The campaign for 0-4 year olds (children aged 6 months and over) began at the end of July, and yet, there is no rush at the gate.
According to data provided by the Ministry of Health and Human Services, as of August 16, only 9,656 doses had been administered and 18,009 appointments had been booked since July 25, out of approximately 400,000 children in this bracket. ‘age.
Experts answered our questions in order to enlighten parents who would like to have more leads to make a decision.
Why should toddlers be vaccinated against COVID-19?
From the outset, Dr. Hélène Decaluwe, specialist in pediatric immunology at the CHU Sainte-Justine, said she heard the fears and concerns of some parents about vaccines in very young children.
Despite this vaccination habit generally acquired in Quebec, a survey conducted last May by the National Institute of Public Health of Quebec (INSPQ) showed that 40 to 44% of parents of children aged 6 months to 4 years considered vaccination against COVID-19 as
less important than routine vaccination.
The reasons are, among others: a perception that their children
are too young and that the risks associated with the coronavirus
are weak in toddlers, then a vaccine hesitation linked to the real safety of vaccines.
Despite the unknown and the novelty, the vaccine against COVID-19 must be perceived, according to Dr. Decaluwe, in the same way as those offered for obtaining a complete vaccination status.
” We must remember that we regularly vaccinate our children from an early age to protect them from various infections. »
The latest study conducted in 2019 by the INSPQ on the vaccination coverage of Quebec children (New window) aged 1, 2 and 7 showed that 85% of one-year-old toddlers (up to 15 months) had received all the vaccines in the regular program.
In the case of 2-year-olds (24 months), 81% of them had received all of them, while 7-year-olds were 70% fully vaccinated.
Are children aged 6 months to 4 years more at risk?
Regarding vaccine hesitancy in the very specific case of COVID-19, Professor of the Faculty of Medicine and Health Sciences at the University of Sherbrooke and neonatologist, Dr. Arnaud Gagneur, underlined in an interview with Radio-Canada in April that
the goal is not to convince those who will participate at all costs, but rather to answer their questions and listen without judgment to their concerns.
It is in this sense that the medical adviser at the INSPQ, Dr. Nicholas Brousseau, wishes to reiterate that the vaccine against the coronavirus – like the majority of vaccines, ultimately –
really helps to prepare the defense system [de l’enfant] to have a less severe infection.
It is particularly effective in greatly reducing your risk of going to hospital or having serious problems. [s’il contracte] COVID-19he points out.
Moreover, all the experts we spoke to concede that at the start of the pandemic, the perception regarding side effects
less intense experienced by children who have contracted COVID-19 may have created some confusion.
At the start of the pandemic, children were not in school or daycare. They were isolated, recalls Dr. Decaluwe. For her, this is what made children – both young and old – seem to be less at risk.
Dr Decaluwe would like to point out, however, that we must take into account the data relating specifically to 6 months to 4 years of age: unlike young people aged 5 to 17, toddlers are
four to five times more likely to be hospitalized if they contract the virus.
Researchers at Vanderbilt Children’s Hospital in Nashville, Tennessee, published in the journal Pediatrics from the American Academy of Pediatrics a recent study of young people aged 2 months to 18 years, conducted during the first two years of the pandemic.
Of the 15,137 children hospitalized due to the virus, 1,060 of them (7%) suffered from neurological complications as a result of their infection, and children aged 2 months to 4 years would be more affected.
However, the appearance of the Omicron variant some time before the end of the study does not make it possible to conclude definitively whether neurological complications ensue. Further studies will be needed.
Long-term COVID-19 and multisystem inflammatory syndrome in children (SIME) are also among the complications noted by the INSPQ in children in general.
It would be too bad if a preschooler did not have access to a vaccine that can protect him from serious complications or death.suggests Dr. Decaluwe.
Does an infection provide protection?
As with people in other age groups, vaccination against COVID-19 for toddlers is not mandatory in Canada, although it remains strongly recommended by all public health authorities in the country.
It is also important, according to Dr. Decaluwe and Dr. Brousseau, not to take it for granted that a COVID-19 infection provides immune protection.
infection does not equal
” Concretely, it is not because you have an infection once that you are necessarily protected and that you have developed all the necessary immunological weapons to fight against an infection. [qui peut devenir] severe. »
In addition, a child who contracts COVID-19 will not be able to receive their dose of vaccine until 8 weeks after infection.
So far, Moderna is the only pharmaceutical to have received authorization from Health Canada to offer its vaccine to 0-4 year olds. The Quebec Immunization Committee (CIQ) also recommends the Spikevax (Moderna) vaccine.
Moderna’s clinical studies, which included testing the efficacy of doses on symptomatic disease, were conducted during the period when the Omicron variant was dominant.
Dr. Decaluwe explains how to interpret results related to vaccine effectiveness: one should not conclude that the vaccine is
half effectivebut rather
only 50% [des] children [de 6 à 23 mois] are fully protected.
She also recalls that the effectiveness rate of the vaccine is reduced due to the variants, which does not mean that the vaccine is of
” We must insist on the effectiveness against serious cases and hospitalizations, which is very high. The important thing is to reduce the risk of complications, not infections. »
In addition, children from 6 months to 4 years old receive a quarter of the regular dose (25 µg). The so-called pediatric dose aims to stimulate a large immune response, but to minimize side effects.
As with other age groups, the vaccine requires two doses, and public health recommends waiting eight weeks or more between them, a way to boost the immune system.
In terms of vaccine safety, Dr. Brousseau maintains that
there was no particular signal that was noted in Quebec, nor in the other countries.
Public data from the INSPQ are also clear on this last point: the post-vaccine reactions recorded are for the most part
local and systemic reactions of mild to moderate intensity, occurring one to two days after vaccination, with resolution within two days. We are talking about reactions such as:
- irritability or crying;
- loss of appetite;
- mild fever;
- edema at the injection site;
- axillary swelling/tenderness.
One case of erythema multiforme (redness) has been reported to public health.
No cases of anaphylaxis, pericarditis or myocarditis have been reported in clinical trialscan we read in the guide on vaccination against COVID-19 in children from the INSPQ.
Wait for new vaccines?
As the available vaccines were made from the original strain of SARS-CoV-2, experts foresee that some people may prefer to wait for the new vaccines.
These bivalent vaccines, based on the original strain and that of the Omicron variant (BA.1), are currently under development by both Pfizer and Moderna.
For the moment, for children, the question does not really arise. Because if this vaccine adapted to Omicron arrives, it will be for adults firstwarns Dr. Brousseau.
” It may take several months before a vaccine suitable for Omicron is available for children. It is better to go ahead with the vaccine [actuel]. »
Especially with the start of the school year or the return to daycare, he adds, we will surely have a good number of outbreaks in September.
Dr. Decaluwe, who works daily with very young children, hopes that this information will challenge parents.
For her, it is essential to understand that vaccination in toddlers, despite the concerns which are all valid, she believes, should not be seen as different from that of school-aged children.
Immunologically, biologically, whether you’re four and a half or seven and a half. It’s the same thingshe assures.
Immune responses [du vaccin] are also effective [chez les 6 mois-4 ans]or even better than those of adolescents and adults.
For the latter, the government launched a new vaccination campaign on August 17 in anticipation of the start of the school year and the return to work.