• The use of masks is optional although recommended for parents and children who are well. 

  • Masks are mandatory for patients and family members who are sick or who have a high-risk medical condition. 

  • Please note that CHILDREN’S HEALTHCARE may need to consider changing from mask optional to mask required should there be significant community transmission of COVID-19 and/or other community acquired infectious diseases.


  • If you or your child is sick with COVID-like symptoms or you or your child has been exposed to COVID, please test yourself and your family members before making or keeping your child’s appointment. 

  • If you or your child test positive for COVID, please talk to our triage staff before scheduling or arriving for an appointment in our office.

  • We strongly recommend that you reschedule any Well Child appointments if you or your child have been diagnosed or are suspected to have a COVID-19 until the minimum 5-day home isolation has been completed.  

  • If you are sick and visiting our office due to concerns related to COVID-19, please inform our office on arrival so that we can have you enter our office through our sick entrance and offer you a mask (and your child if they will wear the mask) to keep you and those around you safe.


  • The CDC recommends the new monovalent COVID-19 vaccines for everyone age 6 months and older to help protect your family from the old and new COVID variants.

  • CHMA has chosen to continue to offer the Pfizer brand of COVID 19 Vaccine that we have been using since the start of the pandemic in 2020. 

  • For parents who prefer the Moderna vaccine, you may be able to obtain the Moderna brand of the vaccine at your pharmacy of choice.

  • If your pharmacy does not have your preferred brand of COVID Vaccine, you may be able to locate a pharmacy that carries Moderna’s new Monovalent COVID vaccine by searching the following website:

  • Children and adults can receive any brand of the new monovalent COVID vaccine regardless of what brand of initial and booster vaccines were given to your child in the past.

  • The updated monovalent COVID-19 vaccine must be given at least 3 months after being sick with COVID or 2 months after receiving any prior COVID vaccine. 

  • CAUTION: Not all health plans have committed to covering the latest COVID vaccine and each insurance company can have a variety of plans where the coverage of clinicians, labs, imaging, outpatient facilities, hospitals, drugs, vaccines and medical equipment can vary from the many options provided by each health plan. 

  • To avoid being billed for the COVID vaccine, we urge you to call the number for customer service on the back of your health plan card BEFORE booking your appointment to receive the COVID vaccine. Your call to customer service allows you to verify that your health plan covers the full cost of the COVID vaccine. When talking to customer service, make sure that you document the name of the representative as well as the time and date of your phone call.


  1. There will be better protection against severe disease, hospitalization, and death from COVID-19 now that newly updated (2023–2024 formula) mRNA COVID vaccines are available. 

  2. The vaccines target XBB.1.5, a subvariant of Omicron that dominated the United States—and the world—from November 2021 until earlier this year. The updated vaccines should also work against currently circulating variants of the SARS-CoV-2 virus. This includes EG.5, the current dominant strain in the U.S., and BA.2.86, a new subvariant sparking concern.

  3. Why would another COVID vaccination help?

  • The updated vaccines are not expected to prevent all cases of COVID, including those causing mild illness. Instead, the aim of the vaccine is to reduce severe illness, hospitalization, and death from infection. According to the CDC, COVID is still a major cause of serious respiratory illness, with more than 200,000 reported deaths since January 2022. That figure includes more than 600 deaths in adolescents and children ages 19 and younger.

  • Immunocompromised people and those with chronic medical conditions, such as diabetes or heart disease, are at the highest risk of severe disease and death, but some young, healthy people have also gotten very ill and died from COVID. 

  1. How is the updated COVID vaccine different from the previous one?

  • The bivalent booster, which is no longer available, was introduced in the fall of 2022. It targeted the BA.4 and BA.5 Omicron sub variants and the original SARS-CoV-2 virus. 

  • The new vaccine is monovalent, designed to prevent severe disease from the Omicron XBB.1.5 subvariant. By September, the long-running XBB.1.5 accounted for only about 3% of cases in the U.S., but most of the strains circulating now are descended from (or closely related to) it.

  • Since the many variants of COVID 19 virus have evolved rapidly, it may be impossible to match each new vaccine update to the variants circulating at the time it is released. However, if you have some immunity to any one COVID VARIANT of the past variants and are exposed to a new offshoot of it, you’ll have some protection.

  1. Why isn’t the new COVID vaccine considered a booster?

  • The FDA is calling the new shots “updated vaccines” in anticipation of needing to provide updated formulas annually in the future, similar to the flu shot, which changes each year.

  • A booster shot is expected to provide protection against currently circulating variants, helping the body build a new response to those variants. 5. How safe is the updated COVID vaccine?

  1. Do the benefits of the COVID-19 vaccine continue to outweigh the risks? Serious reactions after COVID-19 vaccination are rare, according to the CDC. The CDC bases their comfort with the vaccine on a study showing the risk of cardiac complications, including myocarditis (an inflammation of the heart muscle), in males 12-17 years old was 1.8–5.6 times higher after getting sick from the COVID-19 infection than after COVID-19 vaccination.

