Guidance

COVID-19: a guide for parents of children 6 months to 11 years of age at high risk

Updated 9 September 2025

Applies to England

Children at higher risk from COVID-19 infection

Children whose immune systems don’t work as well (immunosuppression) are at serious risk from the complications of COVID-19 infection. 

Eligible children and young people who are aged 6 months to 11 years should have the COVID-19 vaccinations. Your GP or specialist will know if they need to have the vaccine.

What COVID-19 or coronavirus is

COVID-19 is a very infectious respiratory disease caused by the SARS-CoV-2 virus.

Most children who get COVID-19 infection have no symptoms. Those that do have mild symptoms like a bad cold.

A few children and young people will get very poorly and have to go to hospital.

About the vaccine

Infants and children will be offered the Pfizer COVID-19 vaccine. Younger children will be offered an infant dose (one tenth of the adult dose) whereas those over 5 years are offered one third of the adult dose. 

For children aged 6 months to 4 years the initial course is 2 doses, at least 8 weeks apart. Most children aged 5 to 11 years of age initially need one dose of vaccine but if they have a severely weakened immune system they may be offered a second dose, usually at least 8 weeks later. Your child may also need a booster during seasonal campaigns.

Knowing if your child should have a vaccine

Your GP (family doctor) or specialist should advise you about the COVID-19 vaccinations for your child. Some parents may receive a letter or a phone call to invite their child to be assessed to see if they are eligible for vaccination.

Protection from the vaccine

The vaccine doesn’t completely stop everyone from getting COVID-19 infection, but if they do, it should still stop them from becoming very poorly.

Side effects

Common side effects

Like all medicines, vaccines can cause side effects. These include:

• their arm feeling heavy or sore where they had the injection
• feeling achy or like they have the flu
• feeling tired
• having a headache

Most of these are mild and short term and not everyone gets them. These common side effects should only last a day or two.

If they feel feverish (like they are very hot or very cold) they should:

• rest
• take paracetamol (please check that the dose and type of paracetamol is correct for their age – you can find more information on paracetamol on NHS.UK)

They should feel better in less than a week.

The Pfizer vaccine tends to cause more of these common side effects after the second dose than the first dose.

Rare but serious side effects

Worldwide, there have been rare cases of inflammation of the heart reported after the adult dose of COVID-19 vaccines. This seems to be extremely rare after the children’s dose.

These cases have been seen within a few days of vaccination. Most people felt better after a few days of simple treatment.

You should seek medical advice urgently if your child experiences:

• chest pain
• shortness of breath
• feelings of having a fast-beating, fluttering or pounding heart

If you are worried about your child call 111 or go to the 111 website. Make sure you tell them about the vaccine, or show them your child’s record card.

If you think they have had a serious side effect from the vaccine you can report it using the Yellow Card scheme:

• online at Yellow Card Scheme
• downloading and using the Yellow Card app for Apple devices or Android devices
• by calling the Yellow Card scheme on 0800 731 6789 (9am to 5pm).

How to book your appointment

If you receive an invitation letter, it will explain how to make the appointment for your child. They may be offered it through a local GP practice, another vaccination site, or their specialist in clinics. You will get told where to go for your child’s vaccinations and when.

What to do next

When your child has had their first injection, you should get a record card. You should keep this card and bring it with you when taking your child for their next appointment. 

Your child’s GP or specialist will tell you when the next dose should be given. Some children will need a second dose about 8 weeks after their first dose. 

Keep their card safe and make sure you take your child to get their next injection.

How long the vaccine takes to work

It can take a few weeks for the vaccine to protect your child.

If your child is not well when it is their next appointment

Your child should not attend a vaccine appointment if they are self-isolating, waiting for a COVID-19 test or you are unsure if they are fit and well.

If your child has tested positive for COVID-19, you should wait until they are better before having the vaccine.

After the vaccine

You and your child can still reduce the chance of catching COVID-19 infections by:

• washing your hands and your child’s hands carefully and often
• following the current COVID-19 guidance

Signs of COVID-19

The most important symptoms of COVID-19 are recent onset of any of the following:

• a new and persistent cough
• a high temperature
• loss of smell or taste

If you or your child have the symptoms above, stay at home until you are well.

Further information on symptoms is available on NHS.UK.

If you cannot use the NHS website, phone 111 free of charge.

Respiratory and hand hygiene

Adopt good respiratory and hand hygiene practices:

Catch it – germs spread easily. Always carry tissues and use them to catch your cough or sneeze.

Bin it – germs can live for several hours on tissues. Dispose of your tissue as soon as possible.

Kill it – hands can transfer germs to every surface you touch. Clean your hands as soon as you can.

Order or download print copies

Paper copies of this leaflet will are available to order for free from Find Public Health Resources.

A PDF version is available to download.