Information on Vaccines for Children

While fewer children compared to adults have gotten very sick from COVID-19, they have been impacted in many other ways. Children in Ontario have had to attend school remotely, miss out on extra-curricular activities, and spend extended amounts of time away from their friends and peers. This has a big impact on children’s mental health and well-being. Vaccinating all who are eligible, including children, will help to reduce the number of cases of COVID-19 in our community and allow kids to get back to participating in activities they enjoy without disruption. Children who get infected with COVID-19 typically experience mild symptoms. However, some kids can get very sick and require hospitalization. Children can also get a serious medical condition called “Multisystem Inflammatory Syndrome in Children”. This condition, while rare, often requires hospitalization including in the ICU. Others can experience longer-lasting symptoms that can affect their health and well-being, including their concentration and energy. Like adults, children also can transmit the virus to others if they are infected, even if they don’t feel sick. Vaccinating children can also help to protect the health of the broader community. Each time someone is infected with COVID-19, it provides a chance for the virus to mutate and create a variant. New variants are modified versions of the original virus and can be more dangerous or resistant to the available vaccines and treatments. This is why it is really important to prevent COVID-19 infections. The sooner we can stop the virus from spreading, the less likely it will be able to mutate into a new variant. COVID-19 vaccination is voluntary for anyone in Ontario.

The Pfizer-BioNTech vaccine has been demonstrated to be highly effective at protecting against COVID-19 for children age 5 and up.

Children

The Pfizer-BioNTech clinical trial included 2,268 children aged 5 to 11 years old receiving a 10 microgram dose level in a two-dose regimen. The trial showed a strong immune response in children one month after the second dose. A second cohort of 2,379 children were followed for 2 weeks to ensure the vaccine was safe.

Trial data showed the vaccine was 90.7% effective against symptomatic COVID-19. The antibody response to the vaccine was comparable to the one seen in older kids and young adults.

The lower dose was chosen to minimize side effects but still prompt a strong immune response.

Youth

The Pfizer-BioNTech clinical trial studied 2,260 youth aged 12 to 15 years old in the United States. In the trial, there were 18 cases of COVID-19 in the group that did not get the vaccine (the “placebo” group) compared to no cases in the vaccinated group. This means the vaccine was 100% effective in the trial.

When you are given the vaccine, you produce antibodies that protect you in case you are exposed to the virus.

The antibody response in the 12 to 15 year olds who were vaccinated was very strong one month after receiving the second dose. Youth can often have very good immune response following vaccination, resulting in strong protection.

Youth 16 years of age and older were included in the earlier clinical trials with adults. The vaccine has been licensed for 16 years and older since December 2020. The vaccine also works well in 16 to 17 year olds.

Yes. It is advised that you get the vaccine even if you have already had COVID-19. Even though a prior COVID-19 infection may provide some protection from getting sick again, we do not know how long that protection will last and it may not protect against new variants of the virus.

Yes. It is expected that when enough people are protected from COVID-19 the risk of infection will begin to decline. Vaccines, along with mask-wearing, physical distancing and other precautions will help protect the health of the broader community. Only after rates of COVID-19 in the broader community are low, will normal activities for children and youth be possible again.

Visit our website for more information at www.kidshealthfirst.ca

You can also find below more information and resources about COVID-19 and vaccines:

• COVID-19 Vaccine Information Sheet (gov.on.ca)
• COVID-19 What you need to know (gov.on.ca)

Yes. Health Canada has authorized the Pfizer-BioNTech vaccine. Children 5 to 11 get the pediatric vaccine and children 12 and up get the standard vaccine. The vaccine is given in two doses. As part of their rigorous scientific review process, they have determined that this vaccine:

• is safe with no serious side effects;
• works well providing a strong immune response and;
• the vaccine is of high quality.

No serious side effects have been identified in the trials of 5 to 11 year olds. Millions of people aged 12 to 17 have received COVID-19 vaccines in Canada.

Health Canada oversight of COVID-19 vaccines does not stop at approval. Monitoring of vaccine safety and effectiveness will continue into the future.

Children, like adults, may experience side effects after receiving a vaccination. Most side effects are mild and easily tolerated. The side effects are different for every person. You might notice tenderness or pain where the vaccine was given in the upper arm and could feel more tired than usual. Headache, achy muscles or joints, and fever and chills are also possible. These side effects are usually temporary and generally clear up within 1 to 3 days. They are also a positive sign that the vaccine is beginning to work.

