Schools, pharmacies, community clinics: What COVID-19 vaccination for 5-to-11-year-olds could look like in B.C.

B.C. could be undertaking the next major vaccination campaign against COVID-19 in the coming months. Health Canada is expecting a formal submission from Pfizer on its shot for 5 to 11 year olds in the next few weeks.

While the logistics of rolling out vaccines to children may end up looking similar to the adult delivery in some ways, pediatrician and UBC professor of pediatrics Dr. Ran Goldman said addressing hesitancy with a fact-based campaign should begin earlier.

“I believe we need to start the campaign now, even before the vaccines have officially been approved,” he told CTV News Vancouver on Wednesday. “If they are approved, we’re going to be better set up for those vaccinations, both from a knowledge perspective, acceptance, as well as a physical campaign for children.”

In a emailed statement, B.C.’s health ministry said once a vaccine for children is approved, the rollout will likely involve “a mix of health authority community vaccination clinics, pharmacies, and school vaccination clinics.”

“Once the vaccine trials are assessed and accepted by Health Canada, there will be a requirement for the manufacturer to reformat the vaccine itself,” the ministry said. “This will likely add to the timeframe before it will be available for administration.”

The ministry added it will provide more information to parents and schools when the vaccine is approved.

Dr. Goldman said a recently published UBC-led study that looked at the rate of willingness amongst parents to get their children vaccinated showed a slightly higher rate of 65 per cent earlier in the pandemic as compared to 60 per cent later in 2020. The study involved a survey of caregivers in 12 emergency departments in Canada, the U.S., and Israel.

“It sounds like a very small rate (drop), yet I am concerned because I want to see a higher rate among parents now that they got the vaccines themselves, and they’ve seen that it’s safe and effective,” he said. “It’s really hard to know what are the reasons for parents to change their mind, or to second guess the vaccination program. I think we have to make a bigger effort to explain why it’s safe and effective, why it’s important, and get to those parents that have questions and make sure they understand.”

B.C. has recently seen a rise in COVID-19 cases amongst school-aged children, though hospitalizations have remained low.

“We still see that children are not as sick as adults, they don’t need admission to the hospital or intensive care unit, it’s very rare,” Dr. Goldman said. “Yet, we do see more children that have been sick and we need to stop this by vaccinating them.”

Dr. Goldman said Pfizer was asked by the U.S. Food and Drug Administration (FDA) to test the vaccine on more children than they had initially planned, to monitor for adverse events, and did so.

“What they report so far is that those adverse events are extremely rare in children,” he said. “So we’re talking about thousands of children that received the COVID vaccine in the ages 5 to 11, and have shown not only that they’re protected, but also that they have very few adverse events.”

The vaccine dose Pfizer tested in a study involving 2,268 kindergarten and elementary school-aged children was a third of the amount that is contained in a current adult shot. The company said after the second dose, the children developed antibody levels as high as teens and young adults who received the regular-strength shots.

Dr. Goldman said flexibility in the options to vaccinate children will also be key, and added along with schools and larger community clinics, other possibilities could include drive-thru shots for kids, as well as day and nighttime availability.

“I think we need to be creative when we determine how to vaccinate children and we must be accommodating to any family and their needs,” he said. “The more the offering, I hope, the larger the cohort of children that will receive the vaccine in a very timely manner.

UBC Sauder School of Business operations and logistics professor Mahesh Nagarajan said he feels the vaccination rollout for children will go “relatively smoothly” in B.C.

“We’ve learnt a lot about how to set up the logistics for vaccinations,” he said. “I know some of the vaccination centres have sort of closed down, but restarting a limited number of vaccination centres at limited locations is not that difficult, and we know how things operate.”

He also pointed out the age group will be a smaller population to vaccinate, as compared to the massive 12 and up campaign. According to Statistics Canada population estimates as of July 1, there are just over 246,000 children aged 5 to 9 years old in the province.

“Given the urgency, and I think we want to get these kids vaccinated rapidly, we’re going to have a sort of solution where you are going to have some mass vaccination centres and some different solutions,” Nagarajan said, and added that could also potentially include doctor’s offices and pop-up clinics. “We have quite a bit of experience doing it now. We have done it in big centres like Vancouver, we have gone to small geographical regions, so I’m very optimistic.”

He said the cycle of vaccine recipients going through a clinic may not be as “smooth”, particularly with younger children.

“There is going to be crying, there (are) going to be meltdowns. If you’ve visited a pediatrician for getting the flu shot, you know exactly what I’m talking about,” he said. “So those things kind of have to be accounted for, but again...I’m pretty optimistic that we can get this done pretty quickly.”

Health Canada said Pfizer submitted preliminary data on October 1, and a formal submission is expected in mid-October.

“Health Canada only approves a vaccine if it is safe, it works, it meets manufacturing standards, and the benefits outweigh the risks,” the federal department said in an email to CTV News Vancouver. “At this time, no official submission has been received for the approval of any COVID-19 vaccine in children under 12 years of age thus we cannot offer specific timelines for completion.”