Public Health Ontario urging parents to immunize young children against COVID-19 as soon as vaccines are approved

Ontario's provincial public health agency is calling on parents to immunize their children against COVID-19 as soon as a vaccine is available for their age group, warning that the province will not achieve herd immunity otherwise.

Public Health Ontario (PHO) recently released a report on the province's preparedness for the fall. It concludes that because the more transmissible Delta strain of the virus has become dominant in the province the percentage of Ontarians that need to be vaccinated in order for the whole population to be protected has risen dramatically.

And now that "critical threshold" is out of reach without the vaccination of young children, the agency said.

Its report finds that "the level of vaccine coverage needed for ‘herd immunity’ is now estimated to be at least 90 per cent of the population, and over 100 per cent of the vaccine eligible population."

Dr. Jessica Hopkins, chief health protection and emergency preparedness officer at Public Health Ontario, told QP Briefing it's important that families immunize young children for their own safety and the protection of the province as a whole.

"When vaccines are approved for use in your child, please make sure they get vaccinated," said Hopkins in an email interview, when asked what parents need to know.

In the meantime, she said, parents and caregivers of children should ensure they are vaccinated "to create a protective ring around children."

"It is important to note that Ontarians should not rely on herd immunity to protect themselves and their families as approval of a vaccine in this age group is not expected before winter," she said. "Until a vaccine for children under 12 is approved, public health measures such as masking, physical distancing, staying home and, if possible, isolating when sick, continue to be important measures to control the spread of COVID-19."

Both Pfizer and Moderna are currently running vaccine trials of their vaccines for children aged six months to 11 years.

Public Health Ontario's report contains sober warnings about the "potential for widespread outbreaks" among children this fall.

"This would be expected to have a significant impact in daycare, school and before/after school settings," it says. "At the individual level and within relevant populations, children under 12 years of age will still be at risk of infection and for spreading to older individuals who are not fully vaccinated in the community and are at increased risk of severe outcomes. And if there is a surge in cases, the relatively small percentage of children with severe outcomes could become a significant issue."

It recommends that the province makes preparations for the mass vaccination of children when vaccines for ages under 12 years of age to be ready for when the vaccines are available.

Dr. Anna Banerji, a professor of pediatrics and public health at the University of Toronto, agrees with that recommendation and the conclusions of the report.

"Kids, because they're not vaccinated, can get in school and it can spread from that child to other children in a school," she said. "And in that way, it's sort of a reservoir for the infection, and it can go to the schools and then go home to people who are susceptible. So that's the concern with all these kids were unvaccinated."

She called on the province to deliver a vaccination program in schools, as well as to implement a vaccine mandate for students and a stricter mandate for the province's teachers, and implement thorough precautions including masking, improved ventilation and small class sizes.

Banerji said the province's return-to-school and fall plans don't adequately take into account the reality reflected in the PHO report that herd immunity isn't coming any time soon. And while the report was written in July, it was only recently made public.

That delay is "a bad thing" she said because it erodes trust when the province withholds information that is relevant to people and their families.

"That information should have been out there before they were asking families what they're going to choose as far as the about going back to school," she said. "Families need to make informed decisions and that's part of being informed."

The province appears to have reacted to the report slowly. It didn't change its reopening plan until a week ago, when Chief Medical Officer of Health Dr. Kieran Moore said announced a halt to further reopening.

The report noted the province's reopening plan was built on the assumption that the Alpha — or U.K. — variant was dominant, and required 75 per cent of the eligible population to be vaccinated, with no region having rates below 70 per cent but the "critical threshold" is now 90 per cent because of Delta.

That has been reflected in comments from Moore for weeks about seeking a vaccination rate of 90 per cent. This week he said the province could lift restrictions as soon as six to eight months from now if higher vaccination rates are met.

Asked about what has changed since the report was written, Hopkins said its conclusions have not.

"Rising case counts over the past several weeks suggest that Ontario is going into a fourth wave," she said. "PHO will continue to monitor the situation and scenarios as new information becomes available."

QP Briefing has reached out to the office of Health Minister Christine Elliott.