Children 5 to 11 years of age had fewer side effects compared to young adults who received the vaccine.

Allergic reactions to the vaccine can occur, but are rare. Symptoms include hives, swelling of the face, tongue or throat, or difficulty breathing. Everyone stays at the clinic for 15 to 30 minutes after the vaccination to be monitored and treated if an allergic reaction occurs.

Rarely, an inflammation of the heart muscle or lining of the heart can occur following vaccination. Symptoms include chest pain, trouble breathing or heart palpitations. In Ontario, among 12 to 17 year olds who have received their second dose of the vaccine, 0.01% have had this side effect, and it has been a mild illness, often treated with rest and anti-inflammatories. Most children fully recover in days. Inflammation of the heart can occur following viral infections including COVID-19 and can be much more serious.

No. The COVID-19 vaccines that are currently being used in Canada do not contain the virus that causes infection. COVID-19 vaccines tell our body to make antibodies that protect us from COVID-19. The antibodies can protect us from getting sick with COVID-19, as well as from getting and spreading the virus to others.

Doctors and scientists are confident in the long-term safety of the COVID-19 vaccines for several reasons.

First, this is not new vaccine technology. Scientists have been studying and working with mRNA vaccines for decades, including for flu, Zika, rabies, cytomegalovirus (CMV), and cancer treatments. Decades of studying mRNA have shown no long-term side effects.

Second, negative effects generally occur within six weeks of receiving the vaccine, and regulators in many countries required at least eight weeks of safety data. The vaccines have now been in use for many months with billions of doses administered around the world.

Third, we are very confident in the track record of Canada’s vaccine approval and safety monitoring system. This means that the end data and safety tests for COVID-19 vaccines are the same as other vaccines that have been approved in Canada over the last several decades. Canada’s system has proven time and again that the data necessary to get through the approval process is sufficient to prove safety, even for the long-term.

When considering long-term risks, a COVID-19 infection is a much more serious concern. The virus can cause long-term damage to lungs and other organs, as well as many other complications. This is called post-COVID-19 syndrome, or long COVID, and it’s one of the reasons why doctors recommend getting vaccinated.

The vaccine is safe for most people, including anyone who has a medical condition or is taking medications. If someone is taking medications that weakens their immune system, they should speak to their doctor to time their vaccinations with their next dose of medication.

People with allergies to any of the vaccine ingredients or those who have had a serious reaction after the first dose should see their health care provider. Talk to your health care provider if you are unsure about which ingredients you are allergic to. COVID-19 vaccines do not contain eggs, gelatin (pork), gluten, latex, preservatives, antibiotics or aluminum.

The vaccine does not alter genetics or hormones. The active ingredient in the vaccine is called mRNA. It gets broken down very quickly after it is injected and cannot access your child’s genetics. The COVID-19 vaccines do not affect puberty, the ability to have children, or your child’s hormones as it is not involved in these body systems.

The main ingredient in the vaccine is mRNA and that lasts in your body for a few days before it is removed from the body. The body develops an immune response in the first few weeks after vaccination. Some may have a change in their menstrual cycle that is temporary, because of the immune response. There are no long-term impacts on fertility, puberty or growth and development from the vaccine.

The Pfizer-BioNtech COVID-19 vaccine tells your body how to make a protein called the spike protein that is found on the COVID-19 virus. Your body’s immune system then starts creating antibodies and other forms of protection against the spike protein. When the COVID-19 virus shows up, your immune systems recognizes the spike protein and is ready to defend against the virus.

The Pfizer-BioNTech COVID-19 vaccine regular dose (30 micrograms) is given to youth aged 12 and up.

The Pfizer-BioNTech COVID-19 pediatric vaccine is approved for children aged 5 and 11. They will receive a smaller dose (10 micrograms) This lower dose was chosen for children under 12 to minimize side effects but still prompt a strong immune response.

Two doses are required for the best protection. The best spacing between the two doses is 8 weeks or more. By extending the spacing between the two doses, it will boost the immune response from the second vaccine, and result in fewer serious side effects following the second dose.

COVID-19 vaccines are only provided if informed consent is received. For children 5 to 11 years of age, parental or guardian consent is required. For youth aged 12 to 17, and as long as the child has the capability to make this decision, they can provide their own consent. This means the young person understands the treatment, why it is being recommended, and the risks and benefits if they accept or refuse to be vaccinated. If the individual is incapable of consenting to receiving the vaccine, they would need consent from their substitute decision-maker, such as their parent or legal guardian.

