Coronavirus (COVID-19) vaccine for children aged 6 months to 4 years at higher risk of coronavirus

NHS Scotland is offering the coronavirus (COVID-19) vaccine to children aged 6 months to 4 years at higher risk of coronavirus, in line with the Joint Committee on Vaccination and Immunisation (JCVI) advice

To be invited for vaccination this spring/summer, your child must have turned 6 months old by 1 April 2023. Your child may have been identified for vaccination when they were aged 4, but may turn 5 years old before they receive their vaccine.

NHS Scotland will contact you with appointment details if your child is eligible. Please wait to be contacted.

Why is my child being offered the coronavirus vaccine?

Getting the vaccine will help to protect your child against coronavirus. The vaccine helps to build up immunity to coronavirus, so the body can fight it off more easily. If your child is vaccinated, they are much less likely to get seriously ill from coronavirus or need to go to hospital.

Infants and young children with underlying health conditions are 7 times more likely to be admitted to paediatric intensive care units with severe coronavirus, compared to those without underlying health conditions.

Is my child at higher risk of coronavirus?

Children at higher risk from coronavirus are those living with:

Chronic respiratory disease

Including those with poorly controlled asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission, cystic fibrosis, ciliary dyskinesias and bronchopulmonary dysplasia.

Poorly controlled asthma is defined as any of the following:

  • 2 or more courses of oral corticosteroids in the last 24 months
  • on maintenance oral corticosteroids
  • 1 or more hospital admission for asthma in the last 24 months
Chronic heart conditions

Haemodynamically significant congenital and acquired heart disease, or less severe heart disease with other co-morbidity. This includes:

  • single ventricle patients or those palliated with a Fontan (Total Cavopulmonary Connection) circulation
  • those with chronic cyanosis (oxygen saturations <85% persistently)
  • patients with cardiomyopathy requiring medication
  • patients with congenital heart disease on medication to improve heart function
  • patients with pulmonary hypertension (high blood pressure in the lungs) requiring medication
Chronic conditions of the kidney, liver or digestive system

Including those associated with congenital malformations of the organs, metabolic disorders and neoplasms, and conditions such as severe gastro-oesophageal reflux that may predispose to respiratory infection.

Chronic neurological disease or condition

This includes those with:

  • neuro-disability and/or neuromuscular disease including cerebral palsy, autism, epilepsy and muscular dystrophy
  • hereditary and degenerative disease of the nervous system or muscles, other conditions associated with hypoventilation
  • severe or profound and multiple learning disabilities (PMLD), Down’s syndrome, those on the learning disability register
  • neoplasm of the brain
Endocrine disorders

Including diabetes mellitus, Addison’s and hypopituitary syndrome.

Asplenia or dysfunction of the spleen

Including hereditary spherocytosis, homozygous sickle cell disease and thalassemia major.

Serious genetic abnormalities that affect a number of systems

Including mitochondrial disease and chromosomal abnormalities.

A weakened immune system

Immunosuppression due to disease or treatment:

  • those undergoing chemotherapy or radiotherapy
  • solid organ transplant recipients
  • bone marrow or stem cell transplant recipients

Genetic disorders affecting the immune system, for example:

  • deficiencies of IRAK-4 or NEMO
  • complement disorder
  • SCID

Immunosuppressive or immunomodulating biological therapy

Steroid medication - children treated with or likely to be treated with high or moderate dose corticosteroids

Blood cancers - those with haematological malignancy, including leukaemia and lymphoma

Auto-immune diseases that may require long term immunosuppressive treatments

Non-biological oral immune modulating drugs:

  • methotrexate
  • azathioprine
  • 6-mercaptopurine
  • mycophenolate

How many doses of the coronavirus vaccine will my child be offered?

Your child will be offered 2 infant doses of the coronavirus vaccine.

The second dose will be offered at least 8 weeks after the first. Children who have a severely weakened immune system may be offered an additional dose.

My child has already had coronavirus, can they get the vaccine?

Even if your child has already had coronavirus, they could still get it again. If your child is vaccinated, and they get coronavirus again, the vaccine will reduce the risk of your child getting seriously ill and having to go to hospital.

Is the coronavirus vaccine safe?

All medicines (including vaccines) are tested for safety and effectiveness before they are allowed to be used. Once they are in use, the safety of vaccines continues to be carefully monitored.

