Trudeau says antiviral treatment won't make up for low vaccination rate among children

Prime Minister Justin Trudeau today welcomed Health Canada's approval of an antiviral treatment that could keep high-risk COVID-19 patients out of hospital — while also warning that the Pfizer therapeutic is no substitute for vaccination.

Speaking to reporters on Parliament Hill, Trudeau said Pfizer's Paxlovid — which will be available to a limited number of adults starting this week and next — is a "useful tool in the toolkit" but it won't make up for the sagging vaccination rate among children.

To start, Paxlovid will be available only to adults 18 years and older, meaning the best line of defence for kids is still vaccination, he said.

Health Canada approved the Pfizer-BioNTech COVID-19 vaccine for kids aged 5 to 11 in November but vaccine coverage in this cohort has fallen behind coverage rates for other demographic groups.

Two months to the day after the vaccine was first approved for this group, fewer than half of all eligible Canadian kids (48.35 per cent) have had at least one shot — a figure that is forty percentage points lower than the first-dose vaccination rate among adolescents aged 12 to 17 (87.34 per cent).

In Ontario, it took eight weeks for 40 per cent of younger kids to get their first shots. Adolescents reached that milestone in less than a month, according to an analysis of the province's vaccine data.

The Public Health Agency of Canada (PHAC) says only 3.2 per cent of kids 5 to 11 had been fully vaccinated as of Jan. 8. That figure is lower than rates reported in other countries.

For example, in the U.S., where vaccination rates are generally much lower overall, 19 per cent of kids in that age group have had two doses of the Pfizer vaccine.

'We need to do what's right'

"We know as we get back to school, as kids are re-engaging, parents are worried about the health of their kids," Trudeau said. "The vaccination rate for those 5 to 11 is too low in Canada, which means not only are our kids more vulnerable, but also all of society, teachers, grandparents, front line health workers. We need to do what's right."

With immune systems better equipped to fight off the virus, children have been largely spared the brunt of COVID-19.

But with the Omicron variant now the dominant strain in circulation, there has been a small but troubling uptick in the number of children hospitalized for COVID-19.

Infants under the age of one are seven times more likely to be hospitalized than older kids, according to PHAC data, although hospital admissions among this cohort still remain low overall.

Roughly one per cent of kids who contract COVID-19 will be hospitalized. In the first week of this month, there were 22,662 new infections nationwide in kids aged 0 to 11 — which means that up to 226 kids infected between Jan. 2 and Jan. 8 may need hospital care.

Beyond the risk of hospitalization, kids can develop so-called "long COVID" symptoms or a potentially fatal post-infection condition called multisystem inflammatory syndrome in children (MIS-C). The condition causes inflammation of various body parts, including the heart, lungs, kidneys, brain, skin, eyes and gastrointestinal organs.

Research recently published by the U.S. Centers for Disease Control and Prevention (CDC) also found people under the age of 18 who had COVID-19 were much more likely to develop diabetes than those who have not been infected.

"The increased diabetes risk among persons aged <18 years following COVID-19 highlights the importance of COVID-19 prevention strategies in this age group, including vaccination for all eligible persons," the U.S. public health agency said in its Jan. 7 report on the issue.

Adults need to 'up their game,' says Tam

To protect infants and younger children who cannot be vaccinated, Dr. Theresa Tam, Canada's chief public health officer, said everyone eligible for a shot — especially older kids — should get vaccinated to create a "protective cocoon."

"Fortunately, among children there continues to be low rates of intensive care admission. Nevertheless, by keeping infection rates as low as possible, we can reduce more severe illnesses among children," Tam said.

"To protect younger children, the adults around them and their guardians need to up their game."

Vaccination during pregnancy is also important, Tam said, because research shows it triggers the development of protective antibodies that can be passed on to babies.

Some parents have held their kids back vaccination out of a fear that their child could develop myocarditis — a very rare but serious side effect that causes inflammation of the heart muscle.

But recent data compiled by scientific advisers for the CDC found that myocarditis is extremely rare among vaccinated 5- to 11-year-olds. The researchers identified just 12 reported cases as of Dec. 19 out of the 8.7 million doses administered in the U.S. by that date.

In a Jan. 14 report, Canada's National Advisory Committee on Immunization (NACI) said there have been reports of myocarditis in this country – most have occurred in males 12 to 29 years of age after a second dose of an mRNA vaccine — but these cases have been "mild and [were] resolved quickly."

Meanwhile, more than 6.5 million eligible Canadians are not yet fully vaccinated. That gap leaves an already stretched hospital system vulnerable to a surge in unvaccinated patients needing care. PHAC data suggest unvaccinated people are 19 times more likely to be hospitalized with COVID-19 than fully vaccinated people.

Trudeau said these vaccine holdouts shouldn't be "shy" about getting a first dose so late in the immunization campaign.

"The nurses will be happy to welcome you. They would much rather be giving you a vaccine than intubating you in the ICU," he said.

While PHAC has said Omicron is probably less severe than past variants — the risk of hospitalization is lower than with the Delta variant, for example — the sheer number of new infections means more people will be susceptible to severe outcomes.

To put a dent in hospitalizations, Trudeau said 150,000 courses of Pfizer's Paxvloid treatment will be deployed between now and the end of March.

This therapeutic is an oral antiviral treatment administered in pill form. Pfizer reported in November that Paxlovid reduced the risk of hospitalization or death by an impressive 89 per cent compared to a placebo in non-hospitalized high-risk adults with COVID-19.

"This will be a powerful tool to continue to keep people from getting extremely sick. But it needs to be used right and it's not a replacement for getting vaccinated, wearing masks, staying safe and keeping your distance. It's just an extra layer," Trudeau said.

"There's no excuse. People must be vaccinated. This is how we'll get through this."