evidence: The safety of COVID-19 vaccines in children is an important consideration. Serious heart conditions (myocarditis and pericarditis) have been reported during community surveillance with mRNA vaccines Comirnaty and Spikevax in Canada,100 USA101 and Israel102 showing a predominance for male patients in adolescent age groups (15–24 years).101 For this reason, the use of the Spikevax vaccine in Sweden and Norway has been temporarily suspended for those <30 years in Sweden and those <18 years in Norway (with Comirnaty recommended for men <30 years) due to the potential of an increased incidence in heart inflammation compared to Cormirnaty.103,104 While both mRNA vaccines are associated with an increased risk of myocarditis/pericarditis, head-to-head comparison data in the US among 18–39-year olds shows Spikevax has a significantly higher rate of myocarditis/pericarditis compared to Cormirnaty.105 A direct comparison in the 12–18-year age group is still not possible given the different age groups authorised to receive each vaccine.105 Ongoing surveillance will be crucial to detect any rare side effects even with reduced dosages in younger age groups. Until recently, vaccine safety in very young (<12 years of age) was unclear.