Atrium Health Levine Children’s medical experts answer questions about how safe and effective the Pfizer vaccine is for teens ages 12 and up. This is to help you make the best decision for your family.

Child Health, Coronavirus Updates

A Parent’s Guide to the Pfizer Vaccine for Teens

Atrium Health Levine Children’s medical experts answer questions about how safe and effective the Pfizer vaccine is for teens ages 12 and up. This is to help you make the best decision for your family.

As a parent, you want the best for your children. Throughout the pandemic, you have been working hard to protect your children and keep your family safe. However, ongoing efforts will be needed to make sure your family is safe as COVID-19 continues.

To help protect your family and your community, you may have already gotten your COVID-19 vaccine. But what about your children? Are you thinking about getting them vaccinated when you get the chance?

Many people assume that because COVID-19 hasn’t been reported to be as severe in children, getting the vaccine isn’t as necessary as it is in older patients. “COVID-19 infection isn’t always mild or harmless in children,” said Lyn Nuse, MD, specialty medical director of pediatric primary care at Atrium Health Levine Children’s. 

According to Dr. Nuse, children with COVID-19 can develop the following issues from the virus:

  • Multisystem inflammatory syndrome in children. It is a potentially severe condition that can affect many organs and result in damage to the kidneys, heart, brain and/or nervous system (may even cause death).
  • Lung problems.  This can lead to hospital or ICU care.
  • Long-term symptoms.  This includes ongoing inflammation or neurological issues such as chronic headaches and brain fog.

What about the goal of reaching herd immunity? “Children make up about 1 out of 4 of the population, so we need to get children vaccinated as well as adults in order to reach herd immunity,” noted Amina Ahmed, MD, pediatric infectious disease expert and epidemiologist at at Levine Children’s. “Since children tend to have less symptoms, they can spread the infection even if they don’t seem ill. So, it’s vital to get children vaccinated to break the cycle of spread.”

Highlighting the impact of herd immunity, Dr. Nuse added, “The more people we get vaccinated, the sooner we can get back to normal life, which includes school and social activities for our children.”

The FDA approved the Pfizer-BioNTech COVID-19 vaccine for emergency use authorization (EUA) in children age 12 and older. Dr. Nuse and Dr. Ahmed answer important questions about the Pfizer vaccine to help you make the best decision for your family.

What is an mRNA vaccine?

The Pfizer vaccine is a mRNA vaccine, a new type of vaccine that was developed using technology that researchers have studied for decades. In fact, the technology was originally developed in case we needed to mass-produce vaccines for a pandemic. 

The mRNA vaccine teaches our cells how to make a protein that looks like a piece of the COVID-19 virus. That protein is called a spike protein and is found on the surface of the COVID-19 virus. The spike protein triggers an immune response in the body. Basically, the body is tricked into thinking it has the virus and therefore makes antibodies against the virus. The antibodies protect you from getting sick if you are exposed to or infected with the virus.

Are mRNA vaccines safe for my child? 

mRNA vaccines are very safe. Because they do not have the COVID-19 virus, they cannot cause COVID-19. The mRNA does not interact with our DNA because it never enters the nucleus, where the DNA is housed. Once the mRNA is used to make the protein that triggers the immune response, the cell breaks down and gets rid of the mRNA. As we roll out vaccines for adults and children, the Centers for Disease Control and Prevention (CDC) will continue to look for any safety concerns with vigilance.

Should I be worried about how quickly mRNA vaccines were created? 

No. The government removed many barriers, including financial and logistical, that usually cause delays in vaccine development. Pharmaceutical companies shifted priorities away from other projects and focused all their resources on vaccine development.

Once we know the genes of a virus and its parts, mRNA vaccines are quick and easy to manufacture. All the rigorous processes and safety protocols that are embedded in any drug or vaccine development were followed in this process. 

What has research shown us about how effective the Pfizer vaccine is in teens? 

The trials for Pfizer included people 16 to 18 years old from the very beginning. Then, researchers started enrolling the next group of kids age 12 to 15. 

Since we had all the pre-existing data from the original studies of larger populations of patients, we didn’t need to study quite as many children. The study for teens 12 and older was open to people of all ethnic backgrounds and races to join.  The goal was to of include everyone. The original studies showed that the vaccine was 100% effective in at least preventing moderate to severe illness in teens. Based on the data, the vaccine appears to be as effective in teens as it is in adults.

