The promotion for 0-4 year olds (children from 6 months) started at the end of July, and yet there is no rush at the gate.
According to the Department of Health and Social Care, as of August 16, only 9,656 doses had been administered and 18,009 appointments had been booked since July 25, by approximately 400,000 children in that age group.
Experts answered our questions to enlighten parents who would like more decision support.
Why should young children be vaccinated against COVID-19?
dr Hélène Decaluwe, a specialist in pediatric immunology at CHU Sainte-Justine, said from the start that she heard some parents’ fears and concerns about vaccines in very young children.
Despite this widespread vaccination habit in Quebec, a survey conducted last May by the National Institute of Public Health of Quebec (INSPQ) showed that 40% to 44% of parents of children aged 6 months to 4 years were vaccinated against COVID-19 for fewer considered more important than routine vaccination.
The reasons include: a perception that their children are too young and that the risks associated with the coronavirus are low in young children, then a vaccination hesitation linked to the actual safety of vaccines.
Despite the unknown and the novelty, according to Dr. Decaluwe are perceived in the same way as those offered to obtain full vaccination status.
“You have to remember that we vaccinate our children regularly from an early age to protect them from various infections. »
— A quote from Dr. Hélène Decaluwe, Specialist in Pediatric Immunology at CHU Sainte-Justine
The most recent study conducted in 2019 by the INSPQ on the vaccination rate of children in Quebec (New Window) aged 1, 2 and 7 years showed that 85% of the one-year-old infants (up to 15 months) had received all the Vaccinations in the regular program.
Among 2-year-olds (24 months), 81% had received all vaccinations, while 70% of 7-year-olds were fully vaccinated.
Are children aged 6 months to 4 years more at risk?
Referring to the hesitance to vaccinate in the very specific case of COVID-19, University of Sherbrooke Faculty of Medicine and Health Sciences professor and neonatologist Dr. Arnaud Gagneur in an interview with Radio-Canada in April that the goal is not to persuade those who will participate at any cost, but to answer their questions and listen to their concerns without judgement.
With this in mind, the INSPQ Medical Advisor, Dr. Nicholas Brousseau, to reiterate that the vaccine against the coronavirus – like most vaccines ultimately – really helps prepare the immune system. [de l’enfant] have a milder infection.
It is particularly effective in greatly reducing your risk of going to the hospital or getting serious problems. [s’il contracte] COVID-19, he emphasizes.
Additionally, all of the experts we spoke to acknowledge that early in the pandemic, perceptions of the less intense side effects of children who contracted COVID-19 may have caused some confusion.
At the beginning of the pandemic, children were neither in school nor in daycare. They were isolated, recalls Dr. Decaluwe. For them, children – young and old – seemed less at risk.
However, Decaluwe points out that data specifically for the 6 months to 4 years age group needs to be considered: compared to young people aged 5 to 17 years, young children are four to five times more likely to be hospitalized with the infect virus.
Researchers at Vanderbilt Children’s Hospital in Nashville, Tennessee, published a recent study of young people ages 2 months to 18 years, conducted during the first two years of the pandemic, in the American Academy of Pediatrics journal Pediatrics.
Of the 15,137 children hospitalized for the virus, 1,060 (7%) had neurological complications as a result of their infection, and children aged 2 months to 4 years would be more affected.
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However, the appearance of the Omicron variant some time before the end of the study does not allow a definitive conclusion as to whether neurological complications will occur. Further studies are required.
Long-term COVID-19 and pediatric multisystem inflammatory syndrome (SIME) are also among the complications identified by the INSPQ in children in general.
It would be a shame if a preschooler didn’t have access to a vaccine that can protect them from serious complications or death, suggests Dr. Decaluwe before.
Does infection protect?
As with people of other ages, vaccination against COVID-19 is not mandatory for young children in Canada, although it remains highly recommended by all health authorities in the country.
It is also important, according to Dr. Decaluwe and Dr. Brousseau not to assume that a COVID-19 infection provides immune protection.
For researchers, infection is no protection.
“Specifically, this means: It is not because you have an infection that you are necessarily protected and have developed all the necessary immunological weapons to fight an infection. [qui peut devenir] difficult. »
— A quote from Dr. Hélène Decaluwe, Specialist in Pediatric Immunology at CHU Sainte-Justine
In addition, a child who becomes infected with COVID-19 cannot receive their vaccine dose until 8 weeks after infection.
So far, Moderna is the only medicine to receive approval from Health Canada to offer its vaccine to 0- to 4-year-olds. The Committee on Immunization of Quebec (CIQ) also recommends the Spikevax vaccine (Moderna).
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Moderna’s clinical trials, testing the effectiveness of doses in symptomatic conditions, were conducted during the period when the Omicron variant was dominant.
dr Decaluwe explains how to interpret the results in terms of vaccine efficacy: it should not be concluded that the vaccine is only half effective, but that 50% [des] children [de 6 à 23 mois] are fully protected.
She also reminds that the vaccine’s effectiveness rate is reduced due to the variants, which does not mean that the vaccine is of poor quality.
“We must insist on the effectiveness against severe cases and hospitalizations, which is very high. The important thing is to reduce the risk of complications, not infections. »
— A quote from Dr. Hélène Decaluwe, Specialist in Pediatric Immunology at CHU Sainte-Justine
In addition, children aged 6 months to 4 years receive a quarter of the regular dose (25 µg). The so-called pediatric dose is aimed at stimulating a large immune response but minimizing side effects.
As with other age groups, the vaccine requires two doses, and public health recommends waiting eight weeks or more between them to boost the immune system.
Regarding vaccine safety, Dr. Brousseau that no particular signal was detected in either Quebec or other countries.
On this last point, too, the INSPQ public data is unequivocal: the post-vaccination reactions reported are mostly local and systemic reactions of mild to moderate intensity, occurring one to two days after vaccination and resolving within two days. We are talking about reactions like:
- irritability or crying;
- Sleepiness;
- loss of appetite;
- light fever;
- edema at the injection site;
- axillary swelling/tenderness.
One case of erythema multiforme (redness) was reported to public health. No cases of anaphylaxis, pericarditis or myocarditis were reported in clinical trials, we can read in the INSPQ’s guide to vaccination against COVID-19 in children.
Waiting for new vaccines?
Because the available vaccines were made from the original strain of SARS-CoV-2, experts believe some people may prefer to wait for the new vaccines.
These bivalent vaccines, based on the original strain and the Omicron variant (BA.1), are currently in development at both Pfizer and Moderna.
For children, the question doesn’t really arise at the moment. Because when this Omicron-adapted vaccine arrives, it will be for adults first, warns Dr. Brousseau.
“It may be several months before a child vaccine suitable for Omicron is available. It is better to continue with the vaccine [actuel]. »
— A quote from Dr. Nicholas Brousseau, Medical Advisor to INSPQ and member of CIQ
Especially with the start of the school year or the return to daycare, he adds, there will certainly be many more outbreaks in September.
dr Decaluwe, who works with very young children on a daily basis, hopes this information will be challenging for parents.
It is important for them to understand that, despite all legitimate concerns, vaccinating young children is no different than vaccinating school children.
Immunological, biological, whether you’re four and a half or seven and a half. It’s the same, she says.
immune responses [du vaccin] are also effective [chez les 6 mois-4 ans]or even better than that of adolescents and adults.
For the latter, the government launched a new vaccination campaign on August 17 in anticipation of the start of the school year and return to work.