If kids don’t get as sick as adults with Covid, why should we get them vaccinated?


As BC announces the Covid Vaccines rollout program for the kids, there are many parents fighting the dilemma of whether they should get their kids vaccinated or not, or many are weighing the risks versus benefits of vaccines. In an exclusive, Dr Navdeep Grewal, emergency room physician, practicing in Vancouver Coastal and Fraser Health Authorities, and Dr Birinder Narang, a family doctor working in East Vancouver and Burnaby, answer frequently asked questions about kids’ vaccination. Dr Grewal and Dr Narang are both among the co-founders of the BC South Asian Covid Task Force. The Task force is a national grassroots, apolitical volunteer group, which was founded nationally in November 2020 to help address the disproportionate number of Covid cases in the South Asian Community across Canada, (mainly centred in BC and Ontario). They also are 2 of the co-founders of the national This Is Our Shot vaccination campaign launched in April 2021, to promote vaccine confidence by physicians, corporations, and community groups across Canada.

FAQ: If kids don’t get as sick as adults with Covid, why should we get them vaccinated?

Children under 12 years‐old aregenerally at lower risk of infection than other age groups, even after returning to school in September. In BC, clusters of infection were identified in 12% of schools, meaning that 88% of schools have had NO transmission events.

But as more eligible adults and older children have gotten vaccinated, approximately 20% of all new cases in BC are now in the under-12 yrs age group.

While most kids have only a mild illness with Covid infection, they CAN get Long Covid (which includes several weeks or months of fatigue, exercise breathlessness, brain fog) or the very serious and potentially fatal complication called MIS-C which affects younger children (there have been 19 cases of this in BC so far). There is overall a 2% Covid hospitalization rate in kids. Deaths from infection may be rare but they do unfortunately happen in a small number of children and we don’t want to see any child die of Covid infection.

FAQ: What are the benefits vs risks of vaccinating kids?

We can see how effective the Covid-19 vaccine is when we look at the age 12-17 population.

In this group, the risk of getting COVID 19 is ~12-13x higher if unvaccinated.
Zero people have been hospitalized if they have had 1 OR 2 doses.
And the side effect profile of vaccines in this age group is quite low: of 509,806 vaccines given in BC since May, 2021, only 133 adverse events following vaccination were reported (14 serious, ie anaphylaxis)

Health Canada has approved the Pfizer mRNA vaccine for use in the age 5-11 age group, after a through independent review assessing safety and efficacy.

The direct benefit is that it increases the child’s protection to positively benefit their physical and mental health, but there is also an indirect benefit to the rest of society in reducing transmission.

FAQ: What is the long-term safety of the mRNA COVID-19 vaccines? Are they safe for kids?

Historically, vaccine monitoring data shows us that side effects usually happen within 6 weeks of getting a vaccine dose. And most vaccinations we have given in the past have been in kids! It’s extremely unlikely for kids to get serious longterm side effects from Covid vaccines because the components in them (mRNA and lipid carrier) are gone from your body within days to weeks.

We can feel safe knowing that hundreds of millions of people have had vaccines since the original trials last year without persistent side effects.

We should also consider that symptoms or illnesses that occur many years after a vaccination are much less likely to be related to the vaccine, and more likely a baseline development of that symptom or illness.

FAQ: What are the common short-term side effects in kids? 

Most are similar to those in adults, and last 1-3 days. The most frequently reported adverse events include: vaccination site pain, paresthesias (prickly tingling feeling), itch, headache, redness or swelling at vaccination site, fatigue, and nausea.

FAQ: What is the risk of my child getting myocarditis/pericarditis with their shots?

Myocarditis is an inflammation of the heart muscle.Pericarditis is an inflammation of the sac that surrounds the heart.Symptoms include fatigue, chest pain, shortness of breath, palpitations, and fainting.It is diagnosed by a doctor with tests such asECG and bloodwork.

Both conditions can also be caused by Covid and other viral infections, and some medications. It usually doesn’t last very long or make you very sick and is easily treated with common meds like ibuprofen.

This potentially rare, mild, and quickly recoverable side effect of mRNA vaccines is much more rare than the potential risks of Covid infection. And Covid infection itself can cause myocarditis, similar to other viral infections, at a rate 6 times higher than in vaccinated people.

With the lower dose of vaccine for younger kids, and the interval of 8 weeks between doses, it is much less likely that we will see myocarditis side effect of the vaccines, and so far we are seeing this in data from the over 3 million kids in the US who have been vaccinated.

FAQ: What dose and interval of vaccine will be given to kids?

The dose of Pfizer (10 µg dose) that will be given to this younger age group is smaller than for older kids and adults. The studies used to guide Health Canada and other jurisdictions looked at both 10 & 30 µg doses & found similar immune response with less side effects in this age group.Kids’ immune systems respond well to less antigen (stimulation).

BC will be following the NACI recommendation of an8-week interval between first and second dose.

FAQ: Will children need a booster dose as well?

It’s too soon to say whether boosters will be a part of the Covid vaccine schedule for kids, or whether they will need more than one booster dose. But even if data does show that boosters are necessary, this is no different than most other vaccinations given in childhood and beyond, including DTaP-IPV-Hib, MMR and Hep B vaccines.

FAQ: What are the steps to register and vaccinate your child?

You can register your child immediately at https://www.getvaccinated.gov.bc.ca/if you haven’t already done so, and the invitations for booking appointments will start on Monday Nov 29th, with first vaccinations starting that day.

Verbal consent from a parent/legal guardian will be required at time of vaccination. But if a parent is unable to be present with their child, they can give written consent by proxy tothe adult who is accompanying the child.

Children must be at least 5 years old at time of vaccination. They cannot get it before then, ie they are not yet eligible yet if they are turning 5 later in the calendar year.

11 yrolds who are turning 12 soon will receive the pediatric dose of vaccine, and when they turn 12 they will receive the adult dose of vaccine. There is no harm or concern with this different dosage schedule.

FAQ: Where will these vaccinations take place?

There will be multiple clinic types offered in BC.

Family Clinics (Health Authority clinics) – will prioritize kids and immediate family members to get vaccinated together. Families can bring all their eligible children at the same time, if each member is booked at the same clinic sometime that day.

12+ Clinics – will be done in large pharmacies (pediatric vaccines won’t be done here).

FAQ: Should I get my child vaccinated as soon as possible or should I wait?

Most parents are eager to get their children vaccinated as soon as possible, while others are choosing to wait and see what further data shows. However, it is reassuring to know that over 3 million kids in this age range in USA have already been vaccinated with no new safety signals identified. More data is coming all the time to show that these vaccines are both safe and effective.
It is important to consider how widespread the delta variant has become and the need to fully protect yourself and your kids from serious illness with this variant by getting both doses of mRNA vaccine.

More resources

Info at: www2.gov.bc.ca/gov/content/co…

FAQ at: immunizebc.ca/COVID-19-vacci…

Cool app to help support children with anxiety getting vaxxed: respiire.com/COVID-19.html

Compiled by Surbhi Gogia