Health units and school boards across the Greater Toronto Area have no public plans about what the COVID-19 vaccine rollout to children five and up could look like, despite news from Pfizer on Monday suggesting the approval of its jab for this age group may be coming soon.
With the province scaling down mass immunization sites in favour of a “last mile” strategy that focuses on smaller, community-based and targeted outreach, so far, there’s been no word even to family doctors about any preparations ahead of official Health Canada approval.
“We should have been planning for this for weeks and months,” said Dr. Tara Kiran, a family physician at the St. Michael’s Hospital Academic Family Health Team.
“The track record, unfortunately, is that often we’re not ready when we should be.”
Pfizer announced Monday in a press release that its vaccine, now marketed as Comirnaty, provoked a strong immune response in children aged five to 11.
It is aiming to submit its data to the U.S. Food and Drug Administration (FDA) for emergency use authorization of the vaccine in this age group as early as mid-October, a spokesperson for Pfizer Canada said.
The spokesperson could not provide specific timelines for when Pfizer would file the same data to Health Canada. However, the manufacturer plans to submit data to other regulatory agencies around the world like the European Medicines Agency “as soon as possible,” the spokesperson added.
Last year, Pfizer submitted its data for emergency use authorization of the vaccine in adults to Health Canada on Oct. 9, one month before the manufacturer submitted a request for emergency approval to the FDA. Health Canada approved the vaccine after a two-month review, on Dec. 9. The FDA authorized the Pfizer vaccine for emergency use on Dec. 11.
According to non-profit research group ICES, formerly known as the Institute for Clinical Evaluative Sciences, there are 339,910 kids 11 and under in Toronto and 1,827,283 in Ontario. This estimate is from January so it includes some kids who are now already eligible for the vaccine, as well as those under five.
A spokesperson for Health Canada said the agency anticipates manufacturers will provide data of their vaccine’s efficacy in children “in the coming months” but could not provide exact timelines for completion.
Topline results from Pfizer’s pediatric studies evaluating the safety and efficacy of the vaccine in the two youngest cohorts — children aged two to five, and six months to two years of age — are expected between Oct. 1 to Dec. 31 of this year, the company’s spokesperson said.
The Moderna vaccine, now known as SpikeVax, is currently undergoing clinical trials in kids under 12. Moderna did not respond to the Star’s questions about its timeline for when results could be released.
A spokesperson for Toronto Public Health said details about the rollout to kids will be made available publicly upon the vaccine’s approval by Health Canada.
For now, the agency said it’s waiting for provincial guidance on vaccine supply and distribution for children under 12 as well as eligibility guidelines.
The spokesperson did not answer the Star’s questions about what role pediatricians and family doctors will play in the rollout, if jabs will be administered at mass immunization sites or mobile clinics, if preparations have already begun, or the city’s timeline for when families could see jabs administered following Health Canada approval.
Kiran said organizing school-based vaccination clinics would be a “logical, efficient, effective and most equitable” way to get shots to kids quickly.
“Kids are already congregating there, they’ve got the space,” she said.
High-risk schools could be targeted first. Parents could always decline but “you actually have to do something not to get it. That just takes out the complacency factor.”
A spokesperson for the Toronto District School Board said the board will take its lead from the Ministry of Education and Toronto Public Health, and added they were not aware of the public health unit raising the topic of the board’s role in vaccine distribution yet.
At this time, Peel Public Health has not advised the Peel District School Board to direct students 12 years of age and younger to receive a first dose of the vaccination at schools, a spokesperson for the board said. The spokesperson did not respond to the Star’s questions about whether the health unit has been in touch with the board about vaccine distribution to children under 12 or if preparations had begun.
The Ministry of Health “will be ready to administer doses to children aged five to 11 as soon as they are approved by Health Canada,” a ministry spokesperson said.
Alison Blair, associate deputy minister of the pandemic response and recovery division, said in a briefing Sept. 14 that the province’s approach will likely be a “multi-channel vaccination strategy.”
Meanwhile, members of Vaccine Hunters Canada, the grassroots group of volunteers that formed to help adults find their shots, are “excited” about the Pfizer news and monitoring the situation closely.
The group shuttered its social media accounts at the end August, but still has stand-alone tools such as Find Your Immunization.
Spokesperson Sarah Nation said they will come back out of retirement if needed.
“Right now, we don’t have any plan to scale up,” she said.
“But we will be watching how things develop over the next few days and weeks, and if there does happen to be a need for us to come back than we definitely can and would.”
Ottawa-based Dr. Nili Kaplan-Myrth said family doctors like her are also ready to jump in the minute Pfizer is approved for ages five and up in Canada.
“As soon as we have that approval we should be able to immediately start immunizing all of our five to 11-year-olds in family medicine and pediatrics,” she said.
Kaplan-Myrth, who has organized successful “Jabapalooza” street vaccination events in Ottawa, has already figured that 198 kids out of roughly 1,400 people in her practice would qualify.
But she has also not yet been contacted by public health or the province about a rollout plan for this group.
Young children especially are more comfortable in a familiar setting, with someone they recognize and trust who has given them other childhood vaccines, Kaplan-Myrth added.
If physicians need extra space, they could set up shop in a community centre or arena, as she did last year for flu shots. As not everyone has a family doctor, there should also be clinics organized by public health.
“It’s really important that this is not a thing where anybody has to hunt for vaccine, there’s lots of it,” she said.
Article From: The Star
Author: Maria SarrouhStaff Reporter, May WarrenStaff Reporter
