Whenever we play doctor in my house lately, my kids always make sure to give me an X-ray, a band-aid—and an imaginary coronavirus shot.
The idea of a COVID-19 vaccine has been a constant subject in our house since we first explained to my worried six-year-old that all the smartest scientists in the world were working together to develop a shot that would make us immune. “We might not know how this story will go,” I said to him, “but we know how it will end. We’ll all walk into the doctor’s office, get the vaccine, and things will go back to normal.” During this conversation, I was thinking of my childhood habit of reading the last chapter of scary books first, and how knowing that everything was going to turn out okay made me feel better during the bits that frightened me. (I was also trying not to cry.)
The idea that a vaccine would be a magical ticket that sent us back to our 2018 lives turned out to be both correct and wishful thinking. It’s becoming clear that while vaccines are what will end the pandemic in Canada, getting them won’t instantly free us from the need for social distancing, masks and other public health measures. It’s also now obvious that my family won’t get our shots at the same time—the vaccines that are being used in adults haven’t even been tested in children yet, and my six year old and toddler will likely get their shots many months after I do.
Here’s what we do know about how and when Canadian kids will get the COVID-19 vaccine.
Tweens and teens will get the shot before little kids do
There isn’t any finalized research on any of the coronavirus vaccines and kids or teens. “All the initial COVID-19 trials were done in adults,” says Anne Pham-Huy, a paediatric physician and infectious disease specialist at the Children’s Hospital of Eastern Ontario who sits on the National Advisory Committee on Immunization. As a result, neither of the two vaccines currently available in Canada—one made by Pfizer-BioNTech, the other by Moderna—are authorized for use on children. (One exception: The Pfizer-BioNTech vaccine included teens 16 and older in their studies, so it’s approved for those older teens.)
The next step for the vaccines is to test adolescents. Pfizer-BioNTech will likely be first; it has said it could be authorized for use in teens before July, 2021. The company has already begun testing teens from 12 to 15 years old in the U.S., recruiting 2,259 teenage trial participants, and randomly giving half the vaccine and the other half a placebo. It’s now waiting to see if they develop side effects, and how many in each group get sick from the disease. That process should take at least two months, because that’s how long regulators, like Health Canada, require to see if any side effects appear—though Pfizer-BioNTech will continue to follow participants for two years, and Health Canada collects reports of any adverse events from vaccines as well.
Moderna is also starting to test on teenagers, but that’s moving slowly. “Their recruitment has been a bit slower than planned,” says Stephen Freedman, a professor of paediatrics and emergency medicine at the University of Calgary’s Cumming School of Medicine. The Janssen and AstraZeneca vaccines—both of which are under review by Health Canada—are also in a similar state. They’ve been tested on adults, and will move forward on adolescents next.
When will Canadian children get the COVID-19 vaccine?
Moderna has said it won’t be completing studies on younger children until 2022, and the timeline will probably be the same for the other companies as well. They won’t start testing in children until they can prove their vaccines are safe and effective in adolescents.
And yet, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the U.S., said on Feb. 11 that American kids as young as grade one might be able to get the vaccine by September 2021, as long as the trials are successful in that age group, according to an article in ProPublica.
Even when vaccines are approved for younger age groups, other factors come into play as well—like if we have enough of the vaccines, which we know from the Canadian roll out so far, can be a major roadblock. Kids are much less likely to be hospitalized or die from COVID-19, so if there is a shortage, they will be at the back of the line in terms of receiving it (though children with medical conditions who are at a higher risk are likely to get it earlier).
Do kids really need the vaccine anyway?
Experts say yes. “In general, kids don’t get that sick from this coronavirus, especially when compared to adults,” says Freedman. “But that doesn’t mean kids don’t get sick at all. Severe outcomes are uncommon, but they do occur.” He adds that the U.S. has documented 1,659 cases of multisystem inflammatory syndrome from COVID-19, and 215 deaths from coronavirus in kids.
Pham-Huy agrees. “If you have a vaccine that’s been tested and is safe and efficacious, I would definitely go for the vaccine rather than having to chance it with the disease itself.”
But another reason to vaccinate kids is to prevent them from spreading the disease. Although it’s not proven yet that the vaccine reduces people’s chances of transmitting the disease, scientists think that it will, and are hoping that will be borne out in further research. If it is, the idea is that vaccinated kids won’t spread the virus—and we’ll need to vaccinate kids to reach herd immunity, and have life go back to normal. “Children need to be vaccinated to let them return to classrooms, collective recreation, and companionship with each other, for the good of their physical, intellectual, and emotional development,” says Freedman.
And I think we’re all ready for that.