Rolling Out the Complete COVID Vaccination Plans Targeting Children

"We may end up seeing them being more important in transmission going forward."

"We've seen what's happened in children over the last year."

"[Once most adults have been vaccinated], I think at that point we need to take stock and see how many cases are we still seeing -- what is the role of children."

"[Once vaccines are approved for children], we need to think about this logically in the same way we've approached the adult program."

"Think about the current vaccines we use in children. There are very few that we vaccinate across the entire childhood spectrum."

Dr.Manish Sadarangani, director, Vaccine Evaluation Centre, B.C.Children's Hospital

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"Kids haven't really been severely infected by COVID, so before we give them anything we have to make sure that there's no immediate side effects, or in the months following the vaccine, to make sure there's nothing that comes out of an overactive immune response to the vaccine."

"[After every peak of COVID], we see a pretty constant flow of cases. Before we roll out this vaccine we want to make sure there's absolutely no signal for that [hyper inflammatory syndrome]."

"Our pediatric wards are overflowing with teenagers who've decompensated as a result [of school closing, social isolation, etc.] -- I'm talking suicide attempts, overdoses, severe eating disorders, psychoses, depression."

"I've learned to respect this virus, and be humble. I'm just a little worried about what might be next, what the next twist with this virus will be."

"[The question is the pre-puberty age group under age 11 and younger]; there we have to be really careful with dosing. The response might be different."

Dr.Gatima Kakkar, infectious diseases pediatrician,CHU Sainte-Justine, Montreal

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The world has its work cut out aiming to achieve 'herd immunity' throughout human society. The focus for the present is immunizing adult populations in all age groups. Children have demonstrated a slighter reaction from COVID infection, but at the same time they are may be more efficient at spreading the pathogen than they're given credit for. To ensure that control is eventually achieved over the novel coronavirus, children too will have to be vaccinated in the greater interests of safety for all communities.

Word recently came down that Pfizer's COVID vaccine appears to have worked out extremely well at protecting 12- to 15-year-olds. It was already known that the vaccine had proven to be effective in protecting those aged 15 and older and although the Pfizer-BioNtech vaccine is thus far the only one to be authorized for use on those age 16 and over, anticipation is that younger teens' response will be similarly effective. The question looms, however over infants and pre-puberty age groups.

The anticipation is that COVID shots for children are on the near horizon. The urgency is great, given the emergence of hyper-contagious variants that are now deadlier than the original virus, causing younger adults to end up in hospital, many of them connected to lung bypass pumps. Scientists in Ontario gave warning that the risk of being admitted to an ICU for adults is now two times higher, risk of death 1.5 times greater with the mutant variant from the U.K. that is now driving Ontario and B.C. into new shutdowns.

There has been no detection among children with COVID that the new variants have affected them with greater severity, however. At present while children don't appear to be major COVID drivers, their role is yet to be fully understood. The symptoms they suffer are mild, to the effect they may be less likely to get tested than adults. Some studies suggest infection rates in children are similar to those for adults. "When we adjust for under-testing of kids under ten, we find that their risk is the same as that in adults 70 and older", explained University of Toronto epidemiologist David Fisman.

On a national level, the highest proportion of COVID infections (22 percent) are in those aged 19 and under. Dr.Sadarangani, a specialist in pediatric infectious diseases, is in the process of leading a project testing blood samples from a mite over 2,500 children and youth 25 and younger for antibodies to the SARS-CoV-2 virus. The presence of antibodies indicates previous infection. The study is meant to help gain a true picture on how many children have been exposed to the coronavirus.

Citing their trials data, Pfizer Inc. and BioNTech stated that their COVID-19 vaccine appears 100 percent effective, having produced "robust" antibody responses in 12 to 15-year-olds, based on phase 3 trial early results where 2,260 teens participated. Tests on children as young as six months are also proceeding, and Novavax and Oxford-AstraZeneca too have begun or plan to test their vaccines in young children. Children aged up to 19 represent 1.6 percent of hospitalizations.

Typically, half the adult dose is being tested on young children, since younger children have a tendency to exhibit more robust immune responses in that children can have much stronger immune responses to COVID itself resulting in hyper inflammatory syndrome of a type not seen in adults which begins six to eight weeks following a COVID  infection with persistent fever, fatigue fussy eating, abdominal pain and other such symptoms. How to treat the syndrome is known to doctors when the immune system is highly impacted, leading to a concern that children might react similarly to a vaccine.

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