How can Canada roll out COVID-19 vaccines in a 'child-friendly' way?

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As Canada gears up to vaccinate children against COVID-19, a Toronto pediatrician wants to make sure the doses are administered "in a child-friendly way, in spaces that children feel comfortable in."

Health Canada said last week that it is reviewing a request from Pfizer-BioNTech to authorize its COVID-19 vaccine for children ages five to 11. 

On Thursday, Prime Minister Justin Trudeau announced that if that approval happens, Canada will receive 2.8 million new doses from Pfizer — enough to give everyone in that age group a first dose. 

Shazeen Suleman is a pediatrician at St. Michael's Hospital in Toronto who cares for kids who are new to Canada, and an assistant professor at the University of Toronto's Temerty Faculty of Medicine. She spoke to As It Happens host Carol Off about what vaccinating young children might look like. Here is part of their conversation.

Are the parents with whom you're speaking ... eager to get their kids vaccinated?

There are certainly some parents who are eager and want to run to the front of the line, and there are other parents who have lots of questions.

What would you say to those who are hesitant, who are wondering whether they want to get their five-year-old vaccinated against COVID?

The first thing I would tell families is that I hear you. I know that you're coming from a place of love and concern, and you want what's best for your child. And as your child's health-care provider, so do I.

For any parent that is concerned or has questions, I would say go talk to the provider that you normally see for your child's health, and engage them in a conversation. We know your child. We know you. And we want to help you make that decision that's right for you. And we're here to listen.

And if they did come to consult with you, would you encourage them to get the vaccine?

I think I would first have the conversation and remind them of the benefits of vaccination. We know that vaccination has slowed the spread of COVID. We know that vaccination also reduces the chance of variants of concern, and also provides individual protection. 

And even more importantly, particularly recognizing that I work with a lot of families that have older parents at home or older grandparents and children who are immunocompromised, me getting vaccinated protects them as well.

[Parents are] reading … that the risk of COVID making their kids severely sick is much lower than it is for the rest of us, and so maybe the benefits don't outweigh the risks.

I, first of all, totally hear where the parents are coming from, where they're worried. And a few things I would say is, you know, we do know COVID is affecting children. And COVID is a disease in evolution with different variants of concern. We've seen more cases in schools. We've seen more children be affected. And we've seen more children actually get severely ill.

The other thing that I would ask folks to remember is there was a time when we used to think of chickenpox this way. You know, I remember going to chicken pox parties or being told about that growing up. And for the most part, children who got chickenpox were otherwise fine if they got sick. But there were some children who got severely sick. And there were some children who died. And now we have a vaccine for chickenpox. And so we don't have to risk any child.

We don't have any way of knowing if you are going to be the person who does get severely sick [from COVID]. And you also end up protecting, again, not just yourself, but your family and your community, especially those who are immunocompromised

[Parents have also] heard, and we've read, that a lot of kids have had asymptomatic cases of COVID, that maybe lots of kids have had COVID passed through them and they have the immunity, like they have to so many other things. So why should they get a vaccine if it's possible, even probable, that they have had COVID and they have an immunity to it?

Our health is not in isolation. My health depends on the health of people around me.

And so thinking about those in our community who are at high risk of COVID, they are protected by those of us who are vaccinated and, therefore, are not spreading the virus to them. 

I do think it's important that we remember that children are not little adults, and that a vaccine strategy for children absolutely needs to be accessible to every child.- Dr. Shazeen Sulemon, St. Michael's Hospital 

What we've seen over these months of having a vaccine is many inequities in how it's being distributed, right? I mean, we've seen that ... people [who are] living in wealthier areas have time off or they can get time off. They've been able to access the vaccine. We saw so many pockets of where people just didn't have the hours or the transportation or whatever in order to get vaccinated. Are you concerned that that's going to happen with the kids too?

Absolutely, Carol. You know, I do think it's important that we remember that children are not little adults, and that a vaccine strategy for children absolutely needs to be accessible to every child. 

That means children with disabilities, children who are not neurotypical, children who have parents and caregivers who are working and can't take them to vaccinations. Parents whose family may not speak or read English, or who are single parents, or don't have [provincial health insurance].

Every one of these children needs to be thought of when we're making our vaccine strategy. And it's so important that we make the vaccination as low-barrier and accessible as possible — thinking about how we can do this in a child-friendly way, in spaces that children feel comfortable in, that families feel comfortable in, with providers that children trust.

I think it's really important that we also think … about the caregivers of children. Because, for example, as we know … there were temporary sick days put in place [in Ontario] for individuals who needed to take time off to get vaccinated and recover from the vaccine. We need to think about having paid sick days for parents and caregivers to be able to stay home with their children after vaccination as well. 

I'm very eager to see how we learn from what we did earlier on to create an equitable vaccine strategy for all children.

We're already hearing, though, that public health units across the country are making plans for vaccinating kids and providing [doses to] doctor's offices [and] pharmacies. [But kids all] go to one place. It's called school. And isn't that the logical ground for where kids should be getting their vaccines?

We've definitely had really great success with school-based vaccination strategies … and school is another place that children feel safe and comfortable in, and it would be a wonderful place that could be engaged in a vaccine strategy.

What we know is that so many people do not have a family doctor. So where can they go? Where can people go to get the advice, the reliable counsel, they need to make this decision?

I would tell parents one one reliable resource that is great is Caring for Kids by the Canadian Paediatric Society. That has information presented to parents.

I would also invite people to reach out to their public health units. Certainly in the city of Toronto, they have put out fantastic resources in a number of different languages, [and] also in child-friendly and youth-friendly language. 

Written by Sheena Goodyear. Interview produced by Katie Geleff. Q&A has been edited for length and clarity.