Why are our most-at-risk children behind on their COVID vaccines?

As children return to school and another wave of COVID-19 is expected this fall, doctors worry that too few children are up to date with their COVID-19 vaccines, especially those who run the most. risk of becoming seriously ill from the virus.

Data shows that only half of children aged 5 to 11 with complex health conditions – including those with heart or lung disease or immunocompromised – received their first dose, while around 40% received two doses .

And while older children with underlying medical conditions have higher vaccine coverage — about 80% of 12- to 17-year-olds in these high-risk groups have at least two doses of the vaccine — only 22% have been boosted, according to the most recent data from the nonprofit research group ICES, formerly known as the Institute for Clinical Evaluative Sciences.

“These rates are disappointing; we really should have gotten those numbers much higher than that,” says Dr. Jeff Kwong, program manager for population and public health research at ICES.

“These are the high-risk groups. These are the ones where we really want to try to get as high a vaccination coverage as possible.

“And we know that at least one dose of vaccine – and two doses is even better – will reduce your risk of hospitalization and other complications from COVID.”

In Ontario, COVID vaccines began being distributed to children ages 5 to 11 in November 2021. Nine months later, data from Public Health Ontario shows that approximately 54% of children in this age group have received their first dose, including 41% two doses. Booster doses for this group were opened on September 1.

Doctors say that while the COVID vaccine offers protection for all children, its benefits are particularly important for those with underlying medical conditions. They say they fear vaccine uptake is lagging in these high-risk groups and warn that more effort is needed to help close the gap.

“People with underlying chronic conditions are among those at increased risk for poor COVID outcomes and should be vaccinated,” says Dr. Upton Allen, division chief of infectious diseases at the Hospital for Sick Children.

He notes that SickKids doctors have seen “a significant portion” of patients with conditions that put them at higher risk for severe COVID who are “suboptimally vaccinated.” Some of these families say they are reluctant to have their children vaccinated because they believe the vaccine will make their child’s condition worse.

“We clearly need to do more education so families are better informed and aware that vaccines don’t make heart disease, diabetes, kidney or liver disease, or any other chronic disease worse,” Allen says. “It’s a misconception that we have to deal with.”

He says more work is needed to ensure parents and caregivers have a clear understanding of how vaccines work and their benefits.

“One of the comments we get from families is, ‘I know someone who got vaccinated and still got COVID, so why bother? “,” Allen said, adding that the message to parents “needs to be crystallized very clearly.”

“We have to say: vaccines prevent mortality and vaccines prevent serious illness and hospitalizations related to COVID, making it a milder disease. The key point is that even if the vaccine does not prevent you from getting COVID, if you are vaccinated the infection is more likely to be mild.

Dr Peter Azzopardi, chief executive and medical director of pediatrics at the Scarborough Health Network (SHN), said many parents hesitant about the vaccine remain concerned about its safety and still view it as ‘a new vaccine’ , opting for a watch-and-wait approach as it is rolled out to children.

He hopes parents with questions will speak to a trusted healthcare provider, including SHN’s VaxFacts Clinic, for information, especially as children spend more time indoors this fall.

“Schools and daycares are areas that this virus likes to exploit to spread from child to child and family to family,” he says. “The number one best way to prevent serious illness caused by this virus is through vaccination.

“The studies are robust, they have been conservative, the doses are low, the side effects are fewer; all of those things that pediatricians are happy to see are checked off to ensure that this vaccine is safe and yet still very effective in this age group.

Dr Latif Murji, physician-in-charge of the VaxFacts clinic, which offers free one-on-one phone conversations with a physician about vaccines, says ICES data shows immunization efforts for vulnerable children are “falling short” .

“These are our children most at risk and the (vaccine) rates need to be much, much higher,” he says. “We need to do whatever it takes for parents to understand (vaccines) are really important safety measures. It can be a life-saving intervention for them.

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