On Nov. 19, Health Canada announced the approval of the Pfizer-BioNTech two-dose COVID-19 vaccine for children between five and 11-years-old, allowing children in that age group to be vaccinated with a dosage that is one third the size that has been offered to those aged 12 and older.
To date, it is the only COVID-19 vaccine approved for that age group. Health Canada says clinical trials showed that lower doses provided good protection, with no safety issues detected.
The National Advisory Committee on Immunization (NACI) recommends that second doses be given at least eight weeks after the first. Children who turn 12 before their second dose, meanwhile, may receive an adult dose.
As a precaution, Health Canada advises that children not receive the vaccine within 14 days of other vaccines, such the flu vaccine, in order to monitor any side effects from either the COVID-19 or another vaccine.
ELIGIBILITY AND ROLL OUT PLANS BY PROVINCE AND TERRITORY
British Columbia: Parents are able to register their child for a COVID-19 vaccine using the province’s Get Vaccinated system. As of Nov. 19, officials said more than 75,000 children had been registered. The B.C. Centre for Disease Control says children who are four-years-old will only be able to get vaccinated after their fifth birthday. The vaccines are free and children do not need B.C. Care Cards to receive them. First and second doses for children aged five to 11 will be offered eight weeks apart, an FAQ from ImmunizeBC says. B.C. also has made material, including a comic, available to parents for talking to their child about getting vaccinated. Consent from one parent or guardian is required.
Alberta: COVID-19 vaccine appointments for children aged five to 11 in Alberta are available as of Nov. 24 following the receipt of more than 394,000 doses. Doses will be administered at more than 120 Alberta Health Services vaccination clinics and four pharmacies across the province, with more than 390,000 Albertans aged five to 11 able to get vaccinated as early as Nov. 26, a government press release said. Although a number of walk-in vaccine clinics are available, the province says walk-in appointments are not available for children aged five to 11. Parents and guardians are encouraged to talk to their pediatrician or family physician about getting their children immunized against COVID-19. The province also has created an online game where users can take down “COVID-zilla” while learning about COVID-19 immunization.
Saskatchewan: Childhood vaccination booking for Saskatchewan Health Authority (SHA) clinics became available on Nov. 23. Parent or guardian consent will be required, but only one parent is needed. The Saskatchewan government says more than 112,000 doses of the children’s COVID-19 vaccine are expected in the province, enough to provide every child in the five to 11 age group with a first dose. The SHA will offer the pediatric vaccine in 141 communities. Clinics also will be offered in more than 100 schools, along with specialized clinics for children with additional needs, such as autism and those in hospital, and vaccinations from Indigenous Services Canada, Northern Inter-Tribal Health Authority and participating pharmacies. Although NACI has recommended an eight-week interval between doses, the province says Saskatchewan families may choose to receive the second dose as early as 21 days after the first.
Manitoba: Manitoba has allowed parents and caregivers to book appointments online or by phone for children aged five to 11 to receive the Pfizer vaccine as of Nov. 22. Children must be five-years-old at the time the appointment is booked. Manitoba’s Vaccine Implementation Task Force has said vaccines for kids aged five to 11 will be available at pharmacies, physician clinics, urban Indigenous clinics and vaccine clinics. Manitoba also is recommending individuals receive their second dose of vaccine eight weeks after the first. The province has created an interactive map, called the Vaccine Finder, showing where immunization sites in Manitoba are located.
Ontario: Ontario families were able to start booking appointments for their children as of Nov. 23. Appointments can be booked online, by phone, through local public health units, participating pharmacies and select primary care providers. Children must be turning five-years-old by the end of 2021 to be eligible and doses will be offered at least eight weeks apart. Ontario is expected to receive 1,076,000 doses of the pediatric COVID-19 vaccine from the federal government. About one million children are eligible to get the shot in the province. Those with an appointment are asked to bring their booking confirmation code or email, an Ontario health card or a letter from their school, medical provider or faith leader for those without a health card, an immunization record if available, an allergy form if needed, a mask and a support person if necessary. Anyone getting the COVID-19 vaccine in Ontario, including children and youth, must provide informed consent indicating they understand what the vaccine involves, why it is recommended, and the risks and benefits of getting it or not. Parents or “substitute decision makers” for children aged five to 11 will, for the most part, need to provide consent on behalf of the child at the time of the appointment before a vaccine is given, the province says.
