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There’s a children’s COVID-19 vaccine awaiting approval in Canada. What do we know about it?

Since Health Canada announced last week that Pfizer-BioNTech is seeking authorization for its COVID-19 vaccine for younger children, many people have been asking questions. Here’s what we’ve been able to find out:

What do we know about Pfizer’s pediatric COVID-19 vaccine? 

Pfizer-BioNTech is the first company to seek Health Canada’s approval for a pediatric COVID-19 vaccine (although other companies, such as Moderna, are working on children’s formulations).

The pediatric version of the vaccine is for kids age five to 11. Those 12 and older get the already approved adult formulation.  

The pediatric formulation will be given in smaller doses — 10 mcg (micrograms) instead of the 30 mcg used for people 12 years of age and older. 

According to a spokesperson for Pfizer Canada, the vials for the pediatric version will each contain 10 doses and have a “unique label,” and the cap will be a different colour — so health-care workers will be able to tell the difference between the adult and child versions.

Two teenage sisters wait for their COVID-19 shots in Toronto in this file photo. Kids age 12 and older are approved to receive the same vaccine dose as adults. (Evan Mitsui/CBC)

What’s unclear is whether or not the pediatric version is identical to the adult vaccine and simply given in smaller doses, or a different formulation.  CBC News was unable to get a specific answer from either Pfizer or Health Canada on that question. 

Like the adult version, kids will get two doses of the vaccine.  The manufacturer’s instructions will say to space them approximately 21 days apart, the Pfizer spokesperson said.  

But it’s possible that if Health Canada approves the vaccine for younger children, the National Advisory Committee on Immunization (NACI) could recommend a longer gap of up to 12 weeks between doses, like it did for the adult version earlier this year, said Dr. Caroline Quach-Thanh, a pediatric infectious disease specialist and medical microbiologist at Chu Ste. Justine in Montreal.

As the former chair of NACI, Quach-Thanh is familiar with how it operates, but does not speak on NACI’s behalf. 

There’s a lot of evidence now that the longer time between doses produced a better immune response in adults, which the committee would take into account, she said.   

“What helps in NACI’s decisions is that there’s … vaccinology expertise within the committee,” Quach-Thanh said. “And so you can generalize from your prior knowledge [of] this vaccine and make recommendations that are off-label.”

When can my child get the shot?

That depends on how long it takes Health Canada to approve the vaccine.  

“The Department is currently reviewing the submission and will only issue a decision following a thorough scientific review of the vaccine’s safety and efficacy in this younger age group,” a spokesperson said in an email to CBC News. “As with all COVID-19 submissions, Health Canada is prioritizing this review.” . 

The submission includes Pfizer’s clinical trial data, which included 2,268 children aged five to 11, according to the company’s news release

NACI will also review the data and give its recommendations.  

If there are no problems, Quach-Thanh estimates that approval could take four to six weeks. 

The other variable is vaccine supply.  

On Thursday, Prime Minister Justin Trudeau announced that Canada had made an agreement with Pfizer to get enough doses to supply “every kid across the country from five to 11 with vaccinations.”

That’s 2.9 million doses, government officials later confirmed. 

They’ll arrive “as soon as possible” after Health Canada gives the vaccine the green light, Trudeau said.  

Canada to receive millions of Pfizer’s COVID-19 vaccines for kids 5-11

16 hours ago

Prime Minister Justin Trudeau says once Health Canada approves Pfizer’s COVID-19 vaccine for children aged five to 11, there will be millions of doses available to provide a shot to every child across the country. 2:00

The vaccines will then be distributed to the provinces and territories, which are then responsible for working with local public health units to get them into kids’ arms. 

Quach-Thanh said it would be ideal if kids could get a vaccine dose before Christmas, because it could help reduce COVID-19 transmission during a time when people gather. Plus, during the holidays, kids often see grandparents, who are at higher risk of severe illness from COVID-19.   

Where can my child get their shot once it’s available?

It could vary depending on where you live, as the provinces and territories, along with local public health units, determine vaccination plans. 

But based on information gathered by CBC News from Ontario and British Columbia, kids could get their COVID-19 vaccine at doctor’s offices, pharmacies,  community vaccination clinics and school-based clinics. 

In Toronto, for example, some schools are open to making vaccinations available during the school day, while others will host clinics after class is out, said Dr. Eileen de Villa, the city’s medical officer of health. 

What about side effects?

The objective of protecting children against any potential side effects is a big reason they’re last to be enrolled in clinical trials and given the vaccine, Quach-Thanh said.  

“When we see that it’s safe in older people then we are more at ease giving it to younger children,” she said. “So that absolutely is reassuring.”

The most concerning side effects that emerged after millions of teens and adults were immunized were very rare cases of myocarditis or pericarditis (inflammation in or around the heart).  

But even in the rare instances that occurred, most cases were mild and resolved themselves without hospitalization, Quach-Thanh said. 

Plus, people are much more likely to get heart-related illness if they become infected with COVID-19, experts agree.  

What are the benefits to vaccinating my child against COVID-19?

Because children are less likely than adults to get seriously ill from COVID-19, some parents question why their kids need the vaccine, both Quach-Thanh and de Villa said.  

But some do suffer serious illness, de Villa said — and the virus that causes COVID-19 finds people who aren’t vaccinated. 

“If you are not protected, the virus will seize that opportunity to infect, whether you are younger or older,” de Villa said at a media briefing on Wednesday. 

Even if they don’t get sick themselves, children can transmit the virus to people who are more vulnerable to life-threatening illness,  she said. 

Vaccinating your child means “you are protecting them, you are protecting your family and yourself and you are protecting grandparents and elders who could become sick and be at risk as a result,” de Villa said. 

Parents also need to consider the benefits of getting their children back to a more normal life, Quach-Thanh said. 

“You can go back to school and you can stop, you know, going to your testing centre every other week because you have a sniffle once you’re vaccinated,” she said. 

“I think life as we knew it is going to be much easier to get back to [with vaccination].”

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