Carter Giglio, 8, joined by service dog Barney of Hero Dogs, shows off the Band Aid over his injection site after being vaccinated Wednesday at Children’s National Hospital in Washington. Carolyn Kaster/Associated Press

Hugs with friends. Birthday parties indoors. Pillow fights. Schoolchildren who got their first COVID-19 shots Wednesday said these are the pleasures they look forward to as the U.S. enters a major new phase in fighting the pandemic.

Health officials hailed shots for kids ages 5 to 11 as a major breakthrough after more than 18 months of illness, hospitalizations, deaths and disrupted education.

Kid-sized doses of the Pfizer-BioNTech vaccine cleared two final hurdles Tuesday – a recommendation from CDC advisers, followed by a green light from Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

At a Decatur, Georgia, pediatrician’s office, 10-year-old Mackenzie Olson took off her black leather jacket and rolled up her sleeve as her mother looked on.

“I see my friends but not the way I want to. I want to hug them, play games with them that we don’t normally get to,” and have a pillow fight with her best friend, Mackenzie said after getting her shot at the Children’s Medical Group site.

With the federal government promising enough vaccine to protect the nation’s 28 million kids in this age group, pediatricians’ offices and hospitals began inoculating children. Schools, pharmacies and other locations plan to follow suit in the days ahead.

The atmosphere surrounding the launch of shots for elementary-age students was festive in many locations. California vaccine sites welcomed children with inflatable animals and handed out coloring books and prizes. Vehicles lined up before dawn at an Atlanta site.

Many pediatricians’ offices expected strong interest in the shots at least initially, but health officials are worried about demand tapering off. Almost two-thirds of parents recently polled by the Kaiser Family Foundation said they would wait or not seek out vaccines for their kids.

Brian Giglio, 40, of Alexandria, Virginia, brought his 8-year-old son, Carter, in for vaccination at Children’s National Hospital in Washington, where kids with underlying conditions got first dibs. Carter has Type 1 diabetes that puts him at risk for complications if he were to become infected.

Giglio said the vaccine was “like a hallway pass for us to begin living life again.” And Carter said he can’t wait to leave masks behind once he’s fully vaccinated, so he can smell the things he used to be able to smell without it.

“I’m ready to trash it,” he said, though the CDC still recommends masks in schools and indoor public spaces where virus activity is high, even for the fully vaccinated.

Cate Zeigler-Amon, 10, was first in line Wednesday for a drive-through vaccination at Viral Solutions in Atlanta. The girl enthusiastically bounced around the car before the shot, which she broadcast live on her computer during morning announcements at her elementary school.

Afterward, Cate said she was looking forward to hugging her friends and celebrating her birthday indoors next month “instead of having a freezing cold outside birthday party.”

Hartford Hospital in Connecticut vaccinated seven youngsters Tuesday night, minutes after the CDC’s director gave the OK, and three more early Wednesday. As they got their shots, one girl squeezed her eyes shut and a boy barely flinched, and other waiting kids applauded.

The vaccine – one-third the dose given to older children and adults and administered with kid-sized needles – requires two doses three weeks apart, plus two more weeks for full protection. That means children who get vaccinated before Thanksgiving will be covered by Christmas.

“The timing before winter holidays is very fortunate,” said Dr. Jennifer Shu, whose Children’s Medical Group office in Decatur, Georgia, began vaccinating first thing Wednesday. “This age group will be able to spend holidays with friends and family more safely than they have been able to since the start of the pandemic.”

Thousands of pediatricians pre-ordered doses, and Pfizer began shipments soon after the Food and Drug Administration’s decision Friday to authorize emergency use. Pfizer said it expects to make 19,000 shipments totaling about 11 million doses in the coming days, and millions more will be available to order on a weekly basis.

Authorities said they expect a smooth rollout, unlike the chaos that plagued the national one for adults nearly a year ago.

Asked about parents having trouble finding vaccine appointments, White House coronavirus coordinator Jeff Zients said the vaccines.gov website will be updated by Friday for parents to search for locations near them. He said the kid vaccination campaign will be at full speed next week as Pfizer continues to ship millions more doses to locations around the country.

More than 6,000 vaccination clinics are being planned at schools around the country before the winter holiday break, he said.

Walgreens planned to start kids’ vaccinations Saturday and said parents could sign up online or by calling 1-800-Walgreens. CVS was also accepting appointments online and by phone at select pharmacies starting Sunday.

Despite the initial enthusiasm, not everyone is rushing out to get shots.

Hannah Hause, a Colorado mother of four children ages 2, 5, 7 and 8, is herself vaccinated, but wants to see how the child vaccines play out and are studied in the larger childhood population.

“It’s not studied long-term. It just makes me nervous,” she said. “As long as I can wait, I will wait.”

At a White House briefing Wednesday, Walensky said authorities thoroughly reviewed all available data on the vaccine’s safety, efficacy and the immune response it generates before recommending shots for kids.

Dr. Ada Stewart, a Black family physician in Columbia, South Carolina, and past president of the American Academy of Family Physicians, said she’s seen the toll the virus has taken on younger children – not just in family illness and death but with school disruptions, slipping grades and mental strain.

School closures throughout the pandemic have disproportionately burdened children of color, widening academic gaps and worsening mental health, according to data presented Tuesday to CDC advisers. It showed more than 2,000 COVID-related school closures in just the first two months of the current school year.

A Pfizer study of 2,268 children found the vaccine was almost 91 percent effective at preventing symptomatic COVID-19 infections. The FDA examined 3,100 vaccinated kids in concluding the shots are safe.

Some skeptics have questioned the need for kids to get vaccinated since they are less likely than adults to develop severe COVID-19. But with the delta variant, they get infected and transmit “just as readily as adults do,’’ Dr. Anthony Fauci said at a recent White House briefing.

Infected kids have also contributed to the U.S. toll – almost 46 million infections and more than 740,000 deaths.

Since the pandemic began, at least 94 children ages 5 to 11 have died from COVID-19, more than 8,300 have been hospitalized and over 5,000 have developed a serious inflammatory condition linked to the coronavirus. Black and Latino youngsters and those with chronic conditions are among the hardest hit.

Kye’vontay Jordan, 7, who is Black, has diabetes and got his shot at Children’s National Hospital in Washington. The vaccine gave his dad peace of mind.

“Now I can sleep not worrying about him going to school,” said Brian Jordan. “Being exposed to the coronavirus could really affect him and mess him up.”