Getting kids their vaccines will be a relief to parents — but it might not end the pandemic

OPINION: It looks as if children ages five to 11 could be able to get their shots soon. That’s a huge relief. Unvaccinated adults remain the biggest problem
By John Michael McGrath - Published on Sep 28, 2021
Pfizer has reported that its vaccine is safe for children in the five to 11 cohort. (FatCamera/iStock)



Some glimmers of hope for parents of kids under 12 in recent days: Pfizer has reported that its vaccine is safe for children in the five to 11 cohort and that it’ll likely seek emergency FDA approval in coming days. The timeline for Health Canada approval is more ambiguous: Toronto Public Health is starting to assemble its task force for vaccinating younger children, and a slide shared with the local board of health mentions the tantalizing possibility of an immunization campaign starting around November 1 — though that should be understood as a planning assumption TPH is building into its modelling and not a confirmation of anything. Still, for hope-starved parents of younger kids, it’s the most hopeful sign we’ve had in months.

With cases in school-age kids making up a growing share of Ontario’s new cases, vaccine eligibility can’t come soon enough. But as much of a relief as it will be for parents (and maybe even the kids themselves, after they’ve gotten over the affront of the needle), there’s a lingering problem for anyone looking to declare an end to the pandemic in Ontario: the people who could have gotten vaccinated months ago and haven’t yet.

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To repeat a number I’ve had cause to use multiple times over the summer: there are still hundreds of thousands of people over the age of 50 who are entirely unvaccinated — more than 475,000 people in Ontario as of Monday evening. These people have been eligible for their first dose since no later than May 6, and in many cases earlier. They also make up the vast majority of people who’ve ended up hospitalized, in intensive care, or dying.

Professor Tara Moriarty of the University of Toronto has estimated the number of deaths, hospitalizations, and ICU admissions that remain preventable among the unvaccinated in provinces across Canada. I’m going to focus on ICU admissions, because the shortage of critical-care beds has been the single most important constraint throughout the pandemic. Per Moriarty’s estimates (as of September 18), vaccinating 100 per cent of children 0-18 (many of whom are already vaccinated in the 12-17 range) would avoid 889 ICU admissions.

The preventable ICU admission for Ontarians over the age of 50: 13,241, or nearly 15 times as many potentially preventable ICU cases. That’s despite the fact that the large majority of those people are vaccinated (as are the large majority of everyone else who’s eligible). What was true from the beginning of the pandemic is still true: COVID-19 can severely sicken and even kill anyone, but the odds of it doing so are vastly higher in older populations. Even a small fraction of those 13,000 people needing an ICU bed at the same time would be a strain; Ontario’s third lockdown was announced when ICU admissions were over just 700, and the third wave peaked at around 1,000.

Moriarty’s estimates could, of course, be off, but defining the problem doesn’t require them to be perfect. Indeed, the problem can be stated pretty simply without them: for roughly every three unvaccinated children right now, there’s one unvaccinated adult over 50 — but the individual over 50 is overwhelmingly more likely to end up as a severe case that strains our hospital system. And since it’s the strain on our hospital system that determines how serious the government’s public-health measures are, vaccinating young children won’t necessarily open the door to ending such things as masking rules and indoor-capacity limits at bars and restaurants. It simply won’t do the work of avoiding severe COVID-19 outcomes the way that vaccinating older groups does.

One possible reason for optimism is that vaccinating the under-12 group to a very high level might get us to herd immunity, or something so close that only the least-invasive public-health measures will need to be maintained, at which point the province’s unvaccinated over-50 residents might be protected despite themselves. For now. And only from the variants of concern that we currently know and understand. The province’s chief medical officer of health, Kieran Moore, said that he expected vaccine passports to be maintained through the winter; maybe that, combined with masking rules and vaccinated young kids, will be enough to snuff out the pandemic this time. It’s the most plausible case for optimism we’ve had since the Delta variant reared its head, at any rate.

If this all sounds grim, that’s not my intention. If we actually can start vaccinating kids by November 1, that puts a relatively normal Christmas in play, and I dearly want that for your kids as much as I want it for mine. But there’s still more uncertainty around COVID-19 than there is clarity, and Ontario’s performance in relation to other Canadian provinces has been relatively good precisely because of the caution the government has shown since the third wave peaked. We’ll have a better sense of what vaccinating young kids means when we’re able to actually start doing it.

It can’t come soon enough.

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