Several El Paso clinics have begun rolling out COVID-19 vaccines for children ages 6 months through 4 years, following last week’s approval from the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention.

Texas pre-ordered vaccines in anticipation of the long-awaited approval for the last age group to become eligible.

While those under 18 are far less vulnerable to severe illness or death from COVID-19 compared to older age groups, children can develop long COVID-19 or multisystem inflammatory syndrome, an uncommon but serious condition associated with the virus.

Children can also infect those who are at higher risk from COVID-19, such as people who are immunocompromised and the elderly, said El Paso City-County Health Authority Dr. Hector Ocaranza.

“For example, some children go to school, daycare, preschool. They would go home, be sick and affect the grandparents,” Ocaranza said. “We have a lot of households that are multi-generational.”

Vaccinating children and continuing to provide the booster shot to the high-risk population offers the best chance at avoiding hospitalization, Ocaranza said.

El Paso Matters spoke to several health care professionals to answer your questions about the new vaccines.

After COVID-19 vaccines were approved for children under 5 years old, two sisters were the first to get vaccinated at Immunize El Paso’s Eastside clinic on June 20. (Courtesy of Immunize El Paso)

How does the COVID-19 vaccine for infants and toddlers differ from the vaccine for adults?

Two vaccines are approved for children ages 6 months to 5 years: Pfizer-BioNTech and Moderna. Both use mRNA, a molecule that teaches the cells how to recognize and react to the coronavirus. Neither vaccine contains the virus itself.

The Pfizer vaccine requires three doses. Children under 5 should receive the second dose at least three weeks after the first, and the third dose at least two months after the second. Each dose contains 3 micrograms of mRNA, compared to the adult dose that contains 30 micrograms.

The Moderna vaccine requires two doses, spaced at least four weeks apart. Each dose contains 25 micrograms of mRNA, compared to the adult dose containing 100 micrograms.

How effective are the COVID-19 vaccines for children under 5?

In clinical trials from both Pfizer and Moderna, the immune response in the under 5 age group was comparable to adults, according to an FDA analysis. Among 5,400 children who did not previously have COVID-19, the Moderna vaccine was about 37% to 51% effective in preventing symptomatic COVID-19. Among participants in the Pfizer trial, there were not enough COVID-19 cases among participants to determine its effectiveness. 

More than 31,000 COVID-19 cases in El Paso County belonged to children ages 12 and under, or 12.4% of all cases in the county since the start of the pandemic, according to the city’s June 21 report. (The CDC did not approve COVID-19 vaccines for children ages 5 to 11 until November 2021.)

Dr. Jeffrey Schuster, chief medical officer at El Paso Children’s Hospital, likened getting the vaccine to wearing a seatbelt in the car or helmet while riding a bicycle: While neither precautions are a guarantee against injury if someone gets in a wreck, they help reduce the chance of serious injury and even death.

The key point is that vaccines reduce the risk of serious illness from COVID-19, he said.

Students returned to in-person learning Jan. 19, 2021 at Dr. Joseph E. Torres Elementary School in Northeast El Paso. (Photo courtesy of El Paso Independent School District)

Even if a child has already gotten COVID-19, data shows that the vaccine still provides protection, Schuster added.

José Luis Salas, infection control director at El Paso Children’s Hospital, said that inoculating all age groups is a step toward achieving herd immunity, which is when a large portion of a community becomes immune to a disease, limiting further spread. Vaccination is how communities have eradicated other infectious diseases, like measles — which has made a recent comeback in areas where parents did not vaccinate their children.

Does the vaccine protect children from long COVID-19 or multisystem inflammatory syndrome?

Multisystem inflammatory syndrome in children, or MIS-C, was first reported in spring 2020, within four to six weeks of the first wave of COVID-19 in both the U.S. and U.K, said Dr. Glenn Fennelly, chair of pediatrics at Texas Tech University Health Sciences Center El Paso.