  2. When and where can my child receive the updated monovalent COVID Vaccine from Children’s Healthcare:

  • Children 6 months through to 19 years of age can receive the Pfizer COVID Vaccine during any well child office visit at our or visits to our office for mild illness.


  • Children from 6 months to 19 years of age can be seen by appointment at a vaccine only visit:

  • Mondays, Tuesdays, Wednesdays and Friday mornings from 8:30am to 11:30am  

  • Wednesday and Fridays from 1:30 pm to 4:30 pm.


Children aged 6 months through 4 years are up to date when they get:

3 doses of Pfizer-BioNTech vaccine 


2 doses of Moderna vaccine.


At least 1 dose should be an updated Pfizer-BioNTech or Moderna COVID vaccine.

Children aged 5 through 11 years are up to date when they get: 

1 dose of the updated Pfizer-BioNTech vaccine.


1 dose of updated Moderna COVID vaccine.

Adolescents aged 12 through 17 years are up to date when they get:

1 dose of the updated Pfizer-BioNTech or Moderna COVID vaccine.


2 doses of updated Novavax vaccine.


1 dose of any updated COVID vaccine after any original or bivalent COVID vaccine


The US Food and Drug Administration (FDA) and the Centers for Disease Control approved the antibody because of the following statistics:

  • Most children have had RSV by the time that they reach 2 years of age.

  • On average, roughly 2.1 million infants and children under age 5 are impacted by RSV.

  • Roughly 80,000 children were admitted to the hospital with moderate to severe RSV related respiratory problems during the 2022 to 2023 Fall and Winter Season.

What brands of antibody injections / protection from RSV are available for my child?

  • Beyfortus = Single injection at the beginning of the RSV season.

  • Synagis = Monthly injection throughout RSV season for a total of approx. 6 doses. This regimen is much more expensive than Beyfortus.

Which Children Need the Antibody Protection of Beyfortus or Synagis:

  • All high-risk infants less than 8 months born during RSV season (roughly October through March). 

  • Select “high risk” children from 8 months to 20 months of age: Infants who are at highest risk for hospitalization from RSV are infants under 20 months of age who are born premature (INFANTS BORN LESS THAN 37 WEEKS GESTATION), 

  • Infants with cardiac or respiratory problems and infants with immune disorders.

  • If the infant’s mother received the RSV immunization during pregnancy and it was given to the mother more than 14 days prior to delivery, their infant is eligible for the RSV immunization. This is because much like the antibodies produced by our bodies, the Beyfortus antibody levels (and therefore the protection) gradually wanes over time.

  • Nirsevimab (Beyfortus) produced by the Sanofi-Aventis Pharmaceutical Company is charging somewhere between $400 and $500 for each single injection. 

  • CAUTION: Not all health insurance companies have committed to covering the RSV immunization. Furthermore, each health insurance company can have a wide variety of health plan benefits to choose from. Therefore, you may have a plan option that does not cover the cost of the RSV immunization while other plan options from the same insurance carrier may deny your coverage.

  • To avoid being billed for the RSV immunization, we suggest that you call customer service at your health insurance company BEFORE booking your appointment for your child’s RSV immunization at a site other than our office (due to the limited availability throughout the U.S.). This phone call allows you to verify that your specific plan will cover the cost of the RSV immunization. When talking to the representative from your health insurance company please make sure that you document the name of the representative from your health plan as well as the time and date of your phone call.

Contraindications & Precautions:

  • Infants who have had a severe allergic reaction to Beyfortus or any of its components should not receive the immunization, in addition, infants with bleeding disorders can receive Beyfortus with caution.

  • Infants with a moderate to severe illness should not receive Beyfortus until they recover.


  • Beyfortus was shown to reduce the likelihood of admission to the hospital and/or Pediatric Intensive Care Unit between 79% to 90% effective.

When can my child receive the RSV immunization:

  • Children between the 4 weeks and 20 months of age who qualify for the vaccine (as noted above) will be directed to a local vaccine clinic. However, please be aware that there is a significant supply shortage of Beyfortus. 

  • Therefore, for the foreseeable future, the only infants and children UNDER 8 MONTHS OF AGE and high-risk infants with select pre-existing conditions are eligible for Beyfortus.

FLU VACCINE ADMINISTRATION: CHILDREN’S HEALTHCARE has already started to schedule the annual influenza vaccine to the following children and at the following times: 

  • Children 6 months through to 19 years of age during well child visits.

  • Patients who are scheduled for a mild illness (temp under 100.5F). 

  • Children between 6 months through 19 years of age can be seen by appointment at a vaccine only visit on: Mondays, Tuesdays, Wednesdays and Friday mornings from 8:30am to 11:30am OR Wednesdays and Fridays from 1:30 pm to 4:30 pm

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Children's Healthcare Medical Associates

550 Washington Street

Suite 300

San Diego, CA 92103

(619) 297-5437

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