Severe cases of COVID-19 were very rare among Canadian children during the first waves of the pandemic, according to a new study by researchers who warn the findings should not be taken as a reason not to vaccinate youth.
The study was published Monday by the Canadian Medical Association Journal and looked at 264 reported cases of children hospitalized in Canada between March 25 and Dec. 31, 2020, before the more infectious Delta variant emerged.
Of those cases, 43 per cent had been hospitalized for another reason, such as a fracture, and it was only after they were admitted that the positive test came to light.
Nearly 34,000 Canadians of all ages were hospitalized during the same time frame.
“If you look at the numbers in total, that’s only 150 children hospitalized with COVID during the first two waves here in Canada,” said study co-lead author Dr. Fatima Kakkar of Montreal’s Ste-Justine Hospital.
“These are very small numbers, when you compare with what has happened in adults.”
The study was conducted before the emergence of the more infectious Delta variant, which now accounts for most COVID-19 infections in Canada.
The research also took place before COVID-19 vaccines were authorized for youth aged 12 and older. Of the cases studied, 77 involved kids aged 13 to 17. Pfizer has said it intends to seek authorization soon for a vaccine intended for kids aged five to 11.
Researchers originally believed that children may be at higher risk for severe disease, since this is typically seen with respiratory infection in the pediatric population.
Among the 150 children admitted directly because of the coronavirus, the most common symptoms were fever (70 per cent) and cough (34 per cent).
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Half had a severe form of the disease, with 21 per cent admitted to intensive care and 13 per cent needing respiratory or cardiac support.
Researchers add that more than three per cent of Canadian children — a high among all age groups in the country — have recently been shown to carry antibodies to COVID-19, indicating that they have been exposed to the virus.
But the relatively small number of pediatric admissions shows that children had less severe infections than adults, even though they were potentially infected more often, Kakkar said.
Overall, 39 per cent of children and youth hospitalized for COVID-19 had at least one co-morbidity and those with severe disease were more likely to have an underlying health condition including obesity, neurological or respiratory issues.
“We often talk about children who have comorbidities and who are sicker, (…) but 60 per cent had no comorbidity,” she said.
“They were healthy children who were hospitalized for the disease. On the other hand, when we look at the severity, the most severe cases were in children who had comorbidities, such as obesity, major neurodevelopmental disorders.”
Deaths of children infected with COVID-19 were also very rare, confirming the findings of other studies.
But even with the encouraging conclusions, parents should not take from it a false sense of security and not vaccinate their child, Kakkar said, given children in good health also ended up in hospital.
“We do not know, among these children who are in good health, which will be the sickest, and we know that when we have a severe disease, we have consequences,” Kakkar said.
“A child intubated in intensive care needs months of rehabilitation, and unfortunately we cannot predict which child will fall into this category.’
An unvaccinated child will also be more likely to continue the spread of the virus within their own family and friends.
She also noted the Delta variant is much more transmissible and currently wreaking havoc among unvaccinated adults.
“I do not want to discourage parents at all from having their child vaccinated,” she said.
“We really have to look at the total well-being of the child: what will allow them to have a normal life, to do activities, to play sports, to see friends? It’s vaccination.”
Still, Kakkar said the benefits of attending school and seeing friends are essential to development.
“There is a lot of anxiety among parents about the risk of COVID in children,” Kakkar said.
“It is important to reassure parents, it is not the same disease as in adults, (so) I hope that will allow the children to live a little more normal life.”
© 2021 The Canadian Press
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Jennifer Hubert jumped at the opportunity to get her COVID-19 vaccine, but she’s not looking forward to having to make the decision about whether to vaccinate her three-year-old son Jackson.
She recognizes the safety and effectiveness of vaccines, but said she also understands her son is at a much lower risk for serious illness than older adults.
“To me it’s not a clear benefit,” she said.
While many parents were overjoyed at the news that Health Canada is considering approval of the first COVID-19 vaccine for kids age five to 11 in Canada, parents like Hubert are feeling more trepidatious, and public health officials said they are going to have a much more nuanced conversation with parents about vaccination than they did with adults.
While 82 per cent of eligible Canadians aged 12 and up are already fully vaccinated, a recent survey by Angus Reid shows only 51 per cent of parents plan to immediately vaccinate their kids when a pediatric dose becomes available.
Of parents with children in the five to 11 year age range, 23 per cent said they would never give their kids a COVID-19 vaccine, 18 per cent said they would wait, and nine per cent said they weren’t sure, according to the survey of 5,011 Canadians between Sept. 29 and Oct. 3, which cannot be assigned a margin of error because online surveys are not considered random samples.
“Most of the research that I’ve seen sort of indicates that parents are more hesitant to vaccinate their kids against COVID than themselves,” said Kate Allan, a post-doctoral fellow at the Centre for Vaccine-Preventable Diseases at the University of Toronto.
