COVID-19 Vaccine for Children 5-11

The pediatric Pfizer COVID-19 vaccine is coming soon! Once it has received emergency use authorization, we will begin vaccinating children ages 5-11. (We are already vaccinating those 12 and over.)

In the meantime, we are creating a list of families who are interested in receiving this vaccine for their children, once it becomes available. Please complete the form below to be added to our list. This is NOT an appointment or a guarantee that you will receive a vaccine. Rather, it will allow us to contact you once we receive the vaccines and are ready to schedule.

Our plan is to schedule 2-3 vaccination clinics, and at each clinic we will vaccinate about 100 children. These clinics will likely be held in early November, and we will prioritize scheduling those families who have signed up here.

Parent Name*
Child 1*
Children age 5-11 only
Child 1
Child 2
Children age 5-11 only
Child 2
Child 3
Children age 5-11 only
Child 3
Child 4
Children age 5-11 only
Child 4
This field is for validation purposes and should be left unchanged.