In order to improve COVID-19 vaccination rates among children in Alberta aged five to 11, communication needs to change and shots need to be made more accessible, according to a new study from University of Alberta researchers.
And with booster doses going out to kids in the same age group on Wednesday, one author of a new study said “public health has a bit of work on their hands.”
“Our study showed that although a good proportion of folks got their first dose for their kids, second dose dropped off a little bit,” Dr. Shannon MacDonald, associate professor of nursing and public health at the University of Alberta, told Global News.
“So even people who are willing to vaccinate their kids are either forgetting or not getting around to the second dose. And now we’re saying, ‘Okay, time for a third dose.’”
A preprint study published on Tuesday showed the older the child in the age group, the more likely they were to have been vaccinated.
It also showed that children in cities, in wealthier households and in public or publicly-funded Catholic schools were more likely to be vaccinated than their counterparts.
Using Ministry of Health vaccination data, MacDonald’s team looked at trends and demographic data of vaccination of young kids from November 2021 to June 2022.
“It really looked like the vast majority of parents who have vaccinated their kids did it right off the hop. So in the first two months that the vaccine program was out, there was a big increase in coverage and then it sort of tapered off,” MacDonald said.
“If we want to get vaccine coverage higher — which we do — we’re probably going to have to start thinking about some new approaches rather than just continuing with the status quo.”
MacDonald, whose research centres around immunization best practices, programs and policies, suggested leveraging existing technology for reminders: text messages.
“Alberta has started using that for booked appointments. Perhaps we should start using it for people who haven’t booked an appointment, but we can tell through our electronic records they are not yet vaccinated.”
The study also advised using different messaging for different ages within the five to 11-year-old cohort.
“I think we need to really drive home the message to parents of younger children that COVID disease is a risk,” MacDonald said.
She suggested making shots available where children and families frequent, like schools or recreation centres.
“We should be thinking about where these kids go anyways so that it’s not an extra trip, it’s not taking time off work and piling five kids in a car to get them somewhere that is on top of your normal day.
“I’m a huge advocate of school-based vaccinations,” MacDonald added. “The evidence for routine vaccinations is that when you provide them in schools, uptake is substantially higher than if you make people come to a public health center on an appointment basis to get them.”
While the most severe outcomes of COVID-19 have hit elderly populations the hardest, the U of A professor noted not all children escape an infection unharmed.
“There’s still multi inflammatory syndromes that can occur and the long-term impact on respiratory function and things like that,” she said.
“So as a parent of a younger child who’s trying to protect your child, just be sure that you’re balancing those risks. If you’re avoiding the vaccine because you think it’s risky, think about the risk your accepting by allowing your child to be out and about with COVID disease still circulating in the community.”
Back to school, back to sniffles
As kids return to school this week, parents like Dr. Cora Constantinescu is looking forward to a school year that will likely look very different from last year’s. But she also expects the sniffles kids bring home from school to return.
“Once you take kids and you put them in a closed environment as the winter season is going to approach, that makes more respiratory viruses do better. And of course, we know that kids are going to go unmasked and more infections are going to come at our children,” Constantinescu, a pediatrician and infectious disease specialist at the Alberta Children’s Hospital, said.
The ACH doctor said the Omicron wave in early 2022 was the biggest wave in terms of hospitalization and mortality in children in Alberta and worldwide.
Vaccines for school-aged children are a reason for optimism, she said.
Constantinescu and MacDonald noted millions of doses have gone out to young kids, providing ample evidence for their safety and effectiveness in the real world.
“The vaccine helps to prevent severe disease and helps to prevent invasive disease, which are all good things. So we’re not helpless,” Constantinescu told Global News. “We can still protect our kids by having them vaccinated and in addition to all the other precautions.”
Dr. Chris Mody, head of the University of Calgary’s microbiology, immunology and infectious diseases department, said it appears Albertans are “finished with public health measures,” citing a dearth of mask-wearing in indoor public spaces.
“What we’re relying on now is vaccines and immunity from natural infection. That’s what we’ve got left,” Mody said.
Constantinescu, a mother of three kids all younger than 12, suggested parents consider the situation for masking kids, like if a bug is going around a class.
“There might be cases where you want your kid masked, if they’re in a really large group and you think kids are going to be sharing all kinds of viruses and bacteria, then have your kids mask if they’ll tolerate it. And then there might be situations where you’ll choose not to,” she said.
“I think we really are relying on parents having to think about protecting other kids. And you don’t know who the vulnerable people are in children’s lives and who are vulnerable children,” Constantinescu added. “So keep your child at home if they’re sick, whether you think it’s COVID or not, keep them home because that will decrease the chances that this is going to spread.”
Alberta repealed the legal requirement to isolate at home when exhibiting COVID-19-like symptoms on June 14.
The Calgary Board of Education, Calgary Catholic School District, Edmonton Public Schools and Edmonton Catholic School District all recommend and advise parents to keep their kids home when sick.
Back of the vaccination pack
MacDonald noted that for other childhood routine vaccinations, Albertan parents are vaccinating their kids at rates that are in line with other provinces.
But Albertan kids are the least vaccinated against COVID-19 in the country.
According to the latest data collected by the Public Health Agency of Canada, 35.8 per cent of Albertan kids aged five to 11 have completed their primary series of COVID-19 vaccination, and only 47.4 per cent have their first dose.
The national average is 42.4 per cent with a primary series and 55.4 per cent with just a first dose, five per cent higher than Alberta.
Saskatchewan is the province with the second-lowest vaccination rate for young children, with 38.7 per cent completing a primary series and 52.1 per cent with a first dose.
Newfoundland and Labrador lead the country with 70 per cent of kids with a primary series and 87.5 per cent with one dose, nearly double Alberta’s rates.
Recognizing the politicization of the pandemic, MacDonald advised parents to keep their kids’ safety at the centre of their vaccination decision-making.
“All the scientific evidence shows that vaccines are the best way to protect your kids. So try and set aside the politics and think about ‘What do I do to protect my kids?’” MacDonald, a mother herself, said.
“I think parents need to remember that we want our kids to be at school, at activities, living normal lives, and that’s achievable,” Constantinescu said. “It’s achievable with COVID and it’s achievable even with other infections like influenza and so on, because we do have vaccines.”
Six additional deaths per day in past week
In the weekly COVID-19 data release from the province, it showed 42 new deaths from COVID had been accounted for, an average of six per day. One of those new deaths appears to have been an individual aged 20-29.
The pandemic death toll in Alberta is now 4,790.
Hospitalizations were down by 13 from the previous week, to 857, with ICU patients down to 20 from 32.
The seven-day average positivity rate of PCR tests was down just more than three per cent from the week before, to 18.8 per cent. In January, Alberta restricted PCR tests to people with clinical risk factors or who live and work in high-risk settings.