We have recently been notified that Toronto Public Health will be holding Covid 19 vaccine clinics for children as of January 25th 2024. Please go to Toronto Public Health Vaccine website after January 25th to book your appointment.
Clairhurst will not be administering Covid 19 Vaccines in our office in 2023/4
Covid 19 Vaccine Recent Information of Eligibilty (2023):
https://www.toronto.ca/community-people/health-wellness-care/health-programs-advice/respiratory-viruses/covid-19/covid-19-vaccines/covid-19-vaccine-eligibility-doses/
Covid 19 Vaccine Information (2022):
NACI (National Advisory Committee on Immunization) strongly recommends that individuals 12 years of age who are at increased risk of severe illness from COVID-19 should be offered a fall COVID-19 vaccine booster dose regardless of the number of booster doses previously received. (Strong NACI recommendation)
NACI recommends that all other individuals 12 to 64 years of age may be offered a fall COVID-19 booster dose regardless of the number of booster doses previously received. (Discretionary NACI recommendation)
NACI recommends that the authorized dose of a bivalent Omicron-containing mRNA COVID-19 vaccine should be offered as a booster dose to the authorized age groups (18 – 64 years of age).
What does Clairhurst say?:
there are no hard + fast rules here
The new vaccines (bivalent) provide better protection than original vaccines, but no vaccine is complete protection.
Following public health guidelines and deciding what works best for the child/youth.
Roughly – if it has been more than 6 months since your last Covid 19 vaccination or had covid 19 virus itself, consider yourself susceptible.
Covid 19 Vaccines for age 6 months – 5 years
On July 14, 2022, Moderna (aka Spikevax) was approved for use in children 6 months to 5 years (dose is 25mcg per vaccine).
Most children with Covid-19 have mild disease (fever, cough, congestion, runny nose, sore throat, fatigue, vomiting) and are sometimes do not have any symptoms at all. Most do not need to be hospitalized for their illness (15.9 per 100,000 are hospitalized with recent variants). Severity of future variants is unknown. Risk factors for more severe disease include congenital heart problems, chronic lung conditions, the need for a feeding tube, prematurity (in kids <2yo), epilepsy, neurodevelopmental disorders, obesity, high blood pressure, metabolic disorders, and immunosuppression.
Moderna trial data:
Efficacy against symptomatic infection was 50% in kids < 2yo, and 36.8% in kids 2-5yo. Due to the lack of severe outcomes/MIS-C in the trial, the vaccine was not able to be evaluated for efficacy against these. In children who had evidence of covid antibodies before vaccination (ie who had been infected before being vaccinated), the antibody levels rose significantly after vaccination (though what this means in terms of protection from illness is hard to say).
Side effects:
Side effects from the vaccine were largely mild – most often including fatigue (in about half of kids), crankiness, sore arm, a bit of redness at the site of injection, and fever in 10-20% of kids. A smaller percentage of children had nausea/vomiting, joint pains, or lymph nodes enlarged in the underarm area. Of note – there were NO deaths, MIS-C cases, and NO pericarditis/myocarditis cases (this is thought to be seen rarely in older teens/young adults). Keep in mind that vaccine trials do not always pick up very rare side effects due to the number of participants, so close monitoring of vaccine side effects will continue as children are vaccinated in both Canada and the USA.
The vaccine trial was done with 2 doses given 28 days apart. NACI recommends 8wk interval between doses.
Final recommendations from NACI (National Advisory Committee on Immunization):
NACI recommends that a complete series with the Moderna Spikevax COVID-19 vaccine (25 mcg) may be offered to children 6 months to 5 years of age who do not have contraindications to the vaccine, with a dosing interval of at least 8 weeks between the first and second dose.
NACI recommends that children 6 months to 5 years of age who are moderately to severely immunocompromised may be immunized with a primary series of three doses of the Moderna Spikevax (25 mcg) vaccine, using an interval of 4 to 8 weeks between each dose.