There have been 605 cases of MIS-C identified in Texas, as of April 28, according to the Texas Department of State Health Services. Three of those cases were in West Texas.

While the condition is rare and treatable, it can also be dangerous, particularly if children have other underlying health conditions.

MIS-C involves inflammation in two or more organs or systems, such as the heart, kidneys, lungs, brain, blood vessels and digestive system. It typically appears in children two to four weeks after they’ve been infected with COVID-19. Common symptoms include fatigue or dizziness, red eyes, rash, diarrhea or vomiting, and fever.

The COVID-19 vaccine protects children against MIS-C, and if they do get it, it’s much less severe, Fennelly said.

Long COVID-19 is trickier to identify because there’s not a set of parameters that everyone agrees on, Fennelly said. Long COVID-19 has symptoms that can linger for months after initial infection. They range from mild to debilitating and include shortness of breath, heart palpitations and muscle aches.

Long COVID-19 affects both children and adults, and between 24,000 and 73,000 people in El Paso may have suffered from it, El Paso Matters reported in May.

Studies vary on how effective vaccines are against long COVID-19. But Fennelly said the COVID-19 vaccine is still beneficial since it lowers the chances of getting COVID-19 in the first place, as well as protects against severe symptoms.

What are the side effects COVID-19 vaccines for children under 5?

Reported side effects included redness and swelling at the injection site, and fever.

“Overall when you have a large population, of course you will see side effects,” Salas said. “Of course it’s going to hurt where you are getting poked at the site. … Pain at the insertion site, a little redness, those are indications that your immune system is being tested. That is what we want.”

Reports of myocarditis, an inflammation of the heart muscle, have caused some to skip the COVID-19 vaccine. But people are at a much higher risk of myocarditis if they get COVID-19, Schuster said.

Overall, the risk of health complications from COVID-19 are far greater than the risks associated with the vaccine, Schuster said.

He encourages parents whose children have comorbidities to prioritize getting their child vaccinated to prevent the risk of severe illness. That includes children who live with older family members who have comorbidities, such as diabetes, chronic lung disease and cardiovascular disease.

This was how Amanda Beltran came to the decision to vaccinate her then-5-year-old daughter Emory last fall when Emory became eligible for the vaccine.

Emory was born with a rare congenital disorder and spent the first six months of her life intubated in the hospital. She also has asthma. Common cold symptoms for one kid might mean a couple days of sniffles, Beltran said, but for Emory it can mean a month-long battle, weight loss and possible hospitalization. 

Six-year-old Emory Beltran has undergone extensive time in the hospital for her congenital condition. (Photo courtesy of Amanda Beltran)

Beltran’s mother, who works as a nurse’s aid for San Elizario Independent School District, has already seen children with lingering symptoms from COVID-19. While some of those children had pre-existing conditions, like asthma, others did not. Beltran didn’t want to take that chance with Emory.

“I have respect for everyone’s decision to take care of their family the way they see fit,” Beltran said. “In our case, I’ve seen my daughter in that fragile state in the hospital, relying on a ventilator to keep her alive. For us, the small possibility, whatever the statistics are for kids, that chance wasn’t worth taking for us.”

Emory experienced some soreness in the arm where she received the shot, and perhaps took an extra nap that evening. By the next day, she was “back to normal,” Beltran said.

How some El Paso parents are weighing the risk

Dr. Schuster of El Paso Children’s Hospital also advises parents with vaccine questions to talk to their pediatrician. 

That’s the approach Veronica Melendez is taking. She said she plans to vaccinate her 3-year-old son, Xavier, but is setting an appointment with her pediatrician to talk to him first.

Veronica Melendez of El Paso said she’s following her pediatrician’s guidance on vaccinating her 3-year-old son Xavier. (Photo courtesy of Veronica Melendez)

Melendez’s son has gotten CDC-recommended vaccines since he was baby, immunizing him against polio to measles. Xavier is fairly healthy and spends most of his time around friends and family who are already vaccinated.

