Low COVID-19 vaccine uptake in young kids concerning as viruses swirl, doctors say

Click to play video: 'Lagging of vaccine uptake could spell a worst-case scenario in Canada'
Lagging of vaccine uptake could spell a worst-case scenario in Canada
Infectious diseases expert Dr. Isaac Bogoch joins TMS once again for a weekly COVID-19 check-in where he discusses new subvariants, the current situation in Canada and the pandemic’s finish line – Oct 24, 2022

COVID-19 vaccines for children under five in Canada have been available for more than three months, but so far only a small fraction of eligible kids have received a pandemic shot, which is prompting doctors to sound the alarm as other viruses circulate and overwhelm children’s hospitals.

Data compiled by the federal government from the provinces shows just 6.5 per cent of children aged four and under have been administered at least one dose of the vaccine.

This is despite a dedicated advertising blitz launched in August by the federal government called the “lots of questions” campaign, aimed at raising awareness among parents about the benefits of COVID-19 vaccination and the safety and efficacy of the pediatric vaccines approved by Health Canada.

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The campaign, which ran from Aug. 29 to Oct. 30, was shared on a number of digital platforms, including websites and home screens as well as social media sites, such as Instagram, Tik Tok, Youtube, Facebook and Pinterest. Targeted radio spots and ads through search engine results were also used, according to a statement to Global News from Health Canada and the Public Health Agency of Canada (PHAC).

Now that multiple viruses are circulating in Canada, including the virus that causes COVID-19, there has never been a more important time for kids to get their shot, said Anne Genier, senior media relations adviser for Health Canada and PHAC.

“Getting infants and children in your care vaccinated with a COVID-19 vaccine can help protect them against severe illness and hospitalization. This is important this fall as we all spend more time together indoors and children attend school and daycare,” she said.

While most children who get COVID-19 have mild or no symptoms, some children, including those without underlying health conditions, can get very sick and must be hospitalized, Genier said.

“Data continue to show that children under 5 years of age may be more likely to be hospitalized from COVID-19 than older children,” she said.

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“Children who have underlying medical conditions may be at higher risk for getting really sick and experiencing complications.”

Pediatric COVID-19 vaccines have been available in Canada since July 14, when Health Canada announced it had approved the Moderna Spikevax shot for children aged six months to five years of age. In September, Pfizer’s pediatric vaccine was also approved.

In July, the National Advisory Committee on Immunization (NACI) recommended two doses of the vaccine may be offered to children within this age group with dosing intervals of at least eight weeks between the first and second dose.

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But to date, only a little over 122,000 of the nearly two million children under five in Canada have received at least one dose. Even fewer have received their full primary series of two COVID-19 shots — only 18,583 kids aged four and under have had both doses, which represents just one per cent of children of this age in Canada.

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These estimates, except for numbers of kids aged four and under, exclude Quebec from Oct. 9 onward due to changes in Quebec’s vaccination status categories.

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This low uptake of the pediatric vaccine is a concerning trend, says Dr. Ayisha Kurji, a general pediatrician in Saskatoon and assistant professor of pediatrics at the University of Saskatchewan.

“I think we are so lucky to live in an age where we have vaccines that prevent illness and can save our children from devastating outcomes, so any time we see vaccine rates fall low, we get worried,” she said.

“Six-point-five per cent, that’s really low. It makes me sad and it makes me worried for the kids, because it means that if you don’t have the vaccine, you’re more likely to end up with severe outcomes from the disease.”

A number of factors are likely playing into this trend, including misinformation about the safety of the vaccine and about COVID-19 in general, Kurji said.

But there has also been less focus on the pandemic among the public in recent months compared with when the virus first began circulating in Canada and when vaccines were first made available for adults in December 2020.

“COVID was top of mind for many Canadians, it was every day something that we heard about, whereas when the kids’ vaccine came out, it wasn’t,” Kurji said.

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“So we’re not getting those same reports daily of, how many people are in the hospital? What ages are they? What’s going on with them? So it makes it, I think, less important to people because you’re not hearing about it every day.”

It also doesn’t help that some people believe the pandemic is over and that it’s nothing to worry about anymore, she added.

“And that’s not true, unfortunately.”

Dr. Samira Jeimy, a clinical immunologist at London Health Sciences Centre and assistant professor in the department of medicine at Western University, says she is not surprised to see low uptake of the pediatric vaccine because she has observed a general sense of complacency about the need for vaccination among some parents who believe the virus is mild in children.

Hearing this false narrative combined with misinformation about the vaccine, notably around the risks of developing myocarditis — inflammation of the heart muscle — from the shot, could be leading some parents to believe the risks outweigh the benefits, Jeimy said.

“When people are constantly reading, ‘OK this side effect happens and this side effect happens,’ a parent then says, ‘I’ve been told that it is mild in kids, why should I get the vaccine?’ That’s a really primary concern right now.”

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And when it comes to myocarditis, the risks are “manyfold higher” if a child contracts the virus, she added.

A large study in England, which looked at COVID-19 data from 43 million people after the vaccine first became available, found the risk of myocarditis was indeed significantly higher after getting sick with COVID-19 compared with a relatively minor risk after vaccination. The study was published last month in the American Heart Association journal Circulation.

Both Jeimy and Kurji say the fact so few young children are vaccinated is likely adding additional pressures on children’s hospitals, many of which are operating well over capacity due to an earlier-than-usual onset of seasonal respiratory infections, including RSV (respiratory syncytial virus).

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Not only are some of the children now flooding children’s hospital ERs sick with COVID-19, but they also might be more prone to infection from other viruses if they’ve been exposed to SARS-CoV-2, Jeimy said.

“We know that some viruses can sometimes suppress your immune system,” she said, citing the example of measles, which results in immunodeficiency for many months, resulting in increased susceptibility to secondary bacterial and viral infections.

“I am seeing more and more evidence that COVID infection might have that similar impact on the immune system where … after having a bout of COVID illness, people are having all kinds of infections that are not super common.”

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