TORONTO — The number of children under the age of five getting vaccinated against COVID-19 in Ontario is even lower than the relatively small numbers many experts had expected.
Shots for the youngest age group have been available for two months, but only about six per cent of those kids have had their first dose.
Ontario's chief medical officer of health, Dr. Kieran Moore, said that is lower than the numbers he thought he would see by this point.
"I certainly want more families to consider immunizing their children from six months to four years of age," in particular, children at high risk, he said in an interview.
"We know we have a higher percentage than five per cent of children with an underlying medical illness that may predispose them to having a worse outcome associated with COVID and would absolutely encourage those parents to consider having a conversation with your health-care provider regarding the risks and benefits."
Raywat Deonandan, an epidemiologist and associate professor in the faculty of health sciences at the University of Ottawa, said there are a lot of factors at play that likely feed into a low uptake, but he still would have expected a higher number by now.
"I'm not surprised it's low, I'm surprised it's this low," he said.
Many people believe false narratives that the pandemic is over and that kids don't get sick when they're infected with COVID-19, said Deonandan, who also pointed to misinformation about side-effects of the vaccine.
The way that messages about the safety and efficacy of the vaccine get communicated to parents matters, Deonandan said.
"This must be couched as, 'Parents, this is your decision to make and I want to give you all of the transparent information I can so that you make a good choice here,'" he said.
"It's a delicate balancing act here that we have to do when talking about this. You don't want to come across as forcing a foreign thing into your child's body, as we see the population is very sensitive to that kind of narrative. We don't want to come across as being fearmongers trying to force the world back into lockdown .... But at the same time, you just want to advocate for overall child health."
The City of Toronto pulled a series of videos this week about COVID-19 vaccinations for children after one implied kids couldn't go out to play with friends if they were unvaccinated.
"This video missed the mark on that message and should not have been posted," spokesperson Brad Ross wrote in a statement.
"A series of five videos directed at parents and caregivers about children’s vaccines has been paused while each is reviewed to ensure the messages are clear and unambiguous: vaccines are available for children and they are safe."
Pediatricians are who parents should listen to right now, Deonandan said.
"No one trusts the epidemiologists anymore," he said. "They don't trust the government doctors anymore. No one trusts the virologists anymore. They only trust their child's pediatrician, and that's the people who have to have this conversation."
Moore said the province is hearing from parents that one-on-one conversations are the most effective communication tool.
"When you're visiting your primary care provider, your pediatrician, you're getting your standard immunizations at two months, four months, six months, 12, 15, 18 months — all of those are opportunities for families to ask questions about COVID vaccination," he said.
"We have work to do to continue our (official) message. It will accelerate as we head into indoors and head into the fall as we perceive the risk of transmission will increase."
Dr. Paul Roumeliotis, the medical officer of health for the Eastern Ontario Health Unit, said he hopes vaccination for young children will speed up through the fall, as he had anticipated an overall uptake of about 25 to 30 per cent.
He attributed the slow start to the rollout kicking off during the summer, misinformation circulating about the vaccine, as well as a general hesitancy from parents when it comes to children of that age.
"I'm a pediatrician, I know that parents are always hesitant – particularly for younger children and babies – be it a vaccination, or any medication that comes out," he said.
"One of the messages that we need to tell people is that although that vaccine is not as effective as we'd like to be for person-to-person transmission, it's certainly highly effective against severe disease and complications thereof."
Dr. Anna Banerji, a pediatrician, infectious disease specialist and associate professor at the University of Toronto's Dalla Lana School of Public Health, said there is also a complacency factor.
"(People think), 'Oh COVID's not so bad. It's just a mild cold in young kids, I don't really need to worry about it,'" she said.
"There's a lot of, I think, denial that kids, especially younger kids, can get it and get very, very seriously sick with that."
Public Health Ontario said in its most recent report that there was a notable increase in hospitalizations for infants under one year old, with 17 children for the week of Sept. 4 to Sept. 10 compared to eight the week prior. Since the beginning of the pandemic, 1,268 kids in that age group have been hospitalized for COVID-19 – a much higher rate than for older children and teenagers.
Kids have a fairly good chance of catching COVID-19 now that schools are back in session, and it's not just the immediate and possible long-term effects on the young children themselves that parents should keep in mind, Banerji said.
"(They) also can spread it to other kids, can spread it at home, can spread it to grandparents," she said.
"It's something that could significantly impact someone's life. And so I would do what you can to reduce the risk of transmission, which is really vaccination."
This report by The Canadian Press was first published Sept. 22, 2022.
Allison Jones, The Canadian Press