What side effects should teens expect after getting the Pfizer vaccine?

We expect to see side effects in teens just like what we have seen in adults. All of these side effects are because the immune system is activated. The most common side effects are fatigue (tiredness), headache, muscle pain, chills, fever and nausea. People can also get redness or pain at the injection site.

Currently more than 13 million people between the ages of 12- and 15-years old are fully vaccinated and we have not seen a significant difference in side effects compared to older patients. There is an increased risk of myocarditis (inflammation of the heart) following vaccination, especially in males, after the second dose. But the side effect is rare – about 43 cases per 1 million patients – and significantly less than the risk of myocarditis from COVID-19 infection. We may see new side effects as more and more doses are given. That’s why we have ways for healthcare systems to report what happens so we can track new issues.

Will the vaccine affect my child’s future fertility? 

There is no evidence that the COVID-19 vaccine causes any problems with pregnancy or conception. We continue to be watchful about any unexpected side effects. The CDC is constantly monitoring everyone who gets the shot for these side effects.

If my child already had COVID-19, is it still safe to get the vaccine?

Yes. The only risk is that your child might have greater side effects because they already have some immunity from the infection. Since we don’t know how long natural immunity lasts, we recommend vaccination even in those who already had the COVID-19 virus. In people who have COVID-19 symptoms that last for weeks or months after the infection, there is some evidence that vaccination may help improve those symptoms. 

If my child has a chronic condition, such as asthma or cystic fibrosis, should they still get the vaccine? 

Yes. In fact, we encourage children (and adults) with chronic conditions to get vaccinated. This is because their risk of severe COVID-19 infection is greater. If you have specific concerns, talk to your child’s doctor.

After my child gets the Pfizer vaccine, can we stop wearing masks?

We still have much to learn about COVID-19 vaccines. Until we have more answers, do your best to prevent infection or spread of the virus. Continue using a mask and keep a physical distance from outside your home. Consider the following reasons:

  • The vaccines are not 100% effective, so anyone who is fully vaccinated can still become infected. Once infected, you can spread the infection to others.
  • Although the vaccines protect you from getting the virus and from having to be admitted to the hospital, it’s still possible that a vaccinated person may get the infection without becoming ill. In this case, spread is still possible.

Where can my child get the Pfizer vaccine? 

Atrium Health Levine Children’s offers the vaccine to this age group at pediatric primary care and family medicine offices throughout the area. Visit for more details or to schedule.

Can my child get a booster?

Who is considered ‘immunocompromised’ and eligible for a 3rd dose?

In August 2021, the Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC) and the North Carolina Department of Health and Human Services (NCDHHS) recommend a 3rd dose of the mRNA COVID-19 vaccine for: People whose immune systems are moderately or severely compromised (weakened). In January 2022, that recommendation was extended to include children ages 5-11 years old.

The CDC recommends immunocompromised (moderate or severe) people get an extra dose. This includes those who have:

  • Been receiving active cancer treatment for tumors or cancers of the blood
  • Received an organ transplant and are taking medicine to suppress the immune system
  • Received a stem cell transplant within the last 2 years or are taking medicine to suppress the immune system
  • Moderate to severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Adlrich syndrome)
  • Advanced or untreated HIV infection
  • Been getting treatment with high-dose corticosteroids or other drugs that may suppress your immune response

The CDC recommends parents or caregivers talk to their child’s healthcare provider about their medical condition. This will help them know if getting a 3rd dose is needed. However, patients do not need a referral or letter from their doctor to receive their 3rd dose.

Why is a 3rd dose needed?

The 3rd dose will help anyone with a weakened immune system to have stronger protection against COVID-19.  This is since they are more likely to have an infection after getting the vaccine. Studies have shown 2 doses of the COVID-19 vaccine are less effective in this group compared to those without chronic conditions. CDC recommends an extra dose of an mRNA COVID-19 vaccine be given at least 4 weeks after a second dose of Pfizer-BioNTech COVID-19 vaccine.

If your child is younger than 12 and eligible for the Pfizer vaccine for 5-11-year-olds, click here to learn more.

For more information about COVID-19 vaccines and how to schedule an appointment, visit