Kids can't get COVID-19 vaccine yet, but it's on the horizon. Here's what we know

Clinical trials studying the use COVID-19 vaccine in teenagers and children are underway, though experts say it will still be months before they're approved for use.

'Finally we get a chance to actually protect them. I think it’s pretty exciting.'

Sheila Garcia, 3, gets a mask before visiting a patient at the hospital in Palo Alto, Calif. COVID-19 manufacturers Pfizer, Moderna and AstraZeneca are all in the midst of pediatric clinical trials. (Paul Sakuma/The Associated Press)

Clinical trials studying the use COVID-19 vaccine in teenagers and children are underway, though experts say it will still be months before they're approved for use.

While a growing number of Canadians say they are willing to get the COVID-19 vaccine when it is offered to them, what will that look like when the shot is approved for children? And how will health-care practitioners communicate with parents who are vaccine hesitant?

Here's what you need to know about vaccines and kids:

What's happening with studies on vaccinating kids? When will they be approved?

AstraZeneca-Oxford, Pfizer and Moderna are all in the midst of clinical trials to determine how well their vaccines work in kids.

Dr. Cora Constantinescu is a pediatric infectious disease specialist at the Alberta Children's Hospital in Calgary. (Submitted by Cora Constantinescu)

Last week, Moderna started its Phase 2/3 pediatric trials, giving shots to Canadian and American kids aged six months to 11 years.

Some trials involving teens are further ahead, but a timeline for approval is unknown. However, Pfizer can be given to anyone 16 and older, and 16- and 17-year-olds are included in Alberta's phase 2B of the vaccine rollout plan which will see immunization offered to people with a variety of underlying conditions. 

Dr. Cora Constantinescu, a pediatric infectious disease specialist, said it's likely a COVID-19 vaccine will be approved for use in children, something she and her colleagues are excited about. Constantinescu works at the Alberta Children's Hospital in Calgary, where she also helps run a vaccine-hesitancy clinic.

She said it's hard to imagine achieving herd immunity without immunizing kids. And though a lot of attention during the pandemic has been rightfully focused on the welfare of adults at higher risk of severe outcomes, being able to protect children will be a huge relief, she said.

"We cannot underestimate the stress of a child going to school, knowing they are exposed to many people every day and potentially being a vector for bringing this disease to their families," Constantinescu said.

"Finally we get a chance to actually protect them. I think it's pretty exciting."

Why do kids need the vaccine if they aren't getting that sick from COVID-19? 

There are many reasons why kids should get the COVID-19 vaccine when it becomes available to them, the most important being they can still spread the virus even without symptoms, Constantinescu said.

"We're always going to have pockets of vulnerable people in our society and in our lives," she said.

Even if people with cancer, people who are immunosuppressed or the elderly are vaccinated, their response may not be as vigorous as it should. Having all members of their family immunized — including children — can help protect them. 

The pediatrician said another reason for children to be immunized is the more the virus spreads, the more it can mutate into variant strains. Kids might not become particularly ill, but they can carry a high viral load and keep transmission going.

"As long as this moves in the population, the risk of variants will always be there. I think it's every parent's nightmare, and certainly my nightmare, to think there might be a variant that will change, that will be more severe, and will actually kill kids," she said.

Protecting kids from COVID-19 is another good reason to get the vaccine when it's available, Constantinescu said.

She said while much of the research on the outcomes of COVID-19 has focused on adults, it turns out that children who get COVID-19 can end up with multi-system inflammatory syndrome or become pediatric "long haulers, with symptoms lasting for months.

"This is a new disease. There's a lot we don't know," she said

What is vaccine hesitancy and what's behind it? 

Vaccine hesitancy is reluctance or refusal to be immunized or to allow one's child to be immunized against contagious disease. When it comes to vaccine-hesitant parents, the heart of the issue is that they are trying to make the best decision they can for their child, Constantinescu said. 

"Always at the top of their concern when it comes to vaccine hesitancy is safety. It's always at the top of everyone's mind around childhood vaccines," she said. 

She said different parents come to hesitancy from different places.

"You may have somebody who has had cultural trauma, so that's a very different source of hesitancy than somebody who is concerned about infringement on their rights or conspiracy theories," she said.

Understanding the roots of the hesitancy is important when communicating with each family.

With COVID-19 specifically, she said, she and her colleagues in the vaccine-hesitancy clinic have heard about another factor at play.

"Some parents . . . they feel that the children are safe from COVID because of their compliance with public health isolation recommendations," she said.

"Which is an interesting phenomenon, I think, because we also know that we've had a number of COVID cases in schools, and we know that kids, even though sometimes mildly symptomatic or asymptomatic, can still spread this disease."

How do you talk about immunization with parents who are vaccine hesitant?

"We need to meet parents where they're at, and we need to support them as much as we can with education, but not just facts," Constantinescu said.

Clinicians need to build common ground and trust with vaccine-hesitant parents as they work with them on their decision, she said. 

You don't have to be a doctor to have conversations about vaccines, though. Constantinescu has three tips for talking to friends, family or colleagues who are vaccine hesitant: 

  • Connect before communicating: build common ground so you can relate to each other;
  • Make it relevant: When you talk to family, friends and colleagues, chat about why getting immunized would make sense for them in their life;
  • Share your experience: You don't have to be an expert to tell someone about what drove you to get the vaccine and what getting it was like to get the jab.

"I think everybody can become a vaccine champion and everybody can answer this call to action to help all of our fellow members of society and friends and family to be protected," Constantinescu said. 


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