We can't protect our kids from everything, but we can and must protect them against COVID-19 infection

This Opinion piece was written by Dr. Alexander Wong, an infectious disease physician in Regina.

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A few months ago, my three-year-old son asked to sit on the counter and watch as I prepared breakfast. I lifted him up next to the stove, not thinking twice, and he watched and laughed as I made scrambled eggs, his favourite. 

As I pivoted briefly to plate the eggs, I heard a terrible scream. My son had, in a fleeting instant, lost his balance and placed his right hand and wrist onto the hot stovetop. 

All I could think as I rinsed my screaming, crying son's hand under cold water was, "How could I let this happen?" 

No parent ever wants to let their children come to any harm, ever. 

With this in mind, in my dual role as a physician and parent of three young children, I was excited to learn last Friday that Health Canada had approved the use of the Pfizer-BioNTech COVID-19 vaccine in children aged 5 to 11. We expect doses to be administered to children across Canada beginning this week. 

Some parents understandably have questions and want to understand the latest evidence around the efficacy and safety of this vaccine for children.

I am an infectious disease physician. I also have another son who is five years old. I have reviewed all the current evidence carefully and am excited to vaccinate our five-year-old son at the first available opportunity with absolute confidence. 

I'm also encouraging all other parents to do the same. Here is why.

'An ounce of prevention is worth a pound of cure'

Health Canada's approval was based on a clinical trial done in the U.S. amidst a major surge in cases due to the delta variant. It found that being fully vaccinated reduced the likelihood of being infected with COVID-19 by more than 90 per cent, an impressive result.

Many parents question why younger children need this vaccination when the chance of death from COVID-19 is so low. Simply put, an ounce of prevention is worth a pound of cure. Even if COVID-19 is very unlikely to kill children, vaccinating children will practically eliminate this risk. Additionally, COVID-19 infection carries the risk of serious consequences such as multisystem inflammatory syndrome in children (MIS-C) and long-term complications ("long COVID"), our understanding of which is evolving quickly.

It makes sense to prevent COVID-19 whenever possible through vaccination, especially in children.

The primary safety concern of the mRNA vaccines thus far has been incidents of heart inflammation, such as myocarditis. Recent Israeli data showed that the rate of myocarditis was highest in males between ages 16 and 29, at 11 per 100,000 vaccine recipients, or 0.011 per cent. This risk is likely even lower in children aged five to 11, given that myocarditis is typically a post-pubertal phenomenon, and the dose for children in this age group is one-third that of persons over age 12.

We can also take reassurance from the U.S., where children have already started getting the same vaccine. In the last three weeks, nearly 10 per cent of all eligible children aged five to 11 in the United States have received their first dose. No cases of myocarditis or heart inflammation have been reported. Children in the U.S. will be receiving second doses in the coming weeks, so even more data should be available soon.

Here in Canada, the National Advisory Committee on Immunization (NACI) has recommended an eight-week interval between doses in children aged five to 11, rather than the three weeks used in the clinical trial program and in the United States. Data from multiple countries suggests that extending the dosing interval increases overall vaccine effectiveness and lowers rates of myocarditis.

We must listen, educate and counsel so as many eligible children are vaccinated as possible.- Dr. Alexander Wong

Parents sometimes remain hesitant due to the lack of long-term data on COVID-19 mRNA vaccines. There is no scientifically plausible argument that long-term side effects will occur. mRNA degrades in the body quickly, so we would expect any side effects to occur within six to eight weeks of vaccine administration. No impacts on either fertility or pregnancy have been seen after billions of doses of COVID-19 vaccine administered worldwide.

The science around COVID-19 vaccines continues to rapidly evolve. Identifying sources of reliable, evidence-based information is difficult. Hesitancy for some parents is natural and understandable.

Children and their caregivers must be continually supported and respected as they try to make an optimal informed decision, and not stigmatized or shamed for either accepting or refusing the offer of vaccine. I believe at this time that vaccine "mandates" for this age group should not be implemented until there is robust real-world evidence to support vaccination. Fortunately, such data should emerge quickly, given intense post-approval surveillance.

Benefits of vaccine far outweigh potential risk

To conclude, let me take off my professional hat and speak as a parent. 

The pandemic has done profound collateral damage to the physical and mental well-being of children. Based on all of the accumulated scientific evidence to date, along with the current real-world example in the United States, I am confident the benefits of vaccinating young children far outweigh any potential risks. 

Vaccinating our children will help reduce disruptions in their lives from COVID-19, protect them from short- and long-term complications of COVID-19 infection, prevent them from spreading infection to those who are medically vulnerable, and help move society as a whole one step closer to a new semblance of normalcy.

We can't protect our kids from everything the world has in store for them, but we do have the tools to protect them from COVID-19 infection. We must listen, educate and counsel so as many eligible children are vaccinated as possible.

A couple of weeks ago, I was making pancakes on the same stovetop where my son had hurt himself. He asked me if he could sit on the counter again to watch me. I hesitated for a moment, but then agreed. 

As I lifted him up, he pointed for me to put him on a spot far away from the stove.

"Daddy, no more stove owies, OK?"

I nodded and smiled.

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