“To be completely honest and transparent, it’s not the top of my priority list just yet,” Melendez said of the COVID-19 vaccine. “He does stay home and he doesn’t go to any kind of daycare or preschool at this moment. 100% if I was sending him to preschool in August, he would already be in the pediatrician’s office to get the vaccine.”

One motivation behind vaccinating her son is to protect her father, who’s 70 and lives at home with them. Both she and her father are fully vaccinated.

Melendez has personally seen how COVID-19 has affected older people. She worked as a speech pathologist at nursing facilities and a hospital earlier in the pandemic. She eventually left to work from home because she worried about the risk it brought to her son, a baby at the time, and her father.

“These patients were literally dying in front of your eyes,” Melendez said. “I had to leave that because it was a battlefield. It was not fun to see, to hear; none of that experience was good.

Beltran said that with Emory going to school in person, she wants her daughter to have a full experience like any other kid. She trusts other people to want the same — to keep themselves and their children safe — but recalled the comments she heard earlier in the pandemic, when El Paso was under lockdown.

“Everybody wanted their regular freedom and said, ‘Well you can keep your kids home.’ That kind of irked me,” Beltran said. “I wanted her to be educated, have fun, be around other kids — like your kids. When people said that, it felt like, ‘Disregard the elderly, the sick, the fragile.’ Not knowing that you probably know a lot of these people yourself.”

Where in El Paso can I get the COVID-19 vaccine for my child?

These clinics ask for consent from the child’s parent or guardian. All patients have zero out-of-pocket costs, regardless of health insurance or immigration status.

El Paso Department of Public Health: Pfizer vaccines will be available starting Friday, June 24. The city expects to administer Moderna vaccines at a later date. All four community clinics are open 8 a.m. to 5 p.m. Monday to Saturday. The clinics accept walk-ins, but recommend making an appointment at or by calling 915-212-6843. 

  • Lower Valley, 9341 Alameda Ave.
  • Northwest, 7380 Remcon Circle
  • Downtown, 220 S. Stanton St.
  • Northeast, 9566 Railroad Drive

Immunize El Paso: Pfizer and Moderna vaccines are available by appointment or walk-in basis.  To make an appointment, call 915-533-3414.

  • Eastside, 1400 George Dieter Drive, Suite 260
    • 8 a.m. to 5 p.m. Monday to Friday and 9 a.m. to noon Saturday
  • San Juan (Central), 6292 Trowbridge Drive
    • 8 a.m. to 5 p.m. Monday to Friday and 9 a.m. to noon Saturday
  • Downtown, 513 W. San Antonio Ave., Suite B
    • 8 a.m. to 5 p.m. Monday to Friday

El Paso Children’s Hospital: Pfizer vaccines are available. Appointments only; no walk-ins accepted. Call 915-298-5433 to make an appointment or visit for more information.

  • 4845 Alameda Ave, conference room in the basement
  • Appointments are available from 2 to 6 p.m. on the following dates:
    • Thursday, June 23
    • Thursday, June 30
    • Tuesday, July 5
    • Wednesday, July 6

University Medical Center of El Paso: The hospital offers the Pfizer vaccine at numerous clinics throughout the city. To make an appointment, call 915-975-8900. All children receiving the vaccine must be seen by an onsite pediatrician.

CVS and Walgreens pharmacies have begun accepting appointments to vaccinate toddlers against COVID-19. Walgreens is providing Pfizer and Moderna vaccines to children ages 3 years and older. CVS is providing the Pfizer vaccine to children ages 18 months and older.

 El Paso Matters will update this list as more locations become available.

Alex Hinojosa contributed to this story.

Priscilla Totiyapungprasert is a health reporter at El Paso Matters and Report for America corp member. She previously covered food and environment at The Arizona Republic. You can follow her on social...