COVID-19 vaccine: Ages 6 months to 4 years old

A paediatric Pfizer vaccine which contains a lower dose of mRNA is now available for tamariki aged 6 months to 4 years who are at higher risk of severe disease from COVID-19. This is a 3 dose course.

Last updated: 9 February 2023

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Eligibility criteria for tamariki aged 6 months to 4 years 

Not all children between the ages of 6 months and 4 years can have a COVID-19 vaccine. Eligible children include those who are severely immunocompromised, or who have complex and/or multiple health conditions (comorbidities) which increase the risk of severe COVID-19. These are: 

  • chronic lung disease including bronchiectasis, cystic fibrosis, BiPAP for OSA
  • complex congenital heart disease, acquired heart disease or congestive heart failure 
  • diabetes (insulin-dependent) 
  • chronic kidney disease (GFR <15 ml/min/1.73m2) 
  • severe cerebral palsy (or severe neurodisability including neuromuscular disorders)  
  • complex genetic, metabolic disease or multiple congenital anomalies for example trisomy 21/Downs Syndrome 
  • primary or acquired immunodeficiency 
  • haematologic malignancy and/or post-transplant (solid organ or HSCT in last 24 months) 
  • on immunosuppressive treatment including chemotherapy, high-dose corticosteroids (Prednisone 2 mg/kg/day for more than 1 week, or 1 mg/kg/day for more than 1 month), biologics or DMARDS. 

More detailed information on the eligibility criteria can be found in the Starship table of underlying comorbidities
Your child’s usual doctor, nurse, or healthcare provider can give you guidance on whether they are eligible for this vaccine. 

Eligible tamariki need 3 doses

Eligible children need 3 doses of the paediatric Pfizer COVID-19 vaccine, with the second dose given 3 weeks after the first dose, followed by a third dose given at least 8 weeks after the second dose.

Tamariki not eligible

Children aged 6 months to 4 years who do not have these health conditions have a very low likelihood of severe illness from COVID-19 infection and are therefore not eligible to have the vaccine. If you are unsure if your child is eligible, contact your doctor, nurse, or healthcare provider. 

Booking appointments for children aged 6 months to 4 years

Bookings can be made online or over the phone. Only a small number of locations across the motu (country) can administer COVID-19 immunisations for this age group. 

To check where the nearest vaccination site is to you, search the vaccination site map. Make sure you search the age band ‘6 months to 4 years’. 

Vaccination site map 

Online bookings 

You can book COVID-19 vaccinations for tamariki aged 6 months to 4 years old through Book My Vaccine. 

Make sure you select the ‘6 months to 4 years’ age-band. This is so we can direct you to a location that offers vaccinations for this age group. 

Book My Vaccine 

Over the phone 

You can make a booking over the phone by calling the COVID Vaccination Healthline team on 0800 28 29 26 (8am to 8pm, 7 days a week). 

Translation services are available in over 40 languages and there's the option to use NZ Relay Services. 

Giving consent 

Consent for vaccination needs to be given by a legal guardian of the child. 

A responsible adult needs to accompany the child to their appointment(s). This may be a parent, an adult family member, trusted family friend, legal power of attorney, or whanaungatanga carer. 

If the adult who accompanies the child to the appointment is not the child’s legal guardian: 

  • the vaccinator will need to verbally confirm by phone with a legal guardian that they consent to the child being vaccinated, or 
  • the responsible adult can bring a signed copy of the COVID-19 vaccination consent form completed by a guardian. 

This is standard consenting process.

Common questions and concerns

Is the vaccine safe for my child? Has it been tested? 

Medsafe is responsible for approving the use of all medicines and vaccines in New Zealand. They only approve a vaccine in Aotearoa once they are satisfied it has met strict standards for safety, efficacy, and quality. 

The trials in children aged 6 months to 4 years showed the vaccine continues to have an excellent safety profile and that side effects are generally mild. The vaccine has been used in this age group worldwide since the second half of 2022. 

What is the wait time for a vaccine if a child has had COVID-19?

To get the most benefit from the vaccine it’s recommended to wait at least 3 months after a positive test, before getting any COVID-19 vaccination. 

My child does not meet the eligibility criteria for a vaccination – why can’t they have one? 

The vaccine is currently unavailable for otherwise healthy children who are not in high-risk categories for severe COVID-19. These children have a very low likelihood of severe illness from COVID-19. 

Can a child have their second vaccination sooner than 3 weeks? Or their third vaccination sooner than 8 weeks after the second vaccination? 

No. The trials showed that the immune response is best with these gaps between doses.   

What happens if a child turns 5 after their first dose? 

 Any child who has their first dose under the age of 5 will still need three doses - even if they turn 5 after their first or second dose. Any dose given after the age of 5 (whether the second or third dose) will be the Pfizer vaccine used for 5- to 11-year-olds. The spacing between the doses remains the same – the second dose is given 3 weeks after the first dose, and the third dose at least 8 weeks after the second dose. 

