Should I Get My Kid a COVID Booster Now… or Later?

Hi! Boosters for the 5 and up crowd are now available. Should we get one for our little kids or wait until it’s closer to back-to-school time to maximize immunity while in crowded indoor spaces in the fall? Summer activities tend to be more outdoors. However, we are seeing an uptick of cases in our area. Will there be a Flu/COVID booster combo in the fall? How can I decide what’s best?
—Mike

Starting off with an easy one here… or not. I do not think the answer here is completely obvious; I will run through a few facts which might help with the decision:

The booster dose in this age group, like the vaccine overall, looks to be very safe. Adverse reactions are the standard things like rash and swelling.
Kids in this age group are generally at low risk for serious illness, and even more so if fully vaccinated with two shots. From an illness protection standpoint, there is a good argument for vaccinating this group. However, the additional protection against serious illness delivered by a booster is likely to be extremely small for children (this is not true for more vulnerable older adults where the benefits are large). Once a child is fully vaccinated, their risk for serious illness is already really, really small.
Based on what we know from other age groups, boosters are likely to reduce the risk of infection and symptomatic illness over some relatively short period (several weeks to a few months).
Having COVID acts as a booster in terms of this infection risk reduction.

What I take from this is that giving a child in this age group a booster will deliver a short to moderate period of protection against infection. Even though they are very unlikely to get seriously ill, getting sick is disruptive, and kids could pass COVID to others. So, there is value in the booster, if moderate. In this sense, I think the way you ask the question is right: when do you want this period of greater protection?

In the longer run, I would expect we’ll see the flu/booster combo regularly in the fall. Whether that will happen this fall or not, I’m less sure. But you could certainly wait until the fall, although with current case rates I can also see a case for doing it now. I will say, I am having my kids boosted now because we are hoping to travel in June, I do not want to get stuck out of the country, and we are planning to see an immunocompromised grandparent.

One note: if your child recently had COVID (as in, within the last 90 days or so) it likely makes sense to wait since they effectively just had a booster so the benefits to another are small.

I am sure this answer will make a lot of people mad — on both sides — but the reality is that this decision isn’t obvious and reasonable people will make different choices. We can try to respect that (try! I said try!)