Health Canada will authorize the Pfizer COVID vaccine for use in children, which means it will soon begin one of the largest pediatric vaccination campaigns in the country’s history.
With the release of a smaller dose of the vaccine, which is already in use worldwide, expected on Friday, the federal regulator is signaling that it has combed through all the data from clinical trials to manufacturing plans and determined that the vaccine is safe and effective in school-age children.
The news means that Pfizer is now starting to ship child-sized syringes into the country, with vials for vaccination campaigns that are already being planned in many countries. Anita Anand, until recently federal procurement minister, previously said Canada would receive 2.9 million doses “shortly” after approval – enough to give every eligible child a first dose.
The vaccine for children, ages five to 11, uses the same mRNA technology as the adult version, but is about a third the size. Children will also be given two syringes, but Dr. Kieran Moore, Ontario’s chief medical officer of Health, told a radio station this week that they will be eight weeks apart, rather than the American recommendation of a three-week interval.
Studies suggest that even a single dose produced a strong immune response in children: 91.4 percent effectiveness against infection over a period of months.
Not only will the arrival of the cans be greeted with cheers by many parents who want protection for their children, it will be an important step in ending the pandemic for all.
While children are at lower risk of serious complications from COVID-19, they are not without risk, according to experts.
There is a “direct benefit” to children who are vaccinated as some of them develop a severe version of the disease, says Dr. Stephen Freedman, a Calgary-based pediatric ambulance who has conducted multiple studies on the effects of COVID. has directed on children, internationally and in Canada. A Canadian study suggests that every fifth child hospitalized with COVID ends up in intensive care.
There are also those who end up with problems like the multisystem inflammatory syndrome known as MIS-C, which appears to affect about one in 3,500 children who get COVID, or those who have weeks or even months after being infected Symptoms fight.
Then there are the consequential benefits, including the fact that vaccinating children means they are infecting less-at-risk family members, and that this also brings us all one step closer to a version of normal, he adds.
“Open up society because we no longer have such great risk? We want to get to the point, ”he says. “People for dinner, get-togethers, events, family get-togethers, we want all of these things. The vaccine for five to eleven year olds is another step in this direction. ”
While adults and adolescents have been rolling up their sleeves for months, the first-time expansion of the campaign to include children means a higher level of commitment for many parents who are now faced with the decision to vaccinate their child.
“As a pediatrician, I know that all parents want the best for their child,” says Dr. Shazeen Suleman, who works at Unity Health Toronto. “Every decision they make comes from a place of love and care. So we know that there is a lot of information and a lot of parents have questions. “
Suleman, who is also part of the University of Toronto’s Temerty Medical School, says she often hears from parents that the deluge of information about the vaccine is confusing, so it is important to make sure that credible information is available. in several languages. Pediatricians are of course also happy to answer questions about vaccinations, she says.
The introduction must make it easy for parents to bring their children, and the government and employers should consider paid time off for appointments and sick leave for caregivers who may need to stay at home and look after a child who is suffering from side effects, she adds .
Children are not just little adults, says Suleman. This means that vaccination should be carried out in child-friendly rooms, ideally from providers that children trust and that are accessible to children with disabilities or neuro-atypical children.
There are already plans in many parts of the country to get cans in small arms as soon as possible. The city of Toronto has announced that it will develop a “multi-pronged strategy” to reach the city’s more than 200,000 children and their parents. Clinics are opening in every corner of the city, mass vaccinations, school and community clinics are being considered. General practitioners and pharmacists can also offer the vaccine.
Given the urgency, pharmacists have publicly wondered why they couldn’t make smaller doses of the vaccine instead of waiting for a child-sized version.
Dr. Jim Kellner, a professor of pediatrics at the University of Calgary who is also on the state COVID-19 Immunity Task Force, says he is unsure of what Pfizer’s reasoning is, but says that breaking adult doses into smaller amounts ” error-prone “. ”
The adult doses are already small – about 0.3 ml, or less than a tenth of a teaspoon – which means further breaking down while ensuring accuracy would be a challenge, he says. There isn’t enough room in the vials to dilute it and increase the amount for ease of use, he adds.
In an email, a Pfizer spokesman said the vials of child vaccine will contain 10 doses – up to six doses for adults – and will have a different label and colored cap.
Pfizer tested the children’s vaccine on more than 2,000 volunteers in the United States, Finland, Poland and Spain. Although the studies weren’t as large as the adult versions, they were large enough to determine that the vaccine appeared to elicit the same immune response in children as it did in the slightly older, which is a standard way of testing vaccines that a new group did offered, says Waiter.
Prior to the approval decision, experts said they would be looking for more information on side effects from Health Canada.
Occasional cases of myocarditis or inflammation of the heart muscle have raised some concerns – in Septemberthe UK regulator said it is not recommending vaccination for healthy 12-15 year olds for this reason. However, most countries, including Canada, have chosen to introduce youth vaccines on a broader basis, and Canadian experts emphasize that the risk for younger children is very, very rare.
In the worst case, the risk of developing myocarditis could be up to 1 in 10,000, but it’s probably closer to 1 in 50,000 or less, says Kellner. The people who got it generally had a mild case with no lasting effects, he says.
Given the rarity of the complication, the studies likely weren’t large enough to clarify how common it occurs, he says. It is a legitimate concern, and it is important that vaccine side effects continue to be closely monitored.
“I can’t tell a parent that their child is completely safe,” he says. “But what I can tell you honestly and directly, and look you in the eye, is that the risk of an adverse event like myocarditis is very, very rare.”
Much of the pandemic was about learning to assess risks and benefits, and he says if this is the case, vaccinating children makes sense.