Opinion | COVID-19 vaccines should be the norm for children, NACI says. Parents, it’s time to take action

Nobody likes being told what is best for their children.

There was a time, not that long ago, when recommendations to put children in an approved safety seat during car rides seemed like overkill to many. But with progress, today, when we bring our newborns home from the hospital, car seats are a norm. It’s a simple addition that helps protect our children, and while accidents may be rare, imagine how you might feel if your child got hurt when you had the ability to prevent that. Anticipate the regret you would feel.

Today, we’re facing something similar.

Canada’s National Advisory Committee on Immunizations (NACI) could readily be described as a medically-conservative group, often taking a cautious stance and holding off on strong recommendations until enough data accumulates. As a result, their recommendations have not been the same as those in the United States or Europe, or elsewhere. But this past week, they altered their guidance on immunization against COVID-19 for children aged 5 to 11. Briefly, they state that based on the latest data, the recommendation to vaccinate children is no longer discretionary, the recommendation is now as strong as they can make it.

In other words, they are saying that, just like with polio, vaccination against COVID-19 should now be the norm, not simply an option.

So what changed? Why is this expert, independent panel now strongly urging parents to ensure their children are vaccinated? We believe that two things have changed over the last few months.

First, Omicron is a pediatric wave. Children are now disproportionately affected. The past month brought us the greatest surge in children hospitalizations from this disease. COVID-19 is the most significant vaccine preventable threat our kids are facing right now. As physicians (and as parents) we are heartbroken every time one of our young patients gets sick and ends up in hospital under our care — doubly so when it could have been prevented.

Yes, most children who get infected do just fine, and thank goodness for that. But keep in mind that about one-third of children admitted with COVID-19 in US hospitals had no prior medical issues. Vaccinated children are far less likely to get severely ill and less likely to have long-term effects of infection. In older children, the vaccine reduced a severe complication called MIS-C by over 90 per cent.

Every death of a child is a tragedy — especially when it’s preventable. Keep in mind too that 99 per cent of children who contract polio do not end up with paralysis and again, thank goodness. Yet we as a society have decided to protect all our children against even small risks of life-altering events. Statistically, COVID-19 poses a more important risk to children in Canada now than any other vaccine preventable infection.

Second, we have substantially more data on the safety of these vaccines in children, based on many millions of vaccines now completed. Immediate side effects are minimal and transient. We can say confidently now that myocarditis after vaccination in this age group is extremely rare, likely due to both the biology of young children and the lower dose vaccine. We can further state confidently that myocarditis that happens due to COVID-19 infection is a more severe condition against which we can protect our children.

Many parents have questions about the long-term risks of vaccines. To them, we offer three responses. First, there is more reason to be concerned about long-term risks of COVID-19 infection, especially given recent findings showing an association between COVID-19 infection and new onset diabetes and continuous concerns with long COVID in children. Second, in the history of vaccinations, it has never been known for a vaccine to lead to novel problems arising more than a couple months after the immunization. Third, nearly all clinicians and scientists have vaccinated their children. We urge those who are unsure to ask their child’s health care team what they would do if it was their own child.

Well over 90 per cent of Canadian children are vaccinated to protect them against diseases such as polio, pneumococcus and meningococcus, but far fewer have received their immunization against COVID-19. It’s time we close that gap. The new, strong NACI recommendation is a call to action for parents who dutifully vaccinated their child against other vaccine preventable diseases but held back on their COVID-19 protection.

For all those parents who were waiting on more data, we have it now. It’s time to act, take that extra step now to protect your child.

Noah Ivers is a family physician working at Women’s College Hospital and an Associate Professor with the University of Toronto. He is a parent to two children. Follow him @NoahIvers

Cora Constatinescu is a pediatric infectious disease physician working at Alberta Children’s Hospital and Assistant Professor at the University of Calgary. She is a parent to three children. Follow her from her @DrCora_C

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