There are several reasons parents might pause, she said.
It’s true that children are at a much lower risk of serious outcomes associated with COVID-19, and there have been very rare incidents of mRNA vaccines like Pfizer or Moderna linked to cases of myocarditis, a swelling of the heart muscle.
As of Oct. 1, Health Canada has documented 859 cases associated with the vaccines, which mainly seem to affect people under 40 years old, and people who’ve developed the complication have typically been fine.
“I know it’s rare, I know it’s not deadly, but I also see the risk of severe symptoms from COVID as being rare and not deadly for Jackson,” Hubert said when asked about weighing up the risks and benefits of the vaccine.
But public health experts stress that some children do suffer from rare but serious impacts from COVID-19, which can also cause myocarditis as well as the little-understood impacts of the condition known as long COVID.
They say parents should consider the less tangible benefits of vaccination as well.
“It’s less of a conversation about a direct benefit to them, and more of a community benefit,” Allan said.
The pandemic has taken a heavy toll on children, depriving them of school, time with their peers, extracurriculars — and their mental health has suffered as a result, said Dr. Vinita Dubey, associate medical officer of health with Toronto Public Health.
“Not one child has been spared from this pandemic. I mean every single child has had to bear a sacrifice because of the pandemic in one way or the other,” Dubey said.
So far Pfizer-BioNtech is the only manufacturer to request approval for its pediatric COVID-19 vaccine and Health Canada is still reviewing the data.
The regulator has promised the review will be thorough, and the vaccine will only be approved for children if the benefits outweigh the potential risks.
Policy-makers know they’re going to have to take parents’ concerns seriously as well.
On a recent tour of the Children’s Hospital of Eastern Ontario in Ottawa, Prime Minister Justin Trudeau spoke with Dr. Anne Pham-Huy, a pediatric infectious diseases physician.
“Vaccine confidence is going to be the most important part of it this time around,” Pham-Huy said, to which Trudeau agreed.
Dubey has published research on improving parents’ vaccine confidence when it comes to long-established inoculations like mumps and rubella.
While she offered several tips, they mainly come down to building trust. Her research focused on the role of family doctors, but she said during the pandemic anyone can be that trusted sounding board.
“It could be a faith leader, it could be an important family member or friend, someone who you trust, to help guide you to the right sources to make that decision,” she said.
With that in mind, several students from across North America launched a peer-to-peer education program called Students for Herd Immunity to allow kids to have those conversations among themselves.
The public health experts agree, the debate around vaccines has become polarized and open conversations will be the key to addressing parents’ concerns.
“I think one thing to say to parents is you don’t have to make your decision right away,” Dubey said. “I mean for those who are ready to make their decision, but it’s fine but if you have questions, seek the answers.”
Her only advice is to get those answers from a trusted source, and not social media.
Laura Osman, The Canadian Press
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EOHU recommending flu shots for area residents, as winter approaches – The Review Newspaper
As the fall and cooler weather arrive, they bring with them the start of flu season. According to the Eastern Ontario Health Unit, the flu shot is the best protection against the flu, and with the presence of COVID-19 in the community, getting your flu shot is more important now than ever. The flu shot has been approved for use alongside COVID-19 vaccines and is a key step in keeping healthy this season.
“It’s especially important that people get their flu shot this year,” says Dr. Paul Roumeliotis, Medical Officer of Health at the Eastern Ontario Health Unit (EOHU). “Both COVID and the flu share symptoms and, despite their similarities, being fully vaccinated for COVID won’t protect you from the flu.”
“Getting the flu shot can help you stay healthy and reduce the pressure on health care centres.”
Getting the flu shot could also help reduce the demand on COVID-19 assessment centres. The fewer number of people who develop flu symptoms, the fewer who will need to get tested for COVID-19.
The flu shot is available at various locations throughout the five Eastern Counties and Cornwall, including through some healthcare providers, community health centres, participating pharmacies and by appointment at the EOHU for children ages 6 months to under 5 years, and their immediate family.
Appointments for children at the EOHU will be available as of November 1. Call to book your child’s appointment starting on October 25. Residents must bring a piece of identification to their appointment. To find out more about where you can get the flu shot, visit EOHU.ca.
Certain groups of people are at higher risk of complications from the flu and are strongly encouraged to get immunized. These include:
- children 6 months to less than 5 years of age
- people aged 65 and older
- people with chronic medical conditions
If you live with or provide care to someone who falls under one of the groups listed above, or care for newborn infants and children under 6 months of age, it is also highly recommended that you get immunized. This simple step will help protect you and those around you.
For more information about the flu shot, visit EOHU.ca or call 613-933-1375 or 800-267-7120.
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