Opinion | Vaccine for children under 12 for Halloween? Research shows it could happen. Now Canada needs to plan for equitable implementation

We all want the pandemic to end. Last week, that dream got closer to reality.

Pfizer issued a statement showing an effective and safe vaccine in children ages 5 to 11. Pfizer will send the complete data package to Health Canada soon, and if the data is deemed sufficient and no concerns are identified, the vaccine could be approved for this age. group already on Halloween.

A COVID-19 vaccine for children is a game changer. Not only does it protect our children from contracting COVID-19 and its related complications, it also protects their loved ones and the community at large. It will limit transmission of the virus, preventing classes from being sent home, allowing a return to sports and other activities, and reducing the risk of unknowingly passing the virus to someone more vulnerable like a grandparent.

But the vaccine only works if people get it.

We must work quickly to vaccinate as many children as quickly as possible and ensure equitable implementation that prioritizes those most at risk. The most efficient and effective way to do this is by bringing vaccines to schools.

Canada already has a successful track record to use school programs for other vaccines. Every year, 7th grade students receive vaccines against hepatitis B, HPV, and meningitis in their schools. Parents give their consent in advance and public health nurses visit the school for immunizations.

Vaccination in schools means less time is wasted booking and getting to appointments. The schools are located in every neighborhood in the city, and the children are already there. Primary school enrollment in Canada is 99.5%.

A school-based strategy also helps remove barriers and reach children of parents who may not be able to get vaccinated in a timely manner due to competing priorities or those facing challenges navigating our system due to lack of transportation, time limited absence from work, language barriers and more. Not surprisingly, studies estimate that the absorption of the HPV vaccine was almost 4 times greater in school programs compared to community-based ones.

As we prepare to immunize elementary school children, some challenges are predictable. Younger children may feel more anxious about needles or wish their parents were there. We may need a combination of clinics during school and after school so that parents can choose to be with their children when they receive the vaccine.

Another challenge will be related to communications. We need to prepare now to answer questions in a way that parents and their children can understand, even taking into account language accessibility. Some of this communication should emphasize proven ways to limit anxiety and pain.

We will also need to be clear about the risks and benefits of vaccines. We will need forums where parents can get answers to their questions from people who understand the data, the science, and the concerns of parents and children. Healthcare providers will continue to play an important role in providing personalized advice to people with specific concerns. Community Ambassadors can provide a language and culture tailored outreach.

Perhaps most importantly, school immunizations would support an equity-oriented approach.

When adult vaccines were launched, there was a race for dating, a competition you were more likely to win if you spoke English, had access to technology, and the time to navigate a complex reservation system.

Now imagine a system in which each child is offered a vaccination appointment at their local school. You can reject it if you don’t want it. But no one has to “fight for it” and no one has to take time off from work or drive a car to get to a clinic. The appointment is where the child will be. Critically, no child is left behind.

For the approach to be truly equitable, we must prioritize schools that are in the communities most affected by COVID-19. Prioritizing communities with high rates of COVID-19 means that some children will have to wait, but in the end it means more lives are saved.

School shots won’t work for everyone. Some children have opted for virtual school. Others have special needs due to complex medical conditions or developmental disabilities. Some parents may want to discuss the vaccine in depth and may just be comfortable with the doctor vaccinating the child. Smaller private settings can be appropriate for a variety of reasons. To ensure that all children have the opportunity to be vaccinated, we will also need vaccinations in family offices, community clinics, pharmacies, and in some cases, they will be delivered directly to the home, just as we have had them for adults.

As in the past, speed matters. The faster we act to put vaccines in the arms of children, the sooner we will see the end of the pandemic.

Let’s make sure we have our plans in place before the vaccine is approved. Let’s avoid a youth edition of the vaccine “hunger games” and instead give all children the opportunity to be protected.

Tara Kiran is a family physician at St. Michael’s Hospital and the Fidani Chair in Improvement and Innovation at the University of Toronto.

Noah Ivers is a family physician at Women’s College Hospital and the University of Toronto and holds a Canada Research Chair in Implementation of Evidence-Based Practices.


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