Over 1 million coronavirus vaccine doses have been given to children aged 6 months to 5 years in the United States of America since June 2022, with no new or unexpected concerns.

Are there any reasons my child should not get the coronavirus vaccine?

The vaccine should not be given to children who have had a confirmed severe allergic reaction (anaphylaxis) to any of the ingredients in the vaccine. Tell the person giving your child the vaccine if they’ve ever had a serious allergic reaction.

The vaccine is not a live vaccine and does not contain any animal products or egg.

Read the coronavirus vaccine patient information leaflet

It's important to let the vaccinator know if your child is receiving any medicines, treatment or therapy at a hospital or specialist clinic. If you have questions about the timing of your child’s vaccine, speak to their health professional or specialist.

Preparing your child for vaccination


  • make sure your child wears practical clothing that’s easy to get off and on
  • it might be useful to take your child’s favourite toy or blanket with you
  • if you feel anxious yourself, or if you have a fear of needles, try to stay calm and show your child there’s nothing to fear
  • let the person giving the vaccine know if you or your child feel nervous – they'll be very understanding and can provide support

At the vaccination appointment

At the appointment, the vaccinator will check parent or carer consent. They’ll give you information and explain anything that you’re unsure about or do not understand.

The coronavirus vaccine is given as an injection in the upper arm or thigh. The needles used are small and your child should only feel a tiny pinprick.

Can my child get other vaccines on the same day?

Children can safely get other vaccines on the same day they get their coronavirus vaccine. Routine immunisations give your child the best possible protection from serious diseases. They should not be delayed.

Find out more about the routine immunisations your child is eligible for

Can I rearrange my child’s appointment?

If your child's appointment isn't suitable and you'd like to rearrange it, or you do not wish for your child to be vaccinated at this time, please call your local health board. Your local number can be found on your child's invitation letter.

What if my child is ill on the day?

Your child can still have the coronavirus vaccine if they have a minor illness as long as they do not have a fever. If your child feels very unwell, their coronavirus vaccine appointment be postponed until they have fully recovered.

You should not attend an appointment if you or your child have a fever or think you might be infectious to others.

Common side effects

Like all medicines, vaccines can cause side effects. Your child may experience side effects after receiving their vaccine, but these are usually mild, only last a day or two and should not last longer than a week.

Your child might:

  • get redness, swelling or tenderness where the injection was given, which is worst around 1 to 2 days after the vaccine
  • appear to feel more tired
  • have general aches or mild flu-like symptoms
  • have a fever or be a bit irritable

Urgent advice: Phone 111 if:

  • your child’s side effects seem to get worse

You should tell them about your child’s vaccination so they can assess your child properly.

Fever after the coronavirus vaccine

It’s quite common to develop a fever (temperature above 37.8ºC) after a vaccination, but developing a fever is more common after the second dose of the coronavirus vaccine. The fever is a normal response to the vaccine.

Fevers are usually mild, so you only need to give a dose of infant paracetamol if your child is not comfortable or is unwell. Read the instructions on the product packaging and patient information leaflet very carefully and never give medicines that contain aspirin to children under 16 years of age.

If your child’s fever starts more than 48 hours after the vaccine, lasts longer than 48 hours, or is above 39ºC, your child may have another infection and you should seek medical advice.

Phone your GP or NHS 24 on 111.

If you think your child may be seriously ill, trust your instincts and seek urgent medical advice.

Rare side effects

An uncommon side effect is swollen glands in the armpit or neck on the same side as the arm where your child had the vaccine. This can last for around 10 days, but if it lasts longer see your doctor.

Cases of inflammation of the heart (called myocarditis or pericarditis) have been reported rarely after the coronavirus vaccines. Among children, the risk of myocarditis following vaccination decreases with decreasing age. No myocarditis events were reported to the US Vaccine Adverse Event Reporting System after vaccination of over 1 million children aged 6 months to 5 years (as of 21 August 2022).

You should seek medical advice urgently if your child experiences any of the following side effects after vaccination:

  • symptoms of a severe allergic reaction, such as difficulty breathing, wheezing or reduced level of consciousness
  • shortness of breath or chest pain
  • feelings of having a fast-beating, fluttering or pounding heart

Reporting side effects

As with all vaccines, you can report suspected side effects through the Yellow Card website.

Further information

Read Public Health Scotland's information leaflet about the COVID-19 vaccine for children aged 6 months to 4 years at higher risk

Last updated:
16 May 2023