As Canada's Chief Medical Officers of Health, our efforts continue to focus on minimizing COVID-19 serious illness and overall deaths, while preserving health system capacity. We strive to reduce COVID-19 transmission to protect key populations, including those at greatest risk. Every step of the way, our responses balance these aims with the need to minimize the broader negative impacts of the pandemic on society and individual wellbeing. To help us achieve this, we continue to rely on scientific evidence and expert advice to guide our recommendations on the use of safe and effective COVID-19 vaccines authorized for use in Canada.
The Pfizer-BioNTech Comirnaty (10 mcg) pediatric formulation COVID-19 vaccine is the first COVID-19 vaccine authorized by Health Canada (November 19, 2021) for use in children 5 to 11 years of age. This review and authorization was done under Health Canada's Food and Drugs Regulations, the mechanism for authorizing drugs and vaccines in Canada. With the availability of a Health Canada approved vaccine for 5 to 11 year olds, we are adding one more tool to our COVID-19 pandemic toolbox.
We have said this before: the benefits of vaccination are clear. Combined with other public health measures, high vaccination rates have allowed us to collectively make significant headway in protecting our population from the severe outcomes of COVID-19 and enabled us to gradually re-open activities. With pediatric vaccination, we now have an option for added protection for school-aged children from COVID-19. Along with continuing to practice individual public health measures, this option can help them to safely participate in the activities that matter most.
Though children were underrepresented in COVID-19 cases through the first three waves in Canada, this fourth wave is having a greater impact on those under 12 years of age. That is because this age group has not yet been able to be vaccinated and community transmission has continued with the gradual reopening of society. As of mid-November, children 5-11 years of age have the highest rate of COVID-19 cases across all age groups, although hospitalization rates have remained low.
Throughout this pandemic, we have seen the disproportionate impact restrictive community-based measures have had on children. Prolonged schooling disruptions, social isolation, and reduced access to academic and extra-curricular resources have had a profound impact on the mental and physical well-being of children and their families, further exacerbating social inequities.
The National Advisory Committee on Immunization (NACI) has provided its guidance on the use of pediatric vaccines in COVID-19 vaccination programs. NACI recommends that a complete series of the Pfizer-BioNTech COVID-19 vaccine (10 micrograms) may be offered to children 5 to 11 years of age who do not have contraindications to the vaccine, with a dosing interval of at least 8 weeks between the first and second dose.
Canada's Chief Medical Officers of Health welcome NACI's analysis and thank them for providing recommendations based on current evidence to inform provincial and territorial public health decisions on how COVID-19 pediatric vaccines are best used in vaccination programs at this time. As parents and guardians make informed vaccination decisions for their children, they should consider:
- The benefit of being vaccinated in protecting their child from COVID-19 infection. Without vaccination, all children will likely contract the virus at some point, and children who are infected with COVID-19 can develop Multisystem Inflammatory Syndrome (a rare but serious condition) or long COVID-19 (uncommon in this age group). Benefits of vaccination also include reduced time away from school or activities, with positive impacts on physical and mental health of children as a whole;
- Their child's risk of exposure to COVID-19 through in-person activities such as school, extra-curricular activities and in the community, realizing that this changes with time. The unknown risk of exposure in the future should also be considered;
- Their child's risk of severe outcomes from COVID-19 due to underlying medical conditions (may include children with obesity, children who are medically fragile/have medical complexities, children with more than one underlying medical condition, children with neurological disorders, and children with Down Syndrome and other immuno-compromising conditions); and
- Their child's risk of transmission to close contacts who themselves are at higher risk of severe outcomes due to older age or underlying medical conditions.