Children aged 5 – 11 will require parent/guardian consent.

The health care provider and family must respect a young person’s decision to be vaccinated. Ideally, this decision should be discussed in advance with a trusted adult or guardian to ensure that they understand what they are consenting to. When a young person receives their vaccine, the person giving them their shot will check that they understand the nature of the treatment and its risks and benefits.

Allowing access to vaccines in a timely manner and at convenient locations, without requiring parental consent, will improve the health of students and communities and are consistent with practices before COVID-19. Parents are encouraged to discuss vaccination with their children prior to attending a clinic.

Vaccines for children aged 5 and up are planned to be available starting the end of November.

The vaccine for 12 to 17 years old is currently available.

Timing of the booking of appointments and administration of vaccines may vary depending on where you live. Please consult your local public health unit for information about when your child will be able to receive the vaccine and how to book an appointment.

No. If you have a health card, you are asked to bring it to the appointment. If you do not have a health card, vaccine staff at the appointment will be able to assist you. You can also speak to your school, medical provider or faith leader to get a letter stating your child's name, date of birth and address. If you do not have a health card, you may also be asked to book your appointment over the phone instead of online.

Please bring your health card and a list of any medications you may currently be taking. If you are nervous about the vaccination, bring something to help distract you, such as a mobile device, headphones for music, or a book. Let the clinic know when you get there as many will have immunizers ready to provide special assistance to children who are worried.

Children will be given a receipt with information about the vaccine they received. Please make sure to keep this in a safe place. It will also be emailed or texted if that information is provided.

We understand that needles can be a little (or a lot) scary for some children. To help make the vaccination easier for them, check out these resources

• CARD Poster (Four Strategies to Help with Immunization) (source: About Kids Health)
• >Reduce the Pain of Vaccination in Kids and Teens (Source: Immunize Canada)
• >Improving your child’s immunization experience (source: City of Toronto)

Children with allergies can receive the COVID-19 vaccine. Children with severe allergies to food, medications, and insect bites should all be vaccinated. If your child has had a severe allergic reaction to a vaccine or medical product, or if you have other questions about allergic reactions, speak to your health care provider before getting the shot.

Children with other medical conditions such as Autism; ADHD; heart, lung, or kidney problems; or any other condition can safely receive the COVID-19 vaccine. In fact, kids with other medical issues may be at higher risk of complications from COVID-19, so it can be especially important to ensure they are vaccinated.

Yes. If the child is behind on their immunizations please contact their health care provider to make a plan to get up to date.

If possible, the COVID-19 vaccine should be given alone to 5 to 11 year olds. This is a precautionary measure, so if the child has side effects from the vaccine we can be sure which vaccine it is from. Other vaccines should be scheduled 14 days before or 14 days after the COVID-19 vaccine.

In rare cases, some teens have experienced inflammation of the heart following immunization with a COVID-19 mRNA vaccine. Typically, this condition has been mild, and people respond well to treatment and make a full recovery. Symptoms of heart inflammation can include:

• Chest pain
• Shortness of breath
• Feeling of a rapid or abnormal heart rhythm

If your child experiences these symptoms, seek medical attention and inform the health care provider that your child recently received a COVID-19 vaccine.

Scientists will be watching closely to see if there are concerns about myocarditis or pericarditis for the 5-11 age group. In the Pfizer trial for this age group, no cases of myocarditis/pericarditis were observed up to three months after second vaccine doses. This is good news!

There is also growing scientific evidence that a longer interval between the first and second dose, such as 8 weeks, reduces the risk for getting this rare side effect following the vaccination.

Most cases of myocarditis or pericarditis in youth and young adults are mild with symptoms improving with medical treatment. You should seek immediate medical attention if your child complains of chest pain or feelings of tightness, shortness of breath or heart palpitations/irregular heart beat.

Myocarditis and pericarditis are typically caused by injury, complications of an auto-immune disease, or by the body’s response to common viral infections such as influenza or adenovirus, or novel viruses like COVID-19, or by bacteria such as those responsible for Lyme disease. Myocarditis or pericarditis that occur following infections are often much more serious compared to the mild illness that has occurred following vaccination.

Yes, pregnant individuals are able to receive a COVID-19 vaccine. Many people who are pregnant have gotten very sick from COVID-19 requiring hospitalization and critical care. Getting vaccinated is safe and an important way to be protected in pregnancy.