With school around the corner, should kids wait for an Omicron-specific vaccine?

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As Canadian children prepare for their fourth school year amid the COVID-19 pandemic, it may look unlike any other, with the prospect of bivalent vaccines on the horizon. These updated COVID-19 vaccines target both the original strain of the coronavirus, as well as the Omicron BA.1 sub-variant.

Omicron-specific booster doses manufactured by both Pfizer-BioNTech and Moderna are currently undergoing review by Health Canada. This may lead some parents to wonder whether to vaccinate their children before classes resume, or wait for a bivalent vaccine to become available.

For children who have not yet received any COVID-19 vaccine doses but are eligible, Dr. Nazeem Muhajarine encourages parents to get them vaccinated as soon as possible.

“We need to take the vaccine that is available right now, rather than wait for a future vaccine, even if that future is just months away,” the University of Saskatchewan epidemiologist told CTVNews.ca in a telephone interview on Wednesday. “Vaccines available now are still protecting you from ending up in hospital and from long COVID, and that alone is a good enough reason to get them.”

A COVID-19 vaccine that also targets the Omicron variant may offer additional protection compared to current doses being administered, experts say. However, it’s not yet known when that formula will be available to Canadians, said Dr. Joanne Langley, a pediatric infectious disease specialist with Dalhousie University in Nova Scotia. Additionally, similar to the original COVID-19 vaccine, the first authorization will likely be for adult-sized doses, Langley noted.

This can leave unvaccinated children at risk of exposure to the virus as it continues to circulate across the country, particularly in settings such as schools, said Langley. The Omicron BA.5 sub-variant is currently the dominant sub-variant in Canada.

“If there's an infectious disease that's present in a setting where there's a lot of crowding, then there's an increased risk of transmission,” Langley told CTVNews.ca in a telephone interview on Wednesday. “Children are in that setting for six to seven hours a day – they play together, they hug each other … they’ll be laughing and singing. Those are things that increase risk.”

After getting vaccinated, it takes about two weeks for the body to produce antibodies that protect against COVID-19, Muhajarine said. With classes resuming in less than a couple of weeks across the country, parents may also be wondering if it’s too late to get their children vaccinated in time for school.

According to Dr. Ran Goldman, pediatrician and professor at the University of British Columbia, those who are eligible should get vaccinated now rather than later.

“Although we say the vaccines may take up to two weeks to [offer] full protection, I would do it now, I wouldn’t wait,” Goldman told CTVNews.ca in a telephone interview on Wednesday. “This is such an important part of us, as parents, making sure that our children are protected.”

The bivalent vaccines are also being reviewed as boosters shots rather than a completely new vaccine, Muhajarine said, emphasizing the importance of getting vaccinated with the current formula. As of Aug. 25, 42.4 per cent of children between the ages of five and 11 have received two doses of a COVID-19 vaccine, which is considerably less than vaccination rates among older age groups.

“The sooner that we get the next dose that we are eligible for, the more ready we will be [for] that bivalent vaccine,” Muhajarine said. “Enough time will have gone by for that bivalent vaccine to be more effective in our system.”

RISK OF SEVERE OUTCOMES IN KIDS IS NOT ZERO: EXPERT

A key risk factor in the development of severe outcomes from COVID-19 infection is old age, according to the Public Health Agency of Canada (PHAC). According to the agency, data related to COVID-19 hospitalization and deaths also suggests the virus results in a milder disease among children than it does in adults.

However, the risk of severe outcomes as a result of COVID-19 infection is not zero, Langley said. It’s also possible for children to suffer other health consequences after contracting the virus. One study has linked COVID-19 infection to multisystem inflammatory syndrome in children (MIS-C). In a separate study involving eight countries, nearly six per cent of children said they suffered from long COVID.

“Not everyone who gets [COVID-19] will have a more serious outcome, but there is a risk,” Langley said. “We can’t say that it won’t happen to you.”

This is why parents are advised to make sure their children are up-to-date on their recommended vaccine doses, Muhajarine said. Current vaccines not only offer protection against hospitalization and death from COVID-19, but also infection, whether symptomatic or asymptomatic, studies show.

MASKING AND OTHER MEASURES IN SCHOOLS

As children gear up for another academic year amid the pandemic, families will notice COVID-19 measures such as masking are no longer required in schools, according to provincial and territorial public health guidelines. Some universities, however, have said they will continue to require students and employees to wear masks in different settings on campus, and Muhajarine still recommends wearing masks at school.

“Pulling away from those public health measures that we had in place in the first year, and also to a large extent the second year [of the pandemic], is the wrong way to go … because COVID-19 is still present,” he said. “If we’re not careful, we can see spikes [of infection] continuing this winter season.”

However, Goldman said current protocols are appropriate for where Canadians stand in the progression of the pandemic today.

“We're at a different stage of the pandemic right now – we know more about the virus and how to protect [ourselves and] people are immunized,” he said. “Using masks if you're in very close interaction with others … is important, but we also have to think about kids going through the entire day keeping their masks on, [which is] quite difficult.

“I won't recommend mandatory masks for everyone.”

All three experts suggest avoiding close contact with those who are sick, and encourage children with COVID-19-like symptoms to stay home from school until they recover, even if they test negative for the virus.

“You don’t want to give the COVID-19 virus to anybody, particularly people you know and go to school with,” Muhajarine said. “Be kind to yourself and those around you.”

Muhajarine also advises parents to ask their children’s schools about whether ventilation systems have been updated. Proper ventilation in indoor spaces helps exchange the air in a room, which can limit the spread of COVID-19, he said.

For some, virtual learning may also be an option for reducing the risk of contracting COVID-19. This is particularly the case for children with underlying medical conditions, such as asthma, or those who are immunocompromised, Langley said.

However, it is important to note children also benefit from the social interaction that takes place when they physically attend class, Goldman said. Going to school in-person has a positive effect on the physical and mental well-being of children, he said. As a result, Langley suggests taking this into consideration when deciding whether to pursue online learning.

“You have to weigh all those pros and cons together and make the best decision for your little one,” said Langley.

With files from The Canadian Press.