Will tamariki aged 6 months to 4 years need a booster? 

No. Children under the age of 16 are not eligible for a booster.  

What if my child is big for their age? Can they have the 5 to 11 or adult Pfizer dose? 

The weight or body mass of the child is not related to the immune response. The maturity of the immune system is what matters, which depends on the age of the child. Children’s immune systems are different from adult immune systems. Children under 12 produce an appropriately strong immune response with 2 doses of the paediatric vaccine for 5- to 11-year-olds, or 3 doses of the paediatric vaccine for children 6 months to 4 years old. 

What side effects do children experience from the vaccine? 

The side effects of vaccination in children are similar to those seen in adults. These side effects are generally mild and should only last 1 or 2 days. The most common side effects are: 

  • a sore arm from your injection – you can put a cold cloth or ice pack on it to feel better 
  • a headache
  • feeling tired 
  • feeling feverish or sweaty 
  • nausea 
  • aching muscles. 

After vaccination they will need to stay for at least 20 minutes so that a health professional can monitor for any severe reactions. Vaccinators are trained to recognise these symptoms and have the appropriate equipment to treat people on site.  Young children can’t always express how they feel, so if they seem unwell or miserable get them to rest and drink plenty of fluids. They should avoid vigorous exercise, like running around or swimming. Paracetamol can be taken (following instructions on packaging, or as given by your doctor or pharmacist) after vaccination if they seem miserable or in pain. If you have any concerns, contact Healthline on 0800 358 5453 or take your child to seek medical attention. 
You will also be given a leaflet with information on caring for your children after they have received a COVID-19 vaccine. 

Myocarditis and pericarditis 

Myocarditis is an inflammation of the heart muscle, and pericarditis is inflammation of the tissue forming a sac around the heart. Both can be mild or serious. They are usually caused by viruses, such as COVID-19, but are also very rare side effects of the Pfizercovid-19 vaccine. 

These conditions are most commonly seen in adolescents and young adults, and are very rare in children under 12 years of age. The clinical trial in children aged 6 months to 4 years did not have enough participants to assess rates of heart inflammation after vaccination with the Pfizer COVID-19 vaccine. The benefits of vaccination are considered to outweigh this potential risk for infants and children in this age group who are at increased risk of severe illness from COVID-19 infection. 

In older people symptoms of myocarditis and pericarditis linked to the Pfizer COVID-19 vaccine generally appear after a few days, and mostly within the first few weeks after having the vaccine. If a child gets these symptoms after vaccination, you should seek medical help, especially if these symptoms do not go away. 

  • Seems pale, lethargic or floppy 
  • has discomfort, or a funny feeling in the chest or neck caused by the heart beating too quickly or skipping beats 
  • has difficulty breathing or catching their breath or faster breathing than normal 
  • Gets breathless or sweaty while trying to breast or bottle feed 
  • feels faint, dizzy or light-headed. 

If the child experiences any of these symptoms in the days or weeks after the vaccine, they should see a doctor – there will be no charge for the consultation. You can also call Healthline on 0800 358 5453 anytime to get advice. 

If you have an immediate concern about their health, call 111, and make sure you tell them they’ve had a COVID-19 Pfizer vaccine. 

Medsafe and the National Immunisation Programme continue to monitor reported side effects for this vaccine, including myocarditis and pericarditis. 

Can a child have the vaccine if they have an allergy? 

As with all medicines, there is a risk of an allergic response after this vaccine. This is why everyone is asked to wait for at least 20 minutes. The Pfizer COVID-19 vaccine is safe for people with food allergies. Unlike some other vaccines, there are no plant or animal products in the Pfizer COVID-19 vaccine. The only reason that someone may not be able to have this vaccine due to allergy is if they have had a severe allergic response (anaphylaxis) to a previous dose of the Pfizer vaccine. 
If a child has a history of anaphylaxis to other products, including food, medicines or other vaccines, they can still have this vaccine but are asked to stay a little longer (at least 30 minutes) for monitoring. Vaccinators are trained to recognise these symptoms and have the appropriate equipment to treat people on site. 

Can a child get other immunisations at the same time? 

Yes, it is OK to get several vaccines at the same time. Some immunisation clinics may also offer other childhood immunisations at the same time such as the MMR and flu vaccines.  

Ask another question 

If you have another question, you can call Healthline on 0800 28 29 26 from 8am to 8pm, 7 days a week. The team will be able to chat through your concerns and, if needed, can refer you to a medical professional. 

Chat to the disability team

The team is made up of people who have experience of a disability themselves, or who have worked with the disabled community. 

They can answer any questions about:

  • accessibility arrangements at different vaccination centres 
  • getting your vaccination safely 
  • home vaccinations 
  • any effects the vaccine may have on the child or medications. 

The disability team is available Monday to Friday, from 8am to 8pm. 

Call: 0800 28 29 26 and push 2 
Free text: 8988 
Email: [email protected] 

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