Still not having had the opportunity to be vaccinated against COVID-19, young children have been hit hard by the fourth wave since the start of the school year. The 0-9 year olds alone represent 25% of confirmed cases across Quebec over the past two weeks. While the current wave does not seem to subside, will the imminent operation to immunize 5 to 11 year olds make it possible to concretely change things in the daily assessments?
The predictions of the mathematical model of the new scientific opinion of the Committee on Immunization of Quebec (CIQ) indicate that vaccination of young people aged 5 to 11 starting before the holiday season could attenuate the effect of the gatherings that will occur during this period. , in addition to reducing the transmission of COVID-19 in the general population by a gain on group immunity.
Because, according to projections, it is not impossible that we are witnessing an upsurge in cases and hospitalizations following the increase in social contact during the holiday season, despite high vaccination coverage among people aged 12 to 12. years and older. By thus increasing the total immunization coverage of the population, immunization of children could reduce community transmission. However, the timing of childhood immunization would be critical.
“If the vaccination starts before there are all these gatherings, it can further break the transmission. If the vaccination happened when there was already an increase in community transmission, the impact would be less ”, explains Dr.r Nicholas Brousseau, medical specialist at the Institut national de santé publique du Québec (INSPQ) and president of the Quebec Immunization Committee.
For his part, the Dr Jesse Papenburg, pediatric infectious disease specialist and microbiologist at the Montreal Children’s Hospital, also argues that a single dose given to children for the holiday season could improve the situation.
“This first dose confers protection two weeks after its administration. The protection is not complete, but it is still substantial. It will allow families to reunite more safely, with children who have received a first dose. More than if they hadn’t had any at all, ”explains Dr.r Papenburg, who adds that the second dose will be needed for “even better and longer” immunity.
Benefit / risk ratio
In addition to reducing the spread of the virus in the population, vaccination of 5-11 year olds could help reduce cases even within the age group. While 5-11 year olds accounted for about 33% of cases in children in the first wave, this proportion rose to about 40% in the second and third waves and to 60% in the fourth wave, in a context where children aged 12-17 are now widely immunized.
Vaccination would, however, have little effect on hospitalizations in this age group, given their low risk of complications. As of October 16, 2021, 34,410 cases of COVID-19 and 52 hospitalizations have been reported since the start of the pandemic in the population of 650,723 children aged 5-11 years in Quebec. No deaths have been reported.
Although hospitalization rates for 5-11 year olds were the lowest among the pediatric age groups examined, the Dr Papenburg recalls that serious cases are not impossible and that it is worth preventing them. “Studies have reported a few hundred pediatric hospitalizations [au Canada], for acute COVID or for multisystem inflammatory syndrome. These children can be very sick. “
In the United States, where nearly three million children have already received at least one dose, there have been no serious side effects from vaccination so far.
One more step towards normality
Vaccination of children could also have its share of impacts on the school environment, in particular by reducing disruptions related to the management of outbreaks in schools, such as isolation of cases and class closings.
More than 45% of active outbreaks in Quebec as of Tuesday were listed in preschool and elementary schools, making them the settings most affected by outbreaks in the province, according to INSPQ data.
“It is clear that, in settings frequented by children, if we reach high coverage rates, we should indeed see fewer outbreaks and also a change in the management of contacts”, believes Dr Papenburg. A fully vaccinated child who would have had contact with a confirmed case of COVID-19 would eventually no longer need to go into quarantine, he gives as an example.
Of the 248 new outbreaks in the province last week, 113 (45%) originated in preschool and elementary settings, surpassing workplaces (24%) and daycare settings (14%).
For the Dr Papenburg, preventing infections in children will not only save families a lot of hassle, but also take a step closer to a semblance of normalcy, both at school and in extracurricular activities. “Socialization is so important to their development, well-being and mental health,” he says. They suffered a lot during the pandemic. I think the vaccination of this age group takes us one step closer to normalcy. “