Ottawa children, youth lead province in vaccination rates

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Ottawa children and youth have been lining up in record numbers to get vaccinated against COVID-19 and pediatric health officials have been watching closely.

Ottawa leads the province when it comes to COVID-19 vaccination rates among 12- to 17-year-olds: 78 per cent have had at least one dose compared with 58 per cent Ontario-wide. And numbers are growing rapidly.

So far the rollout to kids and youth has gone smoothly.

There have been no serious heart complications related to vaccination among children under 17, CHEO cardiologist Dr. Jane Lougheed says. She and others have been answering questions from parents on a daily basis about the benefits of vaccinations versus potential risks to ensure vaccine confidence remains high.

“We do it as part of our job. All health-care providers are getting lots of questions from parents,” says Dr. Anne Pham-Huy, a pediatric infectious disease specialist at CHEO.

CHEO is among those pediatric centres with special clinics devoted to monitoring adverse events after vaccination. It existed before the pandemic, but part of its focus now is on COVID-19 vaccines as more children are vaccinated. It is part of a special immunization clinic network across Canada whose aim is to ensure vaccine safety and vaccine confidence.

“People are hearing a lot about adverse events, but this is not a new thing in our world,” Pham-Huy says. “In terms of vaccinology, there is always a continuous monitoring of safety. This is just another tool.”

Among potential rare side effects that have been linked to mRNA vaccines are cardiac complications.

Lougheed says she is frequently asked about risk of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the heart lining). The rare adverse event has been linked to mRNA vaccines and is more common in young men. Lougheed says the parents of children she treats with serious cardiac issues have been among those with concerns.

She says children with complex heart issues are at no greater risk of the extremely rare side effect and may be at greater risk of complications from infection — she advises parents to make sure their children are vaccinated.

“Yes, there is a risk associated with vaccination. It is an extremely low risk,” Lougheed says. “And our opinion is this very low risk is very much outweighed by the risk of getting COVID-19.”

Based on data from Israel and the United States, the risk of developing myocarditis or pericarditis after vaccination is about one in 5,000 to one in 10,000, she said. It is more common in males between ages 16 and 19. Many of the cases reported among adults in Ottawa and elsewhere are relatively mild and resolve in a number of days.

“The bottom line is that the risk of a cardiac complication is extremely low.”

Lougheed says CHEO has “not seen a large number of kids to date with any of the cardiac complications or issues related to mRNA vaccines”. No children have been hospitalized with heart complications related to immunization.

Still, Lougheed says she understands that some families are worried.

In addition to reassuring families, Lougheed and others encourage them to bring their children to CHEO if they have any symptoms such as chest pain or shortness of breath after being vaccinated.

And, while children often have milder cases of COVID-19 when they do get infected, she notes that children can end up with serious complications. About one per cent of children who get COVID-19 end up in hospital, she says, and about one-third of those children will end up in intensive care.

Children can also suffer from multi-system inflammatory syndrome after infection, which can be serious. There have been a handful of such cases among children who had to be hospitalized at CHEO during the pandemic. All have recovered.

“Vaccine confidence is really essential in the management of this pandemic.” Pham-Huy says. “It is always concerning to hear of any rare or potential adverse events after vaccine, but we have to remember there are very severe adverse events with infection.”

Research released by Statistics Canada this past week found that more children than older adults had previous COVID-19 infections leading up to the third wave of the pandemic in Ontario, as many as one-third of them asymptomatic. The research supports other evidence that COVID-19 circulates among children and that children are infected at higher rates than positive test results indicate.

Most people who get myocarditis or pericarditis after immunization have mild symptoms and don’t require hospitalizations, Lougheed says.

Most children and teens over 12 have not yet received second doses, but will soon begin to do so. Nor have children under 12 been approved for COVID-19 vaccination. That is expected in late fall.

Lougheed says the high numbers of teens lining up for vaccines are an indication that they are motivated by wanting to return to more normal lives.

“The teens are realizing that they want to get back to some sense of normalcy. There is a lot of motivation on their part.”

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