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Should an 11-year-old get the lower COVID vaccine dose?

The most common question I received in the last week is:

If my child is 11 right now but will be 12 soon, should I get them vaccinated at the lower dose of the COVID-19 vaccine or wait so they can get the higher dose when they turn 12?

Here is insight from this week’s FDA advisory panel meeting. The answer was somewhat technical.

It focused around a slide (view in the video above) that shows before and after with the lower dose for 5 to 11-year-olds. The graph shows the increase in antibody levels was the same for those in 9 to 11-year-olds. So the lower dose would be equally effective.

Read more: FDA panel backs Pfizer’s low-dose COVID-19 vaccine for kids

The lower 5 to 11-year-old dose increases antibody levels as well as the higher dose given to those 12 and older. So there’s no additional benefit to waiting to qualify for the higher dose.

That’s the long technical answer.

The simple bottom line is that there is no reason to wait to get the vaccine if a child is about to turn 12. Either dose will be just as effective in a 12-year-old child.

That brings up a little logical question which was asked by Dr. Ronald Monto of the University of Michigan: What would happen if you gave a lower dose to a 12-year-old?

There’s the potential, although we don’t have the data to show it, that it would provide an antibody response. And we have some possibility of looking at that in the future.

In reality, you’re going to be given whatever dose is recommended based on your child’s age. One benefit to getting the lower dose is that it appears to offer the best balance between generating antibodies and reducing side effects.

Why is it age-based, not weight-based?

Meanwhile, some wonder if it’s better to be weight-based rather than age-based. That is true when it comes to drugs, but vaccines don’t work like that. It’s the response of the immune system. Children’s immune systems are more responsive. That starts to change as they enter puberty and reach adulthood.

So while it may be arbitrary, you have to put the dividing line somewhere, and 12 is roughly about the time puberty starts.


About the Author
Frank McGeorge, MD headshot

Dr. McGeorge can be seen on Local 4 News helping Metro Detroiters with health concerns when he isn't helping save lives in the emergency room at Henry Ford Hospital.

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