Childhood analysis

As Canada prepares to immunize children ages 5-11, a snapshot of immunization across the country

As Health Canada is set to approve Pfizer-BioNTech’s COVID-19 vaccine for children aged five to 11 – and as it continues to review the pediatric version of Moderna – parents of older school-aged children young people now have to decide if they will line up to get their children these shots.

Here is a little reminder on childhood vaccination and school vaccination.

Who is responsible for immunizing children?

Parents and guardians are ultimately responsible for immunizing their children. However, who gives children their regular injections depends on the region. In some areas it may be a nurse, or more specifically a public health nurse, while in others it may be a pediatrician or a family doctor / general practitioner. In some cases, such as a flu shot, it may be a pharmacist.

Provinces and territories distribute and manage the delivery of vaccines, which are approved and purchased by the federal government.

Health officials across the country have already planned how to deploy COVID-19 vaccines for the 5-11 age group, ranging from setting up pediatric vaccination clinics (some with therapy dogs), incorporating pediatricians and family physicians and enlist pharmacy also.

An eight-year-old child, accompanied by a therapy dog, shows off the bandage at his injection site after being vaccinated in Washington, DC on November 3. (Carolyn Kaster / The Associated Press)

In each province and territory, schools are also a common public space to host vaccination programs for students. Several regions have mentioned the planning of COVID-19 vaccination clinics in school spaces, as they have already done for older children, adolescents and families.

Regarding the rollout of COVID-19 vaccination for young children, “there must be adjustments in mass clinics to accommodate children and use pain and anxiety management techniques, as we know that many children are afraid of needles and it could be a stressful event to be vaccinated in a crowd, ”said Ève Dubé, medical anthropologist and researcher at the Institut national de santé publique du Québec.

Is vaccination compulsory to attend school in Canada?

Childhood immunizations are strongly recommended by public health officials and schools across Canada as effective and long-lasting protection against vaccine-preventable diseases.

To attend school in Ontario, the Pupil Immunization Act requires proof of vaccination (or exemption) for a range of illnesses, including diphtheria, measles, mumps, polio, rubella, tetanus and more. A section of New Brunswick Public health law requires parents or guardians of students starting school – who are usually in kindergarten – to show proof of vaccination (or have an accepted exemption).

that of British Columbia Vaccination Status Reporting Regulation requires families to disclose a student’s immunization record or request a waiver. In the event of an epidemic – measles, for example – unvaccinated students are required to stay at home for a specified period.

Other provinces and territories do not make vaccination mandatory, but schools in those areas can still review the vaccination records of students entering school for the first time. Alternatively, public health officials or school nurses may review immunization records of children at the age they typically start school or at later intervals.

In Alberta, for example, public health critics come in Grades 1, 6 and 9. If immunizations are missing or incomplete, information sheets about them are usually sent home, along with parental consent forms, before routine clinics at school.

Binding vaccination can increase absorption, according to a study in the United States, where every state has vaccine requirements. But in Canada, it’s less clear, says Dubé.

Ontario has required proof of vaccination for school attendance since 1982, she said, unlike Quebec. “But when we compare the vaccination in Quebec to that in Ontario, it is quite similar.”

Will COVID-19 vaccines be added to the current list of childhood vaccines?

Early October, California became the first U.S. state to require COVID-19 vaccination for its kindergarten to grade 12 students. Over the past few months, different voices across Canada have called on provincial health authorities to add COVID-19 vaccination to the existing list of childhood vaccines, including the Toronto District School Board Chair (the largest school board in Canada), the head of People of Education public education advocacy group and the Toronto Medical Officer of Health, Dr Eileen de Villa.

At this point, however, it does not appear that Canadian provinces and territories are heading in this direction.

A nurse gives the first injection of the Pfizer-BioNTech COVID-19 vaccine to a six-year-old child in Seattle on November 9. (Ted S. Warren / The Associated Press)

In late October, Ontario’s Chief Medical Officer of Health Dr. Kieran Moore said he was not will add him to the province’s list, but will consider the “continuing threat” of COVID-19 as it reviews that decision in the future. Saskatchewan Premier Scott Moe said in early November that he also would not require schoolchildren to be vaccinated against COVID-19.

WATCH | Making vaccination compulsory for students can “backfire”, according to the epidemiologist:

Making vaccines compulsory for students aged 12 and over could “backfire”, says epidemiologist

Raywat Deonandan, epidemiologist at the University of Ottawa, says making vaccines mandatory for students 12 and older can have unintended consequences, pushing already hesitant parents further. 0:52

Do all regions have school vaccination?

The approach to childhood immunization varies across Canada, with differences that include who gives the vaccines, at what age or at what level a particular vaccine is given, when immunization is officially recorded, what type of health worker monitoring exists, and how immunization data is collected and published .

However, all provinces and territories participate regularly in immunization programs in collaboration with local public health officials, many of which take place in primary and secondary schools.

Standard immunization programs were delayed last year due to the pandemic, but many catch-up initiatives for routine immunizations are planned or already underway.

The federal government lists recommended immunization schedules that exist in each province and territory and provides a tool for families to determine a schedule for children under six, also for students from grades 1 to 12 (or Secondary V in Quebec).

How is Canada doing with childhood immunizations?

Every two years, Statistics Canada conducts the National Childhood Immunization Coverage Survey (cNICS) to measure the proportion of children who have received all routine immunizations at ages two, seven, 14 and 17, as well as what parents and guardians know and think about vaccines.

A six-year-old girl sitting on her mother’s lap receives the Pfizer-BioNTech COVID-19 vaccine in San Diego, Calif., Nov. 3. (Mike Blake / Reuters)

First analysis of the most recent survey, which took place in 2019, found that while the majority of Canadian two-year-olds received the full recommended vaccine package, there was still room to improve uptake. According to Canada’s National Immunization Strategy, the goal for childhood immunization coverage is 95 percent at ages two and seven, and 90 percent for adolescents.

No province or territory has met the childhood goals for all vaccines.

Newfoundland and Labrador comes closest, meeting the target of several vaccines and generally with the highest coverage in all regions of Canada.

Does a child always need parental permission to be vaccinated?

The age at which children themselves can consent to receive a vaccine (as opposed to obtaining parental consent) varies across Canada and depends on whether they are assessed as mature minors by a healthcare professional. . It can start at age 12 in Manitoba and British Columbia, for example, up to age 18 in Alberta.

A child or adolescent assessed as a mature minor should know the risks and benefits of immunization from a health care provider and understand this information before giving consent. Their medical records would be kept confidential, so the parents or guardians of a student considered to be an adult minor might not be aware of the vaccination.

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