Ottawa's top doctor answers 20 questions from parents and children about the COVID-19 vaccine

As Ottawa Public Health prepares to begin administering COVID-19 vaccines to 77,000 Ottawa children ages five to 11, the medical officer of health took time to answer questions from parents and children about the vaccine.

Health Canada approved the Pfizer-BioNTech COVID-19 vaccine for children in Canada last Friday, with the first doses set to be administered this week.

As of Wednesday, over 28,000 appointments have been booked in Ottawa for children ages 5 to 11 to receive the COVID-19 vaccine. The first appointments are scheduled for Friday.

Dr. Vera Etches joined CTV News at Six on Wednesday to answer questions from parents and children about the COVID-19 vaccine. Here are the answers from Dr. Etches to the questions.

How will the vaccinations work at the clinic? Will the COVID-19 vaccine clinics for children be the same as the adult clinics?

"Some of the locations will be the same, but they will be adapted for children. You're going to see fun signage, you're going to see stickers, you're going to see people bringing their stuffy's, you're going to find that the nurses are really supportive of children. They'll be using games for distraction like little 'Eye Spy' games," said Etches.

"The kids, as I said, they're going to get stickers, but there are also other tools to help kids feel comfortable – if they need a numbing spray for their arm, quiet spaces for students and children. It's something that we've been trying to really think of what's child-friendly."

Four-year-old Declan said, "I'm turning five on Christmas. When am I going to get my vaccine?"

"Declan, early Happy Birthday. You know what, because you're turning five this year before the end of the year, you don't have to wait. You can talk to your parents and they can help you make an appointment to get your vaccine, even now."

Will children who were born in 2010 and turning 12 as early as six weeks from now be eligible to receive a full dose of the COVID-19 vaccine instead of the lesser third dose being given to the 5 to 11 age group?

"I want people to understand that the vaccines were studied by age, not by the weight or the size of the child, and they found effectiveness across that whole range age five to 11 and it's a lower dose so it's likely to have fewer side effects. So, we will be giving 11 years-olds the dose for 11 year-olds and 12-year-olds the dose for 12 and above."

"My name is Marty and I'm in the sixth grade. My question is since I'm turning 12 next year, should I get the bigger dose next year or should I get the smaller dose now while I'm 11?"

"I would love to see you get the vaccine as soon as possible, so that means taking the 11-year-old dose and you can book your appointment. That's the way it was studied that 11-year-olds did have the dose, it's the same kind of ingredient as the adults have, and it was shown to provide good protection."

Can the small dose (child vaccine) be requested for a very small 12-year-old?

"I think if there's a parent who has a particular situation they're concerned for their child it never hurts to talk to your family doctor about it and get your questions answered. We will be following the age quite strictly in our clinics, that's how our training and our approach is based on how the companies also are saying their vaccines should be used."

Mya asked, "What is in the vaccine and how long did it take to make the vaccines?"

"What's in the vaccine? It's a liquid. It's actually mostly water and then it has that ingredient that teaches your body how to fight the virus – the MRNA. Then there is some other things that kind of hold it together and help keep it stable; so those things are fats, and sugars, and salts. It's all things that your body can handle," said Dr. Etches.

"People started working on these vaccines almost two years ago, as soon as they started understanding what the virus was that was causing this, looking at how it was made up – they started to think about how can we protect people with vaccines. And it's taken that long because the vaccines have gone through all the usual steps to study the safety and the effectiveness of the vaccine."

Grade 1 student Zachary asked, "What types of needles are there and when were needles invented?"

"It's true there are lots of different types of needles. The needle that will be used to give you the vaccine medicine is the same kind of needle that's used for other vaccines you've had as a child," said Etches.

"I'm not sure when the very first needle was invented, but I can tell you that vaccines have been used for hundreds and hundreds of years, and that things have improved over that time. So the needles are going to be clean and good to go. It is true sometimes even just thinking about that word needle that can cause people to feel a bit anxious, and so I want you to also feel comfortable talking about needles and being a little bit concerned with the nurse that is there. She'll understand that, she'll be happy to help you. You can bring one of your friends (a stuffed animal) if that's what you want to do and hold your parents hand, and there'll be some numbing spray on your shoulder so you might not even feel the needle."

Is there concern about myocarditis in the 5 to 11 age group?

"Based on the studies that have been done so far in children 5 to 11, it hasn't been detected. So myocarditis is an inflammation of the heart, and it has been seen in older age groups - usually older teenagers, young adults, more so in men, more so after the second dose. So it's something we're looking out for, and we do want to make sure, of course, if people have something that seems not right after a vaccine to let us know.  There's a safety system to monitor for anything serious after vaccines and to investigate that."

Molly in Grade 3 asked, "How many vaccines did Pfizer and Moderna give Canada? And which one gave the most?"

"I had to look this up. It's almost 70 million doses of vaccine that these companies who make the vaccines in their factories have given to Canada. Pfizer has given about two times as many vaccines as Moderna – they are both the same type of vaccines. The one that's going to be available for children is made by Pfizer."

Will there be enough Pfizer vaccine to ensure second shots for children? Can we avoid mixing vaccines as happened in adults?

"At this point, we have enough doses for every child between five and 11 to have their first dose in Canada, in Ontario and coming to Ottawa. We know that interval for the second dose is recommended to be eight weeks, and so we expect the supply to be there for that time as well. So enough supply, supply is not a problem.  At this point the only vaccine that we have approved for children is the Pfizer one, so that is the vaccine we will be using."