NACI recommends vaccination 8 weeks after natural infection. Hybrid immunity (ie. vaccination AND natural infection) is better than either on their own!
What does Clairhurst say?
In general, your paediatricians at Clairhurst support vaccines and protecting your kids from severe illness wherever possible. The data shows that this vaccine is very safe and generates a good immune response. As Covid-19 evolves and different variants emerge, current vaccines certainly won’t prevent all infections – but it will prevent some. It also seems reasonable to expect that this vaccine will likely prevent severe disease/MIS-C in young children, similar to vaccines in older children and adults, but because severe disease is (thankfully) quite rare in kids, it is difficult to definitively prove at this time.
Overall – we are in favour of vaccinating your kids, especially if your child has underlying health problems which might put them at higher risk of severe disease.
Aren’t younger children less likely to develop serious illness from COVID compared to adults?
While it is true that younger children are less likely to have bad outcomes from COVID (like hospitalization, death) compared to adults, the risk is NOT zero. Sadly, there are children who have and will develop serious illness, long COVID symptoms, and even death. Deaths have been reported in children with and without underlying medical conditions. Research shows that the vaccine is both safe and effective, and we feel the risk benefit balance strongly favours getting the vaccine over illness.
Are the vaccines safe for a young child? (Short term)
The research shows that in the short term, the vaccine side effects are very similar to many of the vaccines that your children have previously received; injection site soreness, muscle aches, and fever are common examples. The question about myocarditis (inflammation of the heart muscle) and/or pericarditis (inflammation of the sac around the heart), has not yet been answered in this younger age group. It is an uncommon and typically mild (does not require hospitalization) side effect seen in teens and young adults. Keep in mind that getting ill from COVID can lead to myocarditis, which is typically MUCH more severe and life threatening when compared to the vaccine side effect.
Are the vaccines safe for a young child? (Long term)
Obviously, there are no data to answer the question of long term safety of COVID vaccines. Keep in mind that with ANY “new” vaccine, there will be no long term data. To date, there has NOT been a situation where a “new” vaccine -including several vaccines that are part of today’s routine schedule-has caused a long term problem or complication. While this is no guarantee, we feel very confident that vaccination risks are MUCH lower than the risk of COVID illness.
Should my eleven year old wait until 12yrs old to get the adult dose?
The consensus from experts is to get the first covid 19 vaccine available.
Is there a time frame between other vaccines that I have to wait? For example – flu shot, routine childhood vaccines
The National Advisory Committee on Immunization has recommended Covid 19 vaccine for children age 6mths -11 years old should NOT be given at the same time with other vaccines. In the absence of evidence it is considered prudent to wait for a period of at least 14 days before or after administration of another vaccine.
What is the time we need to wait if my child is positive for Covid 19 virus?
After the 10 days quarantine and the patient is feeling well again.
Should I get the 2nd Covid 19 vaccine sooner than 8 weeks after the first one?
There is better immunity if you wait the full 8 weeks.
As you are making this important decision about the vaccine for your children, here is a FACT to consider: vaccines truly are a miracle of science, and save more lives than ANY other medical or surgical intervention. For a truly frightening thought, ask yourself where would we all be today if there was no COVID vaccine?
“You are entitled to your own opinion. But you are not entitled to your own facts” – Daniel Patrick Moynihan
Additionally Covid 19 vaccine information can be found at: aboutkidshealth.ca Ontario Ministry of Health Vaccine Portal opens November 23rd 2021. Children age 5-11yrs will be eligible to book an appointment at tphbookings.ca or Ontario.ca/bookvaccine or by calling 1-833-943-3900
Letter of exemption from Covid 19 Vaccine. Our doctors cannot provide letters of exemption or fill out exemption forms for Covid 19 vaccines unless an allergist/immunologist-confirmed severe allergy or anaphylactic reaction to a previous dose of a COVID-19 vaccine or to any of its components that cannot be mitigated; a diagnosed episode of myocarditis/pericarditis after receipt of an mRNA vaccine).
