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Why should I get my 6 month – 5-year-old Immunized for COVID-19

Most children who get COVID-19 have mild or asymptomatic disease; however, some children experience severe disease and require hospitalization. Children who have had COVID-19 are at risk of experiencing multisystem inflammatory syndrome in children (MIS-C), a rare but serious complication from COVID-19 that usually requires hospitalization. Children who have an underlying medical condition are at higher risk of severe outcomes from COVID-19, but severe disease and MIS-C can occur in any child, even those without an underlying condition.

Clinical trial findings show a Moderna Spikevax 25 mcg dose primary series, produces an immune response in children under the age of 5 equivalent to the immune response seen in young adults aged 18 to 25 years who receive the 100-mcg dose primary series. Preliminary efficacy of the vaccine in preventing symptomatic COVID-19 when Omicron is the dominant variant, is estimated at 50.6% in children aged 6 to 23 months and 36.8% in children 2 to 5 years of age starting 14 days after the second dose.

Clinical trial data shows Moderna Spikevax (25 mcg) COVID-19 vaccine was well tolerated in children 6 months to 5 years of age. No safety signals were reported in the trial. It is important to note, due to the size of the trial, it is unlikely that adverse events occurring at a frequency less often than 6 in 10,000 people would be detected. NACI, Health Canada and PHAC will continue to closely monitor real world data from the use of this vaccine for potential rare and very rare side effects.

My child is healthy, and I have been told children are not impacted by COVID-19. Why should I get my child vaccinated?

Even though COVID-19 infections are relatively milder in many children, we still do not know the long-term impact of COVID-19 infections in children or adults. Being vaccinated reduces the risk of serious complications, including hospitalization and death. Recently, children 5 to 11 years old have become the population with the highest incidence of confirmed COVID-19 infections, although their hospitalization rate has remained low.

Children who get COVID-19 are at risk of developing multisystem inflammatory syndrome in children (MIS-C), which is a serious though uncommon condition. MIS-C is estimated to affect 0.5-3.1% of all children diagnosed with COVID-19, and 0.9-7.6% of hospitalized pediatric COVID-19 patients. Most MIS-C cases recover fully, and no MIS-C-associated deaths have been reported in Canada to date. While evidence is limited in pediatric populations, children may also be at risk of developing so-called “long-haul COVID” (post-acute COVID-19 syndrome).

Children with certain underlying chronic medical conditions have an increased risk of severe COVID-19 disease, but evidence specific to the aged 5 to 11 group is limited. For children under 18, the research has shown:

• 39 per cent of hospitalizations had at least one underlying comorbidity.
• An increased risk of ICU admission for those with chronic pulmonary disease, congenital heart disease, or neurological disorders.
• 75 per cent who required mechanical ventilation had comorbidities, most commonly chronic cardiac disease, immunosuppression, chronic respiratory disease, and obesity.
• Multiple comorbidities, obesity, neurological disorders, feeding tube dependence, Down Syndrome, immunocompromising conditions, and living in group settings as risk factors for severe COVID-19 infection.

Along with the physical health risks posed by COVID-19, the pandemic and public health response have indirectly but significantly affected the mental health and physical well-being of children: disruptions in family routines, school, educational activities, and sports; separation from friends, grandparents, and other close family members. In addition, the pandemic and public health measures may further exacerbate social inequities among racialized and Indigenous communities, refugees and other newcomers to Canada, persons living in low-income settings, as well as children with disabilities.

Children also transmit COVID-19, although it’s not clear how important they are to transmission in different settings. Research on household transmission has reported children aged 0 to 3 have greater odds than older children of passing on the disease to household contacts.

Is the dosage different for children 11 and under?

Each dose is 0.2 mL and contains 10 mcg of SARS-CoV-2 spike protein mRNA (compared with 30 mcg of mRNA in a 0.3 mL dose of vaccine for older children).

A buffer ingredient, tromethamine, has been added to facilitate storage. Tromethamine (also known as “trometamol” or “tris”) is present in vaccine and has been used for many years in some routine childhood vaccines, as well as in other injectable medications, without safety concerns. Allergies to tromethamine have been reported but are extremely rare.

When can I get the second dose for my child?

The National Advisory Committee on Immunization (NACI) recommends two doses of the Pfizer-BioNTech COVID-19 vaccine (10 mcg per dose) for children 5 to 11 years of age, with at least eight weeks between the first and second dose. Children who are moderately or severely immunocompromised should receive three doses, with the third dose given at least 28 days after the second.