Dr. Anne Wormsbecker stands near a children's play area including a slide.

Dr. Anne Wormsbecker

With Health Canada’s approval, Canadian children ages 5-11 will soon have access to COVID-19 vaccines.

Dr. Anne Wormsbecker is a parent, a pediatrician based at St. Michael’s Hospital, prior interim chief of pediatrics at St. Joseph’s Health Centre, and has researched and guided the Ontario government on immunization. She knows parents have questions about the vaccine, how it works and if their child should get it.

Here, Dr. Wormsbecker answers common questions about why kids need a lower dose, the rigorous scientific process that went into its approval, and strategies to help little ones feel comfortable on the big day.

How do you feel about a COVID-19 vaccine for children?

I’m so excited about the COVID-19 vaccine for school-age kids! Our children have paid a huge price during this pandemic and with the COVID-19 vaccine, they will be able to resume more and more of their pre-pandemic activities. Day-to-day life without masks, with extracurricular activities and even spontaneous indoor playdates feels like a fantasy right now. With immunization, we’re one step closer to making that fantasy reality.

How is the COVID-19 vaccine for five to 11 year-olds different from the COVID-19 vaccine for adults?

​For adults, there are a few different COVID-19 vaccines available. For children aged five to 11, the vaccine we’re discussing is the mRNA vaccine manufactured by Pfizer. The manufacturer found a sweet spot for children – the dose they will get is one third of the dose given to adults and youth ages 12 years and up. Kids have a highly robust and strong immune system and only need one third of the dose for adults to have the same immune response as us. The smaller dose also reduces discomfort (side effects) as the body undergoes its immune response. 

How well reviewed is the vaccine for kids?

This question feels like deja-vu – because nearly one year ago we were having this same discussion about the COVID-19 vaccine for adults. I want to reassure everyone that an incredibly rigorous scientific process is followed for all vaccines, from start to finish.

Manufacturers follow strict study protocols, then submit their data for approval to drug regulatory bodies, such as Health Canada. Very high standards must be met for approval by Health Canada and then we have an independent body of volunteer-experts who review the data to provide guidelines. In Canada, that’s the National Advisory Committee on Immunization (NACI). It’s only after this rigorous process that we get provincial and local public health immunization programs for any vaccine.

Why is it important to vaccinate children against COVID-19? Isn’t it good enough just to rely on herd immunity in adults?

I’ve had this question from friends, family members and even colleagues. In order to get to a state of community protection – what’s known as ‘herd immunity’ – we need as many members of our entire population vaccinated, including children.

While our hospitals haven’t been over-run with kids sick with COVID-19, kids do get COVID-19. We know the delta variant affects more young people. South of the border, there was a surge in COVID-19 cases among children in the late summer. We want to avoid a situation like that. By vaccinating all age groups, we can get to a state of community protection faster. Kids can also get back to their pre-pandemic lives.

Is the rare risk of heart inflammation (myocarditis) that was previously reported in young men after getting the COVID-19 vaccine a concern in children?

​The vast majority of children and adults will be vaccinated without experiencing significant side effects. Reassuringly, in the studies of the mRNA COVID-19 vaccine for children age five to 11 years, there were no cases of heart muscle inflammation. As with any new vaccine or medication, there will be ongoing monitoring for rare side effects like this one. We also need to remember two things: 1) the cases of heart muscle inflammation associated with COVID-19 vaccines have been relatively mild and 2) COVID-19 illness itself causes heart muscle inflammation, more commonly than the vaccine, in fact.

What do you say to parents who feel hesitant or nervous?

Parents and health care providers share a common goal – the best health for kids. It’s normal to be nervous when making any decision, let alone a medical decision, for your child. I encourage people to get accurate information from hospital-run websites for parents, from public health, and from their health care providers.

When I’m speaking one-to-one with a parent caring for a child, I find out their specific worries and address them. Some people are worried about the immunization experience. There are incredibly effective strategies for making immunization a positive experience – from numbing creams at the injection site, to distraction and mindfulness strategies.

My own kids, age five and seven years, pretty much have their sleeves rolled up and are ready to go for COVID-19 and influenza vaccines this year. One of them needs a bit more coaxing than the other, so we’ll focus on deep breathing, distracting videos, and even do something fun as a family together after the vaccine to make it a positive experience.

Kids are really smart. We also need to talk to them about both the benefits to them and our community as a whole. If we place an emphasis on those benefits, the drawbacks and discomfort are more worth it.

Is there anything you’d like to add?

Please don’t forget about the influenza vaccine for yourself and your children of all ages! The influenza vaccine is available in Ontario for those age six months and above. As restrictions lift, we’re expecting a big flu season. NACI now advises no set time spacing is needed between COVID-19 vaccine and other vaccines.

By: Jennifer Stranges