No images? Click here MEDICAL ADVISORY: Recommendation on the use of the Pfizer-BioNTech Comirnaty COVID-19 vaccine (10 mcg) in children 5-11 years of ageIssued by: M. Mustafa Hirji, MD, MPH, FRCPC, Medical Officer of Health & Commissioner (Acting) On Nov. 19, 2021, Health Canada authorized the use of the Pfizer-BioNTech Comirnaty COVID-19 vaccine in children 5–11 years of age. Following the authorization, the National Advisory Committee on Immunization (NACI) released their guidance on the use of the Pfizer-BioNTech Comirnaty COVID-19 vaccine (10 mcg) in children 5–11 years of age. Currently in Niagara, children under 12 years of age have the highest rate of COVID-19 infections and we continue to see cases linked to schools and childcare settings. While severe outcomes and hospitalization is less common than in older age groups, some children can develop severe disease, including multisystem inflammatory syndrome in children (MIS-C), a rare but serious condition; a few children do die of COVID-19. The authorization of this COVID-19 vaccine will offer children and families additional protection from these health risks, minimize time missed from school due to isolation, and reduce the ongoing negative impacts of the pandemic. Later this week, Niagara Region Public Health anticipates receiving the pediatric formulation of the vaccine and will shortly thereafter begin holding child-friendly clinics. With Public Health, pharmacies, primary care and pediatricians working together, every eligible child will be able to get their first dose of the COVID-19 vaccine before Christmas. Health Canada’s Vaccine Authorization Health Canada has authorized a two-dose regimen of 10 micrograms (mcg). This pediatric formulation is a lower dose than the 30 micrograms two-dose regimen authorized for adolescents and adults born 2009 and earlier. Clinical trial data demonstrates a comparable immune response in children 5 to 11 to people 16 to 25 years of age. There were no serious side effects identified in the clinical trials with children, and in fact, side effects were generally less common than in persons age 16-25 years of age. Of note, no cases of myocarditis or pericarditis related to the vaccine were reported in the clinical trial. However, if a child experiences myocarditis and/or pericarditis after a first dose of the vaccine, they should wait to get a second dose until more information is available. Dose & Interval Recommendations NACI recommends a complete series of the Pfizer-BioNTech Comirnaty COVID-19 vaccine (10 mcg) be offered to children 5-11 years of age who do not have contraindications to the vaccine, with a dosing interval of at least 8 weeks between the first and second dose. Children Turning 12 Years of Age Before Their Second Dose Children who receive the pediatric formulation (10 mcg) for their first dose who have turned 12 by the time of their second dose may receive the adolescent/adult formulation (30 mcg) to complete their primary series. If a child who has turned 12 by the time of their second dose receives the pediatric formulation (10 mcg), their series should still be considered valid and complete. Concomitant Administration of COVID-19 Vaccine with Other Vaccines NACI currently recommends that children 5–11 preferably receive the Pfizer-BioNTech Comirnaty COVID-19 vaccine (10 mcg) at least 14 days before or after another vaccine. This is a precaution to help to determine if a side effect that may arise is due to the COVID-19 vaccine or another vaccine. However, there are no safety of effectiveness concerns with vaccinating without the 14 day interval, and so it is acceptable to vaccinate with less than 14 days gap depending on patient need or circumstance.
Additional Recommendations Children who had previous COVID-19 infection should have recovered and no longer be infectious prior to vaccination. Children with a history of MIS-C may be vaccinated once they have recovered or once it has been more than 90 days since diagnosis, whichever is longer. Children at increased risk for severe outcomes from COVID-19 infection may include children who are obese, children who are medically fragile/have medical complexities, children with more than one comorbidity, children with neurological disorders, and children with immune dysregulation associated with Down Syndrome and other immunocompromising conditions. Vaccination will increase their protection from severe complication from a COVID-19 infection. More Information
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