Why are our highest-risk children behind on their COVID vaccines?

As children return to school and another wave of COVID-19 is expected this fall, doctors are concerned that too few children are up to date with their COVID-19 vaccines, especially those who are most at risk to become seriously ill with the virus.

Data shows that only half of children ages five to 11 with complex health conditions — including those with heart or lung disease or those with compromised immune systems — received their first dose, while about 40 percent received two doses.

And while older children with underlying medical conditions have higher vaccine uptake — about 80 percent of 12- to 17-year-olds in these higher-risk groups have at least two vaccine doses — only 22 percent have been uptaken, according to the latest data from nonprofit research group ICES, previously known as Institute for Clinical Evaluative Sciences.

“These rates are disappointingly low; we really should have reached those numbers much higher,” says Dr. Jeff Kwong, Head of Population and Public Health Research Program at ICES.

“These are the risk groups. These are the ones where we really want to try to get vaccine uptake as high as possible.

“And we know that at least one dose of the vaccine – and two doses is even better – reduces the risk of hospitalization and other COVID complications.”

Ontario began rolling out COVID vaccines to children ages five to 11 in November 2021. Nine months later, data from Public Health Ontario shows that about 54 percent of children in this age group received their first dose, with 41 percent receiving two doses. Booster doses for this group opened on September 1st.

Doctors say that while the COVID vaccine offers protection for all children, its benefits are especially important for those with underlying medical conditions. They say they are concerned that vaccine uptake is lagging in these higher-risk groups and warn more effort is needed to close the gap.

“People with underlying chronic conditions are among those at increased risk for adverse outcomes from COVID and should be vaccinated,” says Dr. Upton Allen, chief of infectious diseases at the Hospital for Sick Children.

He notes that SickKids doctors have seen “a significant portion” of patients with conditions that put them at higher risk of severe COVID who are “suboptimal vaccinated.” Some of these families say they are reluctant to vaccinate their children because they believe the vaccine will make their child’s health worse.

“We clearly need to do more education so that families are better informed and made aware that vaccines do not worsen heart disease, diabetes, kidney or liver disease or other chronic conditions,” Allen says. “That’s a misunderstanding that we have to deal with.”

He says more effort is needed to ensure parents and carers have a clear understanding of how vaccines work and the benefits they bring.

“One of the comments we get from families is, ‘I know someone who has been vaccinated and still has COVID, so why bother?'” Allen says, adding that the message to parents ” must be crystallized very clearly”.

“We have to say: vaccines prevent mortality and vaccines prevent serious illness and hospitalization associated with COVID, making it a milder disease. The key point is, even if the vaccine doesn’t stop you from getting COVID, if you’re vaccinated, the infection is rather mild.”

dr Peter Azzopardi, corporate executive and medical director for pediatrics at Scarborough Health Network (SHN), says many parents who are hesitant about the vaccine remain concerned about its safety and still see it as “a new vaccine” and are campaigning for one Observation and waiting will decide the approach when it is introduced to children.

He hopes parents with questions will turn to a trusted healthcare provider, including SHN’s VaxFacts clinic, for information, especially as children spend more time indoors this fall.

“Schools and daycares are areas that this virus likes to exploit to spread from child to child and family to family,” he says. “The best way to prevent serious illness from this virus is vaccination.

“The studies are robust, they were careful, the doses are low, the side effects are fewer; All those things that pediatricians like to see are ticked off to make sure this vaccine is safe yet very effective in this age group.”

dr Latif Murji, chief medical officer at the VaxFacts clinic, which offers free one-on-one consultations with a doctor about vaccines, says ICES data shows immunization efforts for vulnerable children are “not enough”.

“These are our children at highest risk and (vaccination) rates need to be much, much higher,” he says. “We must do everything we can to help parents understand that (vaccines) are really important safety measures. It can be a life-saving intervention for them.”

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