Bronwyn in Grade 5 asked, "On a scale of 1 to 10, how badly does the vaccine hurt?

"Oh Bronwyn, I think that you're going to be just fine. This is the kind of pinch feeling from the vaccine that you've had before from other vaccines. It is quick, and it is a feeling that doesn’t last. If you are concerned you could use a numbing spray, the nurses will give that to you and then it might be a zero out of 10, you won't even notice when the needle goes in and you get your vaccine," said Etches.

"What I do want children and families to be prepared for Bronwyn, is the next day you could feel a bit of a bruise kind of a feeling on that arm – you might feel it then.  And some people, it's not the case for everyone, but some people might then feel also a little more tired, sore muscles. That kind of thing can happen and we'd expect that would go away in one to two days."

Grade 2 student Sadie asked, "Why did they start making vaccines for children?

"I'm sure I don't have to tell you, I think you know how hard this pandemic has been for children. The COVID made your school disrupted, you've had to be home from school, it's meant you can't gather in your friend's houses the same way. So, people want to protect children from getting the infection and that vaccine is what can do that. It can prevent you from getting that COVID and make sure that we can get back to some of the things that we enjoy," said Etches.

"So people were interested in stopping the spread of COVID, and that includes making sure children don't get sick."

A parent said their son is 5, and they're wondering, "As it has not been approved for those under 5, if my son is more vulnerable to any adverse reactions or complications because he is close to the cut-off age?"

"This vaccine has been shown to be safe and effective in children who are five, and it's even being studied now in younger ages as well. We feel very comfortable, there were no serious side effects reported in this age group and we recommend that anyone who is turning 5 this year can book an appointment."

Grade 3 student Willow asks, "If we get the vaccine, will we be able to go to more places and do more activities?"

"Willow, that is the idea absolutely! You've been missing out being able to go to some of your sports activities, whether that's hockey or dance, to join in kids in after-school groups or even go to a restaurant where there are crowds or there are more people gathering, children just haven't had that protection from the vaccine. So when you have that - and it's going to take two doses, two little boosts to strengthen your immune system - then you can have really a lot of confidence, you can feel good protection to go forward and do more things."

Grade 4 student Serene asks, "If you've already had COVID-19 and you get the vaccine, what will happen? Will it have the same effect as someone who never had COVID-19?"

"We do want people who had COVID before to get the vaccine because it's more protection. It's like extra training for your immune system to fight off any COVID that comes around again. That can happen; it is still in our community. We think it might actually be some of the best protection you can have if you had an infection and then you get the vaccine afterwards, based on what we're seeing in older kids."

Should children with heart murmurs get vaccinated?

"The vaccine is important for children who have chronic conditions. It can be very important to protect children with heart conditions – heart murmurs are not always serious. If you have questions about an active, serious heart condition like myocarditis is to check in with your regular health care provider."

Grade 4 student Ty asks, "When we get the vaccine shot will it only hurt in one spot?"

"That is the case right when you get that pinchy feeling from getting the vaccine in your arm – it's just your arm that you'll feel it for a second. Then it might be the next day or the day after that where you could feel things actually across your body because your immune system is all through your body, it's learning how to fight the virus and you can feel that sometimes. You can feel tired, you could feel sore muscles, you might get a headache. These things don't happen to everybody, but they are pretty common and they'll go away. Your parents can do what they usually do to help you with those feelings, and I would expect that you'll be better in a couple of days. The kids dose is smaller so it shouldn't be quite as strong as if you had an adult dose."

We are flying internationally over the Christmas break. Are we able to get the second shot for our 11-year-old before leaving on Dec. 22?

"The way that Health Canada approved this vaccine is for a three-week interval, so it can be given the second dose after three weeks. However, what the National Advisory Committee on Immunization did was look at the evidence for how best to use this vaccine and that's where the eight-week interval comes in. There's some evidence that suggests that eight weeks later is going to give you a longer-lasting protection and if we were to see something rare like a myocarditis that's it's less likely to happen if the interval is longer between the two doses," said Dr. Etches.

"If someone is wondering if the risks or benefits for them outweigh, you're trying to measure and add that up, you want to talk to a health care provider about that I would recommend doing that. Ottawa Public Health's clinics are going to use the eight-week interval, and the provincial booking system by default is going to use an eight-week interval. People might be wondering if I can book the second dose right now – actually you can't book the second dose, I've learned, until your first dose is given, then you can book your second dose. For something that's different than an eight-week interval, you'll probably need to make a phone call and get on the provincial booking line and explain the reason."

Grade 6 student Ashrifa asks, "I wanted to know how the vaccine will affect kids?

"This vaccine works a lot like other vaccines. It's giving you the information, instructions, presenting you with something that shows your body how the virus looks so that you build the tools to fight it. So the effect on your body is that your immune system builds those tools, it builds antibodies we call them, to be able to recognize and fight back when you come in contact with the virus. The rest of the ingredients in the vaccine, they disappear. Your body takes care of them and so the thing you're left with is that memory of your body being ready."

Can the COVID-19 vaccine and flu shot be administered at the same time?

"They can be given together. There is no medical reason, no concern about safety with them being given together.  What the National Advisory Committee on Immunization did was recommend if you can, do them two weeks apart just so that if there's something that happens after the vaccine is given, we can investigate it separately. So to find out was it is associated with one type of vaccine or the other type," said Dr. Etches.

"They're similar vaccines in terms of the things you'll get afterwards. The flu vaccine is different because it changes every year, whereas the COVID vaccine it's one formula that we keep using so far in all the boosters."