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COVID-19 vaccination FAQ for 5-11 year olds

Got questions about getting your 5-11 year old vaccinated for COVID-19? Check out these BCCDC frequently asked questions – answered!
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​Health Canada has authorized the Pfizer COVID-19 vaccine for children age 5 to 11 years and the National Advisory Committee on Immunization (NACI) issued a recommendation that a complete series of the vaccine should be offered to children in this age group as part of our broader vaccination strategy. 

Read a summary of NACI’s recommendation.

What do we know about COVID-19 illness in children?

The majority of children who get COVID-19 experience minor symptoms, however, a small number can get very sick. As of February 26, 2022, there have been 311 children under the age of 10 hospitalized in B.C.; 28 of these children required critical care, and there have been 2 deaths. 

Across Canada, 2,750 children under 11 years have been hospitalized, 261 of these children required critical care, and 22 children under the age of 11 have died.

Cases of Multi-system Inflammatory Syndrome in children and adolescents (MIS-C), an illness associated with COVID-19 that typically occurs two to six weeks following infection, have been confirmed in BC. Several of those cases occurred in children age 5 to 11. MIS-C presents as a constellation of symptoms that overlap with a range of conditions such as Kawasaki disease and toxic shock syndrome. The majority of children with MIS-C require hospital treatment to recover.

COVID-19 is usually less severe for children than adults, however, it still is more serious than either the flu or chicken pox. The safest way to protect your children from severe illness with COVID-19 is vaccination.

Why should children get vaccinated against COVID-19?

Although children are less likely than adults to become severely ill from COVID-19, children can still become sick. While uncommon, they can require hospitalization, and some may continue to experience health issues after COVID-19. Vaccinating children against COVID19 helps reduce the risk of children becoming ill from the virus.

The vaccine provides protection against infection and very strong protection against hospitalizations. As of February 26, 2022, our B.C. data indicates there have been no hospitalizations among 5 to 11 year olds who are fully vaccinated, and rate of hospitalization of unvaccinated 12-19 year olds is more than twice that of fully vaccinated 12-19 year olds.

Additionally, vaccinating more people reduces the spread of the virus in the community. This helps protect everyone, particularly people who cannot get vaccinated and those at greater risk of experiencing a severe case of COVID-19 even if they are vaccinated, such as older adults.

What do we know about the safety of the vaccine and risk of myocarditis?

Millions of doses of mRNA vaccines have been given worldwide to children between 5 and 11 years, and the vaccine has an excellent safety profile.

8.7million doses of the Pfizer COVID-19 vaccine have been given to children in the U.S. and only 11 confirmed cases of myocarditis were reported. No deaths attributed to vaccine-related myocarditis have been identified in children or adolescents in Canada. 

Most cases of myocarditis following vaccination recover fully with conservative or no treatment and no serious outcomes. The risk of myocarditis following COVID-19 infection is greater than the risk following COVID-19 vaccination.

Fertility

COVID-19 vaccination does not affect future fertility. There is no biological way for the vaccine to impact future fertility. There is no evidence of an increase in problems trying to conceive or in miscarriages among vaccinated adults.

FNHA video with Dr. Terri Aldred for more information:

https://www.youtube.com/watch?v=d3DG_aAB0A4

What COVID-19 vaccine is used for children and how is it different?

Health Canada has authorized the use of a formulation of the Pfizer vaccine for children aged 5 to 11 years. The pediatric formulation of the Pfizer vaccine uses a smaller dose of the active ingredient because children have a good immune response to this dose. The dosage for vaccines is determined by age, and not weight.

In clinical trials, the smaller dose has been shown to prevent 90.7% of infections in those 5 to 11 years old. This was unchanged whether the 145 children who had evidence of a prior COVID-19 infection were included or excluded in the analysis. Such children did not experience more severe side effects following immunization.

Most children (7 or 8 out of 10) will experience discomfort at the injection site in the days following vaccine receipt, and some (1 or 2 out of 10) will have redness and swelling lasting a few days. The frequency of these side effects is similar following dose 1 and dose 2, and very similar to what has been observed in adolescents/ young adults using the nonpediatric vaccine. Systemic reactions such as fatigue, headache, fever and chills are less frequent and less severe in the 5-11 age group compared to adolescents and young adults who received the non-pediatric vaccine, and more similar to the profile seen in adults aged 55 years and older, with the exception of joint pain which was uncommonly seen in children.

Which formulation should the child get based on their age?

Currently no vaccine has been approved for use in children under age 5. Children are eligible to receive the vaccination after their 5th birthday. Those aged 5 to 11 years old will get the pediatric formulation of Pfizer.

Some parents may wonder which vaccine to get if their child is turning 12 soon. It is recommended that they get the vaccine that has been approved for their current age. For example, an 11-year-old should receive the pediatric formulation for their first dose and if they turn 12 before they are due for their second dose, they should get the adolescent/adult formulation for their second dose.

