With more children now able to get their first dose of the COVID-19 vaccine, many kids are beginning to receive basic protection from the virus — but that doesn’t mean the risk is eliminated.
Parents of children who have received the first jab may want to know when they can start letting their child return to a level of normalcy, especially with a chance of returning to school looming and given the number of kids who have faced mental health challenges throughout the pandemic.
“The last year has been particularly hard on kids and we have to keep reminding ourselves of that,” said Donna Koller, professor in early childhood studies at Ryerson University. “If we don’t acknowledge what they’ve been through and we don’t appreciate that it’s been very, very difficult for a lot of kids and preteens, then we’re less likely to get them to where we want them to be.”
All Ontarians aged 12 and up are now able to book a vaccine appointment on the provinces booking portal.
Dr. Anne Wormsbecker, pediatrician at Unity Health Toronto, said she has spoken with many kids who are looking forward to receiving their first dose and many others who’ve already lined up as fast as they could to get the jab.
“I think they have something to show us and teach us as enthusiastic champions of immunization at a young age,” Wormsbecker said.
The Star spoke with health experts across the GTA to find out what parents need to know about the risks of COVID-19 after their child has received dose one of the vaccine. Here’s what they had to say:
What are the risks for kids with one dose?
The advantage of getting one dose is to begin protecting children, just like adults, from hospitalization and death, according to Dr. Barry Pakes, program director of public health and preventive medicine at the University of Toronto’s Dalla Lana school of public health.
Like Pakes, Peel’s medical officer of health, Dr. Lawrence Loh, noted hospitalization and death is unlikely in children.
“While children are less likely to have more severe presentations of disease, it’s not necessarily a chance that you want to take,” Loh said.
There have been four deaths reported in those 19 and under in Ontario, according to provincial data.
Even with the first dose, a risk of catching or spreading the virus still remains, said Sarah Warr, a senior communications adviser at Toronto’s Sick Kids.
“The second dose of a COVID-19 vaccine is required to be considered fully immunized, which is an important consideration as vaccination efforts are ongoing and variants of concern continue to circulate within the community,” Warr said.
The greatest part about getting the vaccine, according to both Loh and Pakes, is that each dose contributes to the population’s herd immunity.
“Children would benefit from the protection ultimately, because this disease spreads from person to person. It’s looking for vulnerable hosts,” Loh said.
Pakes said getting the vaccine “is part of the bigger picture that helps everybody and that, in turn, helps you.”
Should parents lift restrictions for their children after the first dose of the vaccine?
The short answer is no. Health experts say parents should ensure their child continues to adhere to public health guidelines. If health protocols aren’t followed by those who have one dose, they still run the risk of mild disease and transmitting the virus to vulnerable populations, according to Loh.
“This is not going to be forever, but at least just until we get out of this third wave, we need people to just limit any potential risk of spread,” said Loh.
As many children are still waiting for their first jab, Dr. Anna Banerji, an associate professor of pediatrics at the University of Toronto, said children should still be wearing masks and maintaining physical distance with others. Wormsbecker, who is also currently the interim chief of pediatrics at the St. Joseph’s health centre site of Unity Health Toronto, agreed.
“At this point, I really encourage people to follow their local public health guidance,” Wormsbecker said. “I think we can all breathe a sigh of relief knowing our children are a little bit safer after they’ve been vaccinated. At the same time, we have to think about that broad population level.”
Although the vaccine can start to work after two weeks, dose one’s best level of protection doesn’t come for at least a month, according to Dr. Omar Khan, a professor of biomedical engineering at the University of Toronto.
How does one dose affect immunity in children?
Having at least one dose does reduce the risk of the virus, but it doesn’t eliminate it, health experts say.
While Khan said the vaccine mainly prevents severe disease, he also said to remember a child isn’t fully vaccinated until they’ve received two doses, just as Sick Kids and other health experts also said.
“Your resumé isn’t complete until you get your two doses,” Khan said. “Let’s just remember that.”
If a child were to get sick after the first dose, the chance of them transmitting the virus will also be reduced, according to Khan. This ultimately helps to achieve herd immunity.
“That’s really how this herd immunity thing works. You cut down your transmission but if you do give it to someone and they’re vaccinated, they’re less likely to transmit it as well because the vaccine also cuts down their transmission,” he said. “It just bounces back and forth until it can’t go anywhere.”
Does one dose make it safer for indoor activities? Outdoor activities?
Spending time outside with one dose of the jab still seems to be the safest bet for children, especially with the province currently still under a stay-at-home order. With the order in place, Ontarians are expected to only leave their homes for necessities and exercise.
While Banerji said dose one does make it safer for indoor activities she also said the risk is not gone. She would discourage children who have only one dose from being inside together, unless they’re masked.
Wormsbecker, Loh and other health professionals also strongly encourage outdoor activities.
“I do think it’s so important for people to continue to follow the guidelines and continue to do outdoor activities with appropriate physical distancing and masking,” Wormsbecker said.
Does it make any difference if their friends have one dose?
Although health experts say being outside is safer, they still advise that health guidelines be followed when it comes to hanging out with friends, even if they’ve been partially vaccinated. This is because specific scenarios such as these have yet to be studied, according to Wormsbecker.
Pakes and other health experts said households should still be kept separate for the time being to ensure these guidelines are being followed. Pakes believes this will be a contributing factor to whether kids go back to school or not.
While protection will be increased if two children who have both received the one dose vaccine are in each other’s company, once again, the risk is not eliminated — especially inside.
If one child has received one dose and another hasn’t been vaccinated at all, there will be a risk of exposure, Banerji said. But once again, the outdoors is safer.
“I really feel like we’re working towards goals of bringing kids together in organized activities this summer, as well as getting them back to school as soon as we can do so safely,” Wormsbecker said. “Immunization is a huge part of that.”
Advice for parents who may be hesitant to get their child vaccinated?
Some parents may be hesitant to get their child vaccinated if they know it will cause them upset, according to Ryerson’s Koller. She suggested coming up with a plan for your child to prepare them for what to expect when getting immunized.
“If you really believe it’s important for your child to be vaccinated, it’s also important to talk about what that experience is going to be like,” Koller said.
Like Koller, Loh also believes it is important to talk with children about the jab. If a parent has already been vaccinated, he recommends sharing their vaccine journey with their child.
Khan and many other health professionals also recommend talking with a pediatrician for the best advice.
“You shouldn’t make this decision alone because your pediatrician might have a better idea about your kid’s medical history,” Khan said.
There are a lot of advantages to vaccinating your child as it ultimately helps prevent a wider community spread, according to Banerji. She also said the chances of schools opening in the fall will increase as more children are vaccinated.
“Everyone wants what’s best for their kids and I understand that,” Banerji said.
“The only way we can keep kids in school and have them be safe is if the vast majority of them are vaccinated,” she added. “If kids are not vaccinated and they go back to school and schools are opening and closing, then that’s going to have an impact on the child’s mental health.”
Pakes told the Star two of his five children were vaccinated the first day it was available. Like him, Wormsbecker and Loh said the vaccine is very effective.
“The data are clear: this is a safe and effective vaccine and I encourage people, if they’re eligible, to get vaccinated to protect yourself, to protect your child and to protect those around you,” Wormsbecker said.
Irelyne Lavery is a Toronto-based staff reporter for the Star. Reach her via email: firstname.lastname@example.org