Anxious parents have months to wait before knowing when their younger children can be vaccinated. With the federal government’s recent announcement regarding an upcoming exemption for fully vaccinated travellers this summer, many are left wondering what they’ll be able to do with kids who haven’t gotten the jab.
Not only is travel up in the air, but everyday life, too. From playdates to sleepovers to sporting events, parents are uncertain of what activities will be deemed safe for their unvaccinated children.
While fully vaccinated Canadians will be able to travel abroad without quarantining on their return possibly as soon as July, the issue for Canadians travelling with children may be the return home. Health Minister Patty Hajdu has said that families would not be separated upon arrival. One option being considered is that families returning with unvaccinated children would be permitted to quarantine at home rather than at a hotel.
Nearly 1 million adolescents between the ages of 12 and 17 have received at least one dose of a COVID-19 vaccine as of June 5. However, vaccines for children under 12 are not expected to be available until the fall at the very earliest. At this time, the only COVID-19 vaccine approved for use in Canada for those under 18 is Pfizer-BioNTech. The remaining three, Moderna, AstraZeneca and Janssen, are still in trials.
In mid-June, the federal government invested $1.8 million into a pan-Canadian study to monitor the safety and effectiveness of COVID-19 vaccines in youth. The study is to be conducted through the IMPACT (Immunization Monitoring Program ACTive) network, which has analyzed pediatric vaccines for more than 30 years.
Shaun Morris, a principal investigator on the study and a pediatric infectious disease physician at Toronto’s Hospital for Sick Children, says the study will build on the information gathered in his research team’s Canadian Paediatric Surveillance Program COVID-19 study.
“That study collected data on this illness from the beginning of the pandemic until the end of May 2021 to provide a more complete understanding of how COVID-19 affects children and youth and how we can best protect them,” says Morris.
Scott Halperin, the Canadian Immunization Research Network’s principal investigator, says it will be crucial for the research to consider the parents’ perspectives “once the vaccines are available for children.”
“Understanding parents’ concerns and the type of information they want to make decisions … is going to be very important,” says Halperin. “If public health officials know what parents are thinking and a recommendation is made to immunize all children, (the) type of information that parents are going to want for them to be comfortable with their decision (should be available).”
Here is an update on where the trials stand.
Health Canada approved Pfizer-BioNTech for children 12 and up on May 5. The results of the company’s vaccine study in adolescents demonstrated “100 per cent efficacy and robust antibody responses” in participants aged 12 to 15. This age group has been eligible to receive the first dose of Pfizer since May 23 and can do so by booking appointments.
Pfizer-BioNTech has announced that a large study to test its vaccine on children under 12 is underway. The first group of volunteers in the early-stage trial received the first injection in March 2021. Data on 5- to-11-year-olds is anticipated to be available in September, with more information regarding children 5 and under potentially following in the late fall, said a Pfizer spokesperson.
Moderna’s vaccine is currently only authorized for adults 18 and up. In May, the company announced that the second phase of its TeenCOVE study of 12- to 17-year-olds “met its primary immunogenicity endpoint, successfully bridging immune responses to the adult vaccination.” No cases of COVID-19 were found in participants who had received two doses of Moderna.
As of June 7, the company has filed for authorization with Health Canada for kids aged 12 to 17. It also has filed for emergency use authorization for this age group in the U.S.
Moderna’s CEO Stéphane Bancel says the company is encouraged that its vaccine is highly effective in preventing the disease in adolescents. Bancel says the results of testing on children as young as 5 are expected to be available by the fall.
Clinical trials for children under 2 are currently underway at UF Health Jacksonville at the University of Florida. The small group of four children are to be monitored for a year to determine how well they are protected against COVID, its variants, and vaccine side effects. Mobeen Rathore, UF Health’s chief of infectious diseases, says a second cohort is scheduled to be enrolled in July.
In February, pediatric trials of the AstraZeneca-Oxford vaccine began with about 300 children aged 6 to 17 years old enrolled. However, the University of Oxford halted its trial in April while an investigation into the vaccine’s potential link to rare blood clots in adults was conducted by the United Kingdom’s drug regulator.
The trial saw no safety concerns, but “additional vaccinations in the pediatric study will be postponed to allow further discussions with the (Medicines and Healthcare products Regulatory Agency) and the trial’s data safety monitoring board,” says an AstraZeneca spokesperson in an email. Children who had received a vaccine prior to or at the time of the pause “are still moving forward with their scheduled visits.”
Janssen (Johnson & Johnson)
The one-shot Janssen vaccine, which was approved by Health Canada for adults 18 and older on March 5, has not yet been administered in Canada.
The first batch of 300,000 doses will not be released due to a possible quality control issue, according to a recent statement from Health Canada. The decision was made after Health Canada was “unable to determine that (the) shipment of Janssen vaccines meets the department’s rigorous quality standards.” A statement from Johnson & Johnson says future batches will remain under review.
The company included adolescents aged 12 to 17 in its ongoing trials in early April. The study initially started last September 2020 and had been limited to adults aged 18 to 55 as well as those 65 and older. No results have been released yet.
Halperin says getting children vaccinated will be beneficial “from a practical standpoint.” At this point, once borders open for fully vaccinated travellers, it’s likely parents will either have to leave their children behind or not travel at all unless further exemptions are made.
“Or if they say (…) unimmunized children are OK to travel,” says Halperin. “Then you have the concern of ‘Where am I going? Is the virus circulating there? Do I want to bring my children with me if they’re not immunized?’”