What a paediatrician mom wants you to know about the COVID vaccine

COVID vaccines for kids in the 5 to 11 age group are on the horizon, with Health Canada currently reviewing study data from Pfizer and provinces getting ready to start getting shots into younger arms. Officials in Ontario have said plans are underway for rolling out the vaccine once it’s approved and in British Columbia, you can even register your kid for the vaccine through the GetVaccinated website.

But of course, as parents, we have questions, so we spoke to vaccine advocate and paediatrician at Unity Health Toronto Anne Wormsbecker, who also happens to have a five- and seven-year old who can’t wait to get their shots. 

We’re getting much closer to getting our 5- to 11-year-olds vaccinated in Canada, which is super exciting, but of course parents want to make sure they’re going to be safe. What are you looking for before you’re comfortable having your own kids get the vaccine? 

I really trust our immunization system in Canada. I’m fortunate to know a little about the vaccine approval process and about the recommendations that come from the National Advisory Committee on Immunization (NACI). For me, knowing that something has been vetted and that it's effective and safe, and recommended for the child population, gives me reassurance.

We know that Pfizer has submitted trial data to Health Canada and that they have officially requested approval for their mRNA vaccine in the 5 to 11 age group. What are they looking at? 

Health Canada will review all of the data that's been supplied by the manufacturer, showing things like antibody levels, disease case counts in vaccinated versus unvaccinated individuals, and showing common side effects that we expect from all vaccines like a sore arm, and feeling tired. They will also review the data for more rare side effects as well. 

They're also looking to see if these studies have been done in a robust, scientifically rigorous manner. After Health Canada does that, then the vaccines go to the National Advisory Committee for Immunizations (NACI), that's made up of scientists, physicians and epidemiologists, all of whom volunteer their time to review the data as well and come up with program recommendations—that is, how the vaccine is delivered to the population. 

Side effects are a major concern for parents. What do we know so far? 

As with any vaccine, parents can expect their child to have discomfort, redness or swelling where the vaccine was given. That's the immune system doing its job. For example, I had my flu vaccine last week and my arm was sore for a couple of days.

Like adults, children can also have generalized, whole body discomfort after vaccine with fever, chills, muscle and joint aches, low energy, headaches, and even vomiting and diarrhea. Low energy, muscle aches and headaches are expected to be common whereas the others are not expected as frequently. In the manufacturer's studies, where kids were given one-third of the adult dose, approximately 90 percent of kids did not develop fever and chills.

Other side effects are extremely rare. Reassuringly, there were no cases of heart muscle inflammation [myocarditis] or severe allergic reaction in the studies used to approve the vaccine. There will be ongoing monitoring for these.

Where can we expect our kids to get the vaccine? I think a lot of parents would prefer it was at their doctor's office rather than a big convention centre. 

I wish I had some insider information, but I don’t. I do think it’s important to have child- and family-friendly immunization experiences. I would be delighted if there were programs that made the experience a positive one for kids and their parents. But we don't know yet. 

A recent Angus Reid poll showed 50 percent of parents are ready to vaccinate their kids as soon as it’s available, while almost a quarter don’t plan to do so. How do you reassure parents and encourage those who are on the fence?

When it comes to vaccines, and medications in general, we spend a lot of time talking about potential side effects, but that’s only because we know they work. So I like to focus on the benefits. I ask the family what they understand about the benefits of being vaccinated and the drawbacks of not being vaccinated. 

Then I ask if they have any questions. Some people want to hear about the science and others want to hear about how a vaccine works. Others want to know more about the basics, like, ‘How is this going to get in me?’

How does it work?

Using the metaphor of a recipe or instruction manual is a great way to describe how mRNA works. The vaccine sends an instruction manual to your cells to make a specific protein that's on the outside of the COVID-19 virus, the spike protein, and then that, in turn, has your body make the antibodies against the spike protein. Once that recipe is used, it’s no longer in your body. It's kind of like when you searched online for that perfect recipe to bake cookies, and then you can't find that online recipe anymore.

The other thing I explain is that the vaccine doesn't go into the very centre of the cell, what we call the nucleus. It doesn't join your DNA, your own recipe for your body and yourself. 

How can you prepare your kid for getting the vaccine? 

For kids who are really anxious, you don't want to be talking about something for a month, two weeks, or multiple days in advance because it gives them an opportunity to worry. Instead, spend time in advance taking a lot about the benefits. Then maybe the morning of the appointment,  talk to them about what they can expect in the room when they go for their vaccine. So it's not a total surprise to them, but at the same time, you haven't given the opportunity for their anxiety to build it up and imagine it to be more than it's going to be.

For kids who have fear of injection and fear of pain, you can buy a numbing patch over-the-counter that you put on prior to the immunizations, that can make it less painful. Also, pulling out a video of their favourite song or favourite show can easily distract them. 

There’s also guidance that encourages people to get vaccinated in their dominant arm because you use that arm more, and there's good blood flow to the area. You'll actually experience less discomfort in that side versus if you got it in your non-dominant arm.

Some parents are wondering why we even need to bother with vaccinating kids, since they don't get that sick from COVID. Do the risks of the vaccine outweigh the benefits?

We know with the Delta variant of COVID-19, younger patients are experiencing it more than they had with other variants. So there is, in fact, risk to kids. Likewise, when we are immunized, we have the ability to protect others. 

The other thing is, we've often said we're suffering through a parallel pandemic, with missed school time, increased sedentary activity in kids, and worsening mental health for children and youth. By getting vaccinated kids can get out and about and get on with their regular kid lives, which is really important right now.

Yes! Kids are missing out on so many things. What are your kids looking forward to after they get their vaccinations? 

My son's birthday is in March and the pandemic was declared the day before his birthday. We cancelled his birthday party at an indoor playground and we still have a credit note. Having a birthday party at an indoor playground and running around with friends, sitting to share cake, ice cream and snacks—for my kids, that would really be a sign that we're back to how things were before the pandemic.