose, it’s not a huge deal, said Paul Offit, a pediatrician and the director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“It is somewhat arbitrary to try to draw a line with regard to these doses. I think the bottom line is [they] all work,” he said.

Experts said to keep an eye out for the official guidance and then talk to your child’s pediatrician if you have questions.

— Lindsey Bever

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