This doctor says his 5-year-old will be among the 1st in line for a COVID-19 vaccine

Story Transcript

Dr. Alexander Wong says he's comfortable getting his five-year-old child vaccinated against COVID-19, and he hopes other parents will be too.

Health Canada approved Pfizer-BioNTech's vaccine for children aged five to 11 on Friday, and the federal government says the first doses — which are one-third the size of those given to people 12 and up — will arrive in Canada on Sunday. 

Health Canada authorized a two-dose regimen to be administered three weeks apart. The National Advisory Committee on Immunization (NACI), however, is recommending that the spacing between doses be increased to at least eight weeks, citing growing evidence that a longer interval generates a more robust immune response, and may also help decrease the likelihood a rare side-effect called myocarditis, an inflammation of the heart muscle.

Wong, an infectious diseases physician at Regina General Hospital and the Saskatchewan Health Authority, spoke to As It Happens host Carol Off. Here is part of their conversation.

When should we expect to see five-year-olds getting the vaccine in Saskatchewan?

We don't know for sure exactly when doses are going to be delivered, but we would anticipate that the moment doses are available, I think here in the province that we're going to start to see jabs go into arms, hopefully, you know, as early as next week. 

And when will you have your own five-year-old in line?

As most people probably know, I'm super excited to be able to get our five-year-old vaccinated. And so he's going to be in line, I think, when it becomes available, with all the other parents who are super enthusiastic.

We anticipate 50 to 60 per cent of parents are pretty much going to be wanting to kind of break the doors down to get access to this. 

But, again, there's a lot of parents and kids that still have lots of questions about what this is all going to look like.

There's still a lot of unknowns, and we're going to follow the safety data very closely.

I think people are listening to you say the words "a lot of unknowns," and having a moment here. So can you tell us what you mean by that?

We anticipate that the data is going to suggest that this is going to be a really safe and effective vaccine for ages five to 11. But ... the clinical trials were done with just 2,000 to 3,000 kids, and so there are still questions around what is the incidence rate of heart inflammation or myocarditis going to look like, for example.

Based on everything that we have and everything that we know, we would anticipate that that incidence rate is going to be exceedingly low…. But the point is that we don't have real-world experience in this space. I mean, there's literally millions of doses going into arms [of children aged five to 11] right now in the U.S., so we're going to see a lot more data very soon.

We're going to have to watch that safety signal closely. But for me personally, as an [infectious diseases] physician, I'm confident and I'm excited and I'm ready to get our five-year-old vaccinated as quickly as possible.

You mentioned myocarditis. That's an inflammation of the heart muscle. We've been hearing about that since the vaccine began. Very rare side effect, but it exists. It's also considered that it might be less of a risk of myocarditis if the double-doses are further apart. Is that what you're hearing?

There is emerging data from multiple jurisdictions, including Canada, as well as the United Kingdom, suggesting that an extended dose interval of eight or 12 weeks ... does seem to lead to a lower or decreased signal of heart inflammation events. 

And at the same time, we know how kids' immune systems' work. That extended dose, that prime boost, you know, of eight to 12 weeks is probably the optimal time frame to get the longest lasting, most robust immune response in kids.

So that's why the [NACI] recommendation [to extend the interval between doses] was made.

I know you spoke to hundreds of 12- to 14-year-olds about the vaccine. You had a virtual forum reassuring them, answering their questions. But now you've got kids five to 11. What could you tell them? What will you tell them about the vaccine?

We want to talk about how we believe the vaccine is going to be safe and efficacious and how it's important to get the vaccine to protect themselves and their own health in terms of preventing COVID, not getting any long-term complications of COVID, and preventing the spread of COVID to other individuals, including higher-risk persons like their grandparents, for example, or other friends and family who might be immunocompromised.

At the same time, we also acknowledge that we need to continue to follow the data closely and that we don't believe that kids should be sort of mandated to receive vaccines or should be limited in terms of their ability to go to school or attend activities or events as a result of their vaccination status.

You mentioned at the beginning that you figure about 50 to 60 per cent of parents will be banging down the door to get the vaccine. If it's 40 to 50 [per cent] who are not doing that. That's a pretty high rate of hesitancy. And so you said it shouldn't be mandated, there shouldn't be segregation. How effective is this going to be in the school system if there is that low rate of vaccinations?

We know there's probably going to be a decent majority … of parents who, as you say, are super enthusiastic, like myself. 

And then there's probably going to be about 20 to 25 per cent of parents who are kind of waiting to see what the safety data is going to look like. 

And then there's going to be probably, again, about 10 to 15 per cent of parents who are just not going to be super keen at this time to get their kids vaccinated.

What level of vaccination, what percentage do we need to see, for this vaccine to actually be effective amongst that age group?

Even one dose of vaccine in a child is going to elicit a very robust, protective immune response quite quickly. And there is no sort of definitive percentage around what the number looks like. 

Obviously, at a societal level, we would want that number to be as high as it possibly could be — like 90 per cent plus — realizing it's not going to be 100.

The other big piece …. is that it is going to significantly limit this group of children as a potential vector of transmission because they are then going to be immune. And that is going to play a huge role in cutting down overall transmission in our community, as well as transmission to, again, older individuals, persons with medical conditions and immunocompromised.

And that's going to, again, help us get eventually to that new normal, where we're not going to necessarily be worrying ... constantly about surges of COVID-19 devastating our health-care systems.

Written by Sheena Goodyear with files from CBC News. Interview produced by Kate Cornick. This Q&A has been edited for length and clarity.