Have questions about the COVID vaccine for kids under 5? We’ve got you covered

Eight months and three Omicron waves after older kids became eligible for COVID-19 vaccines, parents of children under five - the final age group authorized for the jab - can finally book first doses.

Moderna's Spikevax 25-microgram two-dose series was given the official Health Canada stamp of approval earlier this month, and experts predict Pfizer's three-dose course should soon follow.

With the online provincial portal opening Thursday morning for kids as young as six months, the Star reviewed the evidence and checked in with experts ahead of the rollout into tiny legs and arms.

What are the main reasons to vaccinate my young child for COVID?

One of the reasons to do it is to prevent spread, in and amongst families, another reason would be to actually prevent severe hospitalization and disease in kids themselves," says Dr. Doug Campbell, director of the neonatal intensive care unit (NICU) and deputy chief of pediatrics at St. Michael's Hospital, a site of Unity Health Toronto.

Although it's rare, there are kids who end up in the hospital with the disease, and it spreads easily among younger children, packed together in settings such as daycares, he says.

Clinical trial data shows the vaccine produced an immune response similar to that seen in young adults. Studies also suggest it reduces the risk of multi-system inflammatory syndrome in children (MIS-C), a rare but serious condition.

Are there any side-effects or risks?

Campbell says the initial data shows there are no serious side-effects in younger kids. Minor ones such as a sore arm, redness and mild fever were reported, but they were less common than in adults.

Canada's National Advisory Committee on Immunization (NACI) said in its July 14 statement that clinical trial data showed the vaccine was well tolerated," that no safety signals were reported" in this age group, and that it would monitor real world data" for any rare side-effects.

How is this Moderna Spikevax vaccine different from what I got or what my older child got?

It's a smaller dose - 25-micrograms, compared to 50 micrograms for older children and 100 micrograms for adults.

The primary series is two doses that NACI has recommended giving at least eight weeks apart.

My child is turning five next month. Which vaccine should I get?

Get the vaccine that your child is eligible for," says Dr. Latif Murji, physician lead for the VaxFacts Clinic at the Scarborough Health Network. The free service, available to anyone in the province, lets people ask a physician questions about the vaccine.

If your child is four years and 11 months, they qualify for the 25-microgram dose ... And then, after eight weeks, when they're due for their second dose and they are in another age group, get Moderna's 50-microgram dose," Murji says, noting both doses will be safe and effective.

Go ahead and just start the process now; there's no need to wait. Because your child's immune system is going to react appropriately to either of those doses."

My infant or young child already had COVID. Why should I choose to vaccinate?

Experts and health agency guidance says while previous COVID infections can provide some protection, studies show vaccination mounts a stronger and longer-lasting immune response.

Vaccines boost the body's response to natural COVID virus infection and, in fact, the long-term protection is better with a vaccine," says Campbell. If your child is infected, he recommends waiting at least eight weeks, then getting them a vaccine or a booster as soon as possible.

I'm unsure about giving my young child a COVID vaccine. What advice do you have?

Vaccine hesitancy often stems from parents wanting to be careful and to protect their child, Murji says, adding that people who choose not to vaccinate are taking on an unnecessary risk" as Ontario is in the midst of a COVID wave.

I would tell people: clinical trials were done, so we already have the evidence that you're looking for. There's already been this observation period and Health Canada has already looked at that data in close, close detail and approved (the vaccine). ... Now is your chance to protect your child."

I'm always nervous to see my baby or toddler get a needle. What can I do to make it easier?

Plan ahead about how you will help your infant or toddler cope, which will also ease your own worries, says Dr. Anna Taddio, professor at the University of Toronto's Leslie Dan Faculty of Pharmacy, who led the development of the CARD (C - Comfort, A - Ask, R - Relax, D - Distract) system, which helps children and families have a positive vaccine experience.

For those who breastfeed, Taddio recommends nursing your baby before, during and after the vaccine as research has shown it reduces an infant's pain.

If breastfeeding isn't an option, close cuddling, hugging and holding your baby or toddler under two as if you were nursing, including using a pacifier, also helps them stay calm, Taddio says, noting a favourite toy can help distract or redirect their attention.

You want to provide physical comfort, supporting them through any pain or stress."

How can I prepare my child for the experience?

Starting around age four, it's good to offer a short explanation about why getting the vaccine is important and to answer questions, including whether the needle will hurt, in an honest, but neutral way, says Taddio, also a senior associate scientist at the Hospital for Sick Children.

You shouldn't just bring them and not tell them what's going to happen; being deceitful is not good because it doesn't build trust with a child."

Taddio recommends saying things such as: We're going to go get an important medicine, it will be a needle, but we're going to bring your toys so that you're comfortable and we'll get some ice cream after."

As for whether it will hurt, she suggests explaining that some kids say they feel a little pinch or pushing while others say they don't mind at all, and to say that you will help them be brave.

Kids need to know what's going to happen, what it's going to feel like and how you're going to help them cope."

More information on the CARD system, which provides strategies to help kids through a needle experience, can be found on the SickKids website.