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People pass by the sign of a COVID-19 immunization clinic in downtown Toronto on July 18, 2021.Kamran Jebreili/The Associated Press

As Canada prepares to embark on the largest and most urgent childhood mass vaccination campaign since the polio epidemic of the 1950s, health experts say planning is urgently needed to put in place child-friendly COVID-19 outreach strategies that avoid the logistical headaches that plagued the vaccine rollout for adults earlier this year.

COVID-19 vaccines are currently approved in Canada only for people aged 12 and older. But the arrival of shots for younger Canadians is imminent. Last week, Pfizer/BioNTech submitted preliminary data to Health Canada for the approval of its COVID-19 vaccine for children aged 5 to 11.

Once the shots are available, the work of getting them into children’s arms will begin. But orchestrating a vaccination campaign for children poses several unique challenges, experts say, and answering parents’ questions about vaccine safety will be key to success. Complicating matters further will be the lack of national co-ordination: Provinces and local health authorities will each be in charge of implementing strategies for their jurisdictions, but many say they have only just begun the process of developing those plans.

Canadian children 5 to 11 could become eligible for COVID-19 vaccine next month

Throughout the pandemic, parents have heard that COVID-19 cases among children are generally mild and rarely serious. Data from Ontario, for instance, show that less than 1 per cent of school-aged children infected with COVID-19 end up in hospital.

“The whole time, we’ve deprioritized children, saying, ‘Oh, they’re fine, schools are good, kids are okay.’ Now, that has to be undone,” said Cora Constantinescu, a Calgary pediatrician and infectious disease specialist who helps run a vaccine hesitancy clinic. “Kids’ lives have to be prioritized. We need to say enough is enough.”

Serious outcomes in children are rare – but when they do happen, they can be devastating. A number of children may develop complications such as long COVID, when symptoms persist for weeks or months, Dr. Constantinescu said. And she said that uncontrolled spread of the virus can lead to disruptions to in-person schooling and other childhood activities.

Now is the time to figure out the specifics of running mass vaccine clinics for children, said Peter Azzopardi, chief of pediatrics at the Scarborough Health Network in Toronto.

“We need to do this in a different way than we do adults,” Dr. Azzopardi said. “We will need to be very conscious about what are [children] hearing, what are they saying, what may potentially upset them.”

Dr. Azzopardi said it will be important for health officials to remember that children have different needs than adults, and that the strategies that worked earlier this year may not be suitable for the smallest Canadians.

For instance, instead of open vaccination stations in convention centres or hockey arenas, Dr. Azzopardi said, it may be necessary to create private booths, and to find clever ways to get children in and out while preventing them from being frightened by a clinic’s sights or sounds.

Dr. Azzopardi said his hospital is working with Toronto Public Health and other partners to put plans in place so they’re ready to go once vaccines are approved for children.

Ran Goldman, a pediatrician and professor of pediatrics at the University of British Columbia, said provinces should be creative with the locations of vaccine clinics to make the process easy and convenient for families. The shots, he suggested, could be given in schools, or at drive-in locations where children could be vaccinated in their families’ cars.

“I think that it is important to think outside the box when it comes to vaccinating children,” Dr. Goldman said. “We need to do it as fast as possible once it’s approved by Health Canada.”

Despite urgent calls by some experts to create vaccine plans for children under 12, many jurisdictions have not yet released the details of their strategies.

A spokesperson for Alberta Health Services said the province will move quickly to develop a plan if and when Health Canada approves vaccines for children. Last week, Toronto Public Health said it had formed a working group for a vaccine rollout for children, but that no plans or details are ready for public release. A spokesperson for British Columbia’s Ministry of Health said the province’s vaccine campaign for 5- to 11-year-olds will likely take place in a mix of community and school clinics and pharmacies, but provided no specific details.

Experts say provinces should make the COVID-19 vaccine mandatory for school attendance. Some provinces, including Ontario, already have similar requirements for routine childhood immunizations.

Parents may be more worried about getting their children vaccinated than they were about being inoculated themselves. An August survey conducted on behalf of Toronto Public Health found that only about two-thirds of parents planned on having their children under 12 vaccinated. About one quarter said they were unlikely to, and 10 per cent said they were unsure. At the time the survey was conducted, more than 80 per cent of Toronto residents 12 and older had received at least one dose of a COVID-19 vaccine.

“Since this is a new vaccine for kids, people have some reservations. We have to accept that, we have to understand that,” said Mehrdad Hariri, CEO of the Canadian Science Policy Centre.

That’s why experts say it’s critical for the next phase of the country’s mass vaccination campaign to include open, transparent messages that answer questions about safety. But the campaign also has to hit the ground running, because cases among school-aged children are already spiking across the country.

“Right now, COVID is the biggest threat in terms of vaccine-preventable diseases in our country,” Dr. Constantinescu said. “I think we need to change the conversation.”

She wants people to know that after nearly two years of worry, a way to protect their children is almost at their doorstep. While she acknowledges that it’s important to answer every question parents have about safety and efficacy, she also wants the message to be about hope.

“This is going to be a really big campaign in terms of how hopeful it is for many parents,” Dr. Constantinescu said. Her own three children attend in-person school in Alberta, where the COVID-19 threat is at its highest level ever. “It’s finally a sense of, ‘I can give direct protection to my child.’ ”

With a report from from Xiao Xu

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