Kids 5-11 can get second vaccine before eight weeks, says Hamilton public health

As cases of COVID-19's Omicron variant rise rapidly, parents eager to get their child's second vaccination earlier than the recommended eight-week interval are able to do so in some Ontario cities such as Hamilton, the city's public health department said Wednesday.

Hamilton Public Health Services says that while it recommends the eight-week interval supported by the National Advisory Committee on Immunization (NACI) for children between the ages of 5 and 11, it will permit bookings for a second dose any time after 21 days. 

"Community members may wish to consult with their family's general practitioner, pediatrician or local pharmacist to understand benefits and risks," public health spokesperson James Berry told CBC Hamilton in an email. 

"[NACI] recommends an interval of at least eight weeks between the first and second dose since emerging evidence in adults suggests that compared to shorter intervals, longer intervals between the first and second doses result in a stronger immune response, higher vaccine effectiveness that is expected to last longer," Berry said.

He says the longer interval "may be" associated with lower risk of myocarditis and pericarditis, inflammatory conditions affecting the heart and surrounding tissues.

When asked if the city might change its recommendation to try to speed up vaccination in light of Omicron, Berry deferred to the province.

Ontario's Ministry of Health did not respond to questions on whether changes to the recommendations are being considered to help fight Omicron. 

"To provide the strongest protection possible against COVID-19 and variants, the province continues to strongly recommend an interval of eight weeks between first and second doses for children aged five to 11," said spokesperson Bill Campbell on Wednesday.

Campbell was unable to respond Wednesday to the question on whether kids could receive an earlier second shot, saying he needed more time to provide an answer. 

While CBC could not find a reference to the three-week option on both the Ontario Ministry of Health or City of Hamilton's websites, some pharmacies in the province are already booking second shots sooner than eight weeks. 

On Dec. 7, pharmacist Kristen Watt tweeted a section of a provincial document dated Nov. 25 that states Ontario pharmacists can give second doses of the pediatric vaccine if "less than eight weeks have passed... provided that the interval between doses is consistent with the product monograph."

Watt, a pharmacist and owner of Kristen's Pharmacy in Southampton, Ont., noted that three weeks between doses was the interval Pfizer used in its research that led Health Canada to approve the vaccine, "so we do know there's good protection against symptomatic disease, severe illness and death for children." 

She has started lining up second doses for eligible families — and her own two children — and has spent lots of time discussing the pros and cons of an earlier second dose with parents.

Weighing urgency versus efficacy

She says the Omicron surge adds urgency to the efforts to vaccinate children and, for many families, it makes more sense to focus on getting as much protection as they can in the short term. 

"What I've told parents is, in the absence of strong feelings either way, stick with the NACI guidelines," she told CBC Hamilton on Wednesday. "However, if you're concerned about increasing case rates [and] exposures… get it done sooner, and we can have that conversation about decreased efficacy down the road.

"We were going to wait the eight weeks," Watt added, referring to her own children. "We decided that being fully protected now was more important to us than being concerned about waning protection in six months."

She says about four million children in the United States, where they use the same vaccine at a three-week interval, have been vaccinated, "and we have not seen a huge surge in myocarditis rates."

Hamilton mom Stacey Marshall says she's only heard about the three-week option on Twitter, saying she wished there was more information on the pros and cons coming from Hamilton Public Health. Her kids, 9-year-old Max and 11-year-old Rhys, have had their first vaccinations already, and as Marshall stares down the coming Omicron wave, she'd consider getting their second doses sooner if she knew it was safe.

"Accurate information is so hard to come by, especially when it comes to vaccinations: getting them, booking them, eligibility," she said Wednesday. "I follow a lot of news outlets, public health, and the municipality [on social media], and I haven't heard anything."