Children age 12 and older should get the adolescent/ adult formulation for both doses.

Parents may wonder if their child is heavier if they should get the adolescent dose, because they are aware of weight being an important factor for medications like Tylenol. As vaccines work in an entirely different way than medications, COVID-19 vaccine dosage does not vary by patient weight but by age on the day of vaccination.

Can children get the COVID-19 vaccine at the same time as other vaccinations?

Yes. The COVID-19 vaccine can be given at the same time or any number of days before/after other childhood vaccinations, including the influenza vaccine.

What resources are available to help parents and children if children are anxious about needles?

It may have been several years since a child has received a vaccine and they may not remember it. It is important that they feel comfortable and understand what will happen at the appointment. 

Here are some tips/resources for parents:

  • The ImmunizeBC website is a reliable source of information and answers to common questions: immunizebc.ca
  • Parents can share their own experience with getting a COVID-19 vaccine.
  • Be honest - they may feel a pinch or poke with the needle, but it will be very quick.
  • Their arm may feel heavy or sore for a few hours, but the feeling will go away.
  • Use the CARD system - Comfort, Ask, Relax, Distract to help the child find their own strategy such as playing games or watching a video on a cell phone, listening to music or blowing bubbles.
  • Some people find that numbing creams or patches help. You can buy these without a prescription at most pharmacies. These can be applied an hour before the vaccine appointment.
  • A team from BC Children’s Hospital has developed a game that helps children practise belly breathing to help manage anxiety and their response to pain. You can access this on mobile devices at respiire.com/COVID-19.html
  • HealthLink BC has more information on preparing a child for vaccination: www.healthlinkbc.ca/healthlinkbc-files/immunization-experience-child
  • FNHA resource: https://www.fnha.ca/what-we-do/communicable-disease-control/coronavirus/covid-19-vaccine
What to expect after the vaccine

It is common to feel some pain at the injection site for a few days; redness and swelling are less frequent. A damp cloth or wrapped ice pack can help reduce the pain. Side effects like muscle aches and headache are not common in this age group, but if these occur, acetaminophen (Tylenol) can be given to reduce these symptoms.

Serious side effects are very rare. However, if a parent or guardian notices any health or behaviour changes, they should contact a healthcare provider or call 811. If the child experiences chest pain, shortness of breath, or feeling of rapid/abnormal heart rhythm, which could be indicative of myocarditis, they should seek medical attention right away.

These are rare, but would typically occur within a few days of receiving the vaccine. Inform the health care provider that the child recently received a COVID-19 vaccine.

Vaccination after COVID-19

People who have had COVID-19, including the Omicron variant should still be immunized with COVID-19 vaccines, not everyone develops a strong immune response after having COVID-19, and the vaccine is the best way to ensure longer lasting immunity.

In B.C., we recommend that families continue or begin the COVID-19 vaccine series as soon as the child feels better and they are no longer required to self-isolate. The vaccine continues to offer effective protection against all current variants of COVID-19.

Some studies suggest that immune response may be greater if vaccination is delayed 8 weeks after infection. However, if parents do not have confirmation that the symptoms their child had were COVID-19 it is recommended that they should start or continue the vaccine series as soon as their child feels better and is no longer required to isolate to reduce the chance of COVID-19 infection.

How can a family get their child vaccinated?

Parents and guardians can register their child through the Get Vaccinated system, the same system they used to register themselves. They will be sent an invitation to book an appointment when their child is eligible.

Online: gov.bc.ca/getvaccinated OR call 1-833-838-2323 (7 am to 7 pm daily, translators available)

Second doses

Once a child has been registered with the Get Vaccinated system, the parent or guardian will be invited to book the second dose appointment about eight weeks after their first dose.

Longer intervals between vaccine doses allow for more robust immune responses, and help establish durable protection against new or resurgent variants that may be more severe.

It is likely that longer intervals between vaccine doses will further reduce the already very low risk of myocarditis or pericarditis following vaccination in children.

Boosters for young children who are Clinically Extremely Vulnerable (CEV)
  • For CEV children five to 11 who are immunosuppressed, NACI has recommended full vaccination and recently recommended a Dose 3 to complete their primary series (at 28 days/four weeks from their Dose 2) – all those children who fall into this group will receive an invite for their Dose 3 based on that interval.
  • A third dose will help maintain and lengthen protection against severe outcomes of COVID-19.
  • It’s extra important for these children to get a third dose if they are moderately to severely immunocompromised, even if they’ve already had COVID-19. COVID-19 vaccines for children 5 to 11 - Province of British Columbia (gov.bc.ca)
Reporting an adverse event

Health care providers must report adverse events following immunization (AEFIs) to public health. 

More information for families: Call 8-1-1 or visit bccdc.ca/covid19vaccinechildren

References


 
 
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