Heather Costley and her son Koen are shown in this handout image at Queensland Beach, N.S. THE CANADIAN PRESS/Heather Costley

Heather Costley and her son Koen are shown in this handout image at Queensland Beach, N.S. THE CANADIAN PRESS/Heather Costley

Experts divided on urgency to vaccinate teens from COVID-19 before September

Heather Costley was thrilled to hear her 12-year-old son would soon be eligible for a COVID-19 vaccine in Nova Scotia

Heather Costley was thrilled to hear her 12-year-old son would soon be eligible for a COVID-19 vaccine, giving the Nova Scotia mother hope that a return to normalcy isn’t as far off as she initially believed.

While Costley doesn’t expect Koen’s life to change drastically once he’s vaccinated, she says it will open the door to socializing with his classmates, and bring the family a step closer to rebooking a trip to Disney World they had to cancel last year.

“He was like: ‘Yay, great. I can hang out with my friends again,’” Costley said of her son’s reaction to news last week that Health Canada had authorized the Pfizer-BioNTech jab for children 12- to 15-years-old.

“So he’s aware of how important (the vaccine) is.”

Koen, who’s been learning virtually as COVID-19 cases surge near his Halifax-area community, attends a private school for kids with learning disabilities. While the online atmosphere can be tough, Costley says the small class size has helped Koen do relatively well.

She knows, however, that many his age have been strongly impacted by the pandemic, and she hopes there’s a push to vaccinate teens before September.

If that means making COVID-19 vaccines mandatory before students can return to in-person learning, Costley is all for it.

“I think it’s a necessity,” she said. “There’s a lot of misinformation out there about vaccines … and maybe it has to be regulated, maybe that’s the answer.”

Provinces have not said whether they’re considering mandatory COVID-19 vaccines for youth, a contentious issue likely to cause debate over the next few months.

There is precedent, however, for provinces to mandate vaccines for kids in public schools — though exemptions can be offered for various reasons.

Ontario and New Brunswick make some immunizations, including measles, diphtheria, tetanus, polio and rubella, compulsory for school-aged children. Other provinces treat those vaccinations as voluntary.

In Ontario, mandatory vaccines are part of the Immunization of School Pupils Act of 1990, which Western University health law expert Jacob Shelley says can theoretically be modified to add a new required vaccine without passing an additional law.

Provinces that don’t already have mandatory vaccines for school-aged children could introduce them through new laws, Shelley says, though that usually takes time. He adds, however, that enacting emergency orders could speed up the process.

But having the ability to make vaccines mandatory for teens doesn’t mean it will happen.

“The question is going to be a political one more than a legal one, in my mind, whether or not jurisdictions are going to be interested in navigating what may end up proving to be a contentious issue,” Shelley said. “But it’s certainly possible.”

Dr. Anna Banerji, an infectious disease pediatrician with the University of Toronto, says it’s reasonable to believe a COVID-19 vaccine could be added to the list of mandatory inoculations in some provinces.

She says children, while less likely to suffer severe outcomes from COVID-19 infections, can get sick — they’ve represented roughly 20 per cent of Canadian cases — and they can spread the virus to others.

Banerji adds there’s “huge stress” and mental health implications on children and parents facing constant closures and re-openings of schools.

“So if this can happen before they go back (in September), and you have teachers vaccinated, custodians vaccinated and kids vaccinated, those schools become a much safer place,” she said.

Still, Banerji adds, some will resist the notion of mandating COVID-19 vaccines for in-person learning.

Françoise Baylis, a health ethics researcher at Dalhousie University, says there are plenty of factors for jurisdictions to consider when making that decision, including ensuring anyone impacted by a potential vaccine mandate has access to the jabs.

She expects some to adopt a hybrid learning agreement, where vaccinated students can return in person and those who aren’t continue to learn online. But, Baylis says, that’s not a perfect fix, since quality of education often suffers in an online environment.

While a mandate would help ensure most kids are inoculated before returning to class, Baylis says there’s a chance it backfires and increases hesitancy in some.

“People could experience it as a type of coercion,” she said. “So I think there’s value in having a respectful, informed conversation (with parents and kids)…. If you take that approach, you get a lot more buy-in.”

Some jurisdictions, including Alberta and the Northwest Territories, have already opened up booking to the 12-and-older cohort, leading some to wonder whether there’s an urgency to vaccinate that group.

Dr. Zain Chagla, an infectious disease expert in Hamilton, says high schools can act “like any other adult workplace” in spreading the virus. So inoculating teenagers will curb transmission.

Still, he doesn’t see the rush to vaccinate them right away. And younger kids, unless they have medical conditions that make severe cases more likely, can probably wait longer.

Chagla pointed to data from Israel that shows how positivity rates in unvaccinated youth dropped after adults around them were immunized.

He says vaccinating teens later in the summer, or even after school begins — perhaps adding COVID-19 vaccines to existing in-school inoculation programs — could work. In the meantime, he says, priority should be on getting high-risk individuals their second doses.

“If you have a large portion of the (adult) population, including kids’ parents, vaccinated heading into the school year… I think we can live with that,” he said.

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