Quebec: Vaccine appointments for children aged five to 11 are open, with residents able to book online on the Clic-Santé website. The first vaccine appointments started Nov. 24 and vaccinations at schools are slated to begin Nov. 29. Anyone between five and 17 years of age can be vaccinated at a clinic with or without an appointment. Vaccinations for children and youth are being done in vaccination centres or at school, but not in pharmacies. Children 13-years-old and younger need consent from a parent or legal guardian in order to be vaccinated, while adolescents 14-years-old and older can give their own consent.
New Brunswick: Vaccination appointments for children aged five to 11, offered through the Vitalité and Horizon health networks, can be made online as of Nov. 23. Anyone aged five, turning five this year, or older is eligible to get the vaccine. About 54,500 children are eligible to receive it, according to the province. Under the New Brunswick Medical Consent of Minors Act, children can give consent as a mature minor to receive health care, like the vaccine. While they do not require parental consent under certain conditions, the province says it is “preferred” that parents or legal guardians consent to immunizations for minors younger than 16.
Nova Scotia: Nova Scotia announced Nov. 24 it expects vaccines for children aged five and 11 to arrive this week, with parents and guardians expected to be able to start booking appointments soon. Pharmacies and the IWK Health Centre in Halifax will be the province’s main vaccinators. Nova Scotia’s chief medical officer of health, Dr. Robert Strang, says they will be ready to start giving children vaccines by Dec. 2. Children will need two doses of vaccine, administered at least eight weeks apart. A child who turns 12 during that eight-week period may receive an adolescent or adult dose for their second. The province has a map available showing where vaccination clinics are located.
Prince Edward Island: Vaccinations will initially be offered at immunization clinics on dedicated dates and times. Starting in January 2022, in-school vaccinations will be offered to students in grades four, five and six. Eligible students in other grades will need to be vaccinated at a COVID-19 immunization clinic. An eight-week interval between doses is recommended. The province says, as with all immunizations, a parent or guardian must provide signed consent before their child can be vaccinated. Children who are 11-years-old can receive the adult version of their second dose if they turn 12 within the recommended eight-week interval.
Newfoundland and Labrador: The province expects to have vaccines arrive by Nov. 26, with the immunization campaign for children beginning “within days.” Appointments can be booked on the province’s Get the Shot webpage. Vaccines also are expected to be offered in schools. It is recommended that the second dose be booked at least eight weeks after the first. Children who receive a pediatric dose will receive the adult dose for their second vaccine if they turn 12-years-old during the eight-week period. Signed consent from a parent or guardian will be required.
Territories: Nunavut and Yukon had no readily available information on their government websites on vaccinations for children aged five to 11. The Canadian Press, however, has reported that COVID-19 vaccinations for children in Yukon between five and 11 years of age will start in early December. The Northwest Territories Health and Social Services Authority, meanwhile, says while the Pfizer vaccine has been approved for children aged five to 11, clinics are not yet scheduled and residents are asked not to book appointments until then. The territory expects to receive its vaccine allotment before the end of November. Eligibility for the five to 11 age group will be based on age at the time of appointment and not the year the individual was born.
VACCINES AND CHILDREN
Although children and youth are less likely to get seriously ill from COVID-19, Health Canada says they can still spread it to others, experience long-term effects from infection or develop a rare but serious complication called multisystem inflammatory syndrome.
Common side effects from the COVID-19 vaccine include redness, soreness and swelling at the injection site, along with more general symptoms such as chills, fatigue, joint pain, headache, mild fever and muscle aches.
Myocarditis and pericarditis — inflammation of the heart muscle and lining around the heart respectively — have been reported following vaccination with mRNA COVID-19 vaccines but appear to occur more often in adolescents and young adults, males, following a second dose and, while mild, typically shortly after vaccination, Health Canada says.
A statement in October from the Council of Chief Medical Officers of Health also noted that the risk of cardiac complications, including myocarditis, substantially increases following COVID-19 infection compared to after vaccination.
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