IWK doctor answers questions about children and COVID-19 vaccines

Pfizer-BioNTech was the first company to submit COVID-19 vaccine data for children five to 11 to Canadian officials for review. If Health Canada gives the green light, children across the country could be receiving the pediatric vaccine in a matter of weeks. 

Portia Clark of CBC's Information Morning Nova Scotia spoke to Dr. Karina Top, an infectious disease specialist at the IWK Health Centre in Halifax and a researcher with the Canadian Center for Vaccinology, about what parents need to know about the vaccine. 

This discussion has been edited for length and clarity.

How is this vaccine for kids under 12 different from the vaccine that the rest of us are getting as adults who are 12 and up? 

The vaccine for younger children is about one third of the dose that we're giving to adults and teens, and otherwise it's the same active ingredient — it's just diluted slightly differently. 

Why was 12 determined to be the age for the cut off between a child's dose and a dose for adults and teens?

When children's immune systems are developing, they have a very strong inflammatory response. So a young child can get a high fever with a cold, whereas with an adult, that would be unusual. And it's just around puberty that we start to see that the immune system develops into more of the adult immune response and so that was the cutoff to consider a lower dose in those younger kids to ensure that it was well-tolerated and safe.

So for someone who has a child who's 11 but maybe about to turn 12, what should they do? Should they wait and get vaccinated with the adult dose or the teen dose instead of the kid dose? 

We will be looking to the National Advisory Committee on Immunization to make recommendations and guidance around what to do with that 11 to 12 cut off. But children were included in that study up till their 12th birthday.

Are there likely to be side effects from the vaccine in young children that are similar to what the rest of us have experienced?

What this study has shown is that they certainly can get fever, headache, muscle aches, fatigue, those sorts of things that many of us experienced when we got our own vaccine, more often after the second dose.

But there weren't any episodes of the heart inflammation or myocarditis that we've seen in teens and young adults. And there were no significant differences between girls and boys. 

What else should we be considering when we think about getting children, young children vaccinated, when we're hearing that kids don't get COVID as severely as adults do?

Fortunately, most children do well with COVID, but some of them can get severely ill. So we do want to prevent those severe complications.

And of course, they can transmit it to other people who are vulnerable. And we've seen that cases being introduced in the schools have caused a lot of disruption, even if there isn't a lot of spread in schools.

So vaccinating children will help prevent, will help them to be able to stay in school and continue their education.

Are you anticipating that parents or caregivers of younger children might have more questions about getting the vaccine?

I would encourage parents if they have questions to talk to their child's family doctor or pediatrician, if they have one, or a pharmacist, and Public Health will have information around this. The Canadian Paediatric Society is a good source of information.

Moderna is saying this week that it's also ready to submit its vaccine data for children six to 11. What's your reaction to that news? 

I think that's great news. It's good to have more vaccines available for younger children, we'll see what the data show when it's available and what the timelines are around when they actually submitted and when it might be approved. 

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