Ont. woman books child's dose five weeks early over Omicron concerns

An Ontario mother has opted to get her child's second COVID-19 vaccine dose after three weeks, rather than waiting the recommended eight weeks between shots, amid growing concern of the Omicron variants and its impact on schools.

Kari Raymer Bishop's son, Henry, has a chronic lung disease and has been kept home from school since March 10, 2020 out of caution. While he is not immunocompromised, Raymer Bishop said Henry is more vulnerable to COVID-19.

Raymer Bishop told CTVNews.ca that she and her husband, who is an infectious disease researcher at McMaster University, felt it was important that Henry receive his second dose as soon as possible given his health, and so that he can possible return to school come January.

"We were very concerned for our child, and then as soon as we knew we had that first booking, I just started asking around what are the possibilities of getting a second dose after three weeks," Raymer Bishop said in a telephone interview on Thursday.

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Shazeen Suleman, a pediatrician at St. Michael's Hospital and an assistant professor at the University of Toronto's Temerty Faculty of Medicine, told CTVNews.ca that Canada’s National Advisory Committee on Immunization (NACI) has issued the eight-week guidance for kids' COVID-19 vaccine "out of an abundance of caution" for possible side-effects, though she said she hasn't heard of any to date.

Despite this, Suleman said it is up to parents to evaluate the possible risks and benefits to an earlier dose interval for their child.

"If parents do want to vaccinate their children earlier, I think that is certainly something that they can speak with their physician about and make a decision about what feels safest for them, given the new environment that we're in with the higher risk of Omicron," Suleman said in a telephone interview on Thursday.

Raymer Bishop, who lives in Paris, Ont., said Henry received his first COVID-19 vaccine dose on Nov. 26, and that same day, she emailed her local public health authority – the Brant County Health Unit -- to see if she could get his second dose moved up.

Given Raymer Bishop's concerns, she said the health unit's acting medical officer, Dr. Rebecca Comley, responded saying the family's reasoning for wanting a shortened dose interval period for Henry was reasonable and she advised Raymer Bishop to call to book the appointment.

NACI announced Nov. 19 that it was recommending an eight-week interval between doses for the newly approved Pfizer-BioNTech COVID-19 vaccine for children between five and 11 years of age, rather than the three weeks approved by Health Canada, leaving it up to the provinces to decide which interval is best.

Health Canada authorized the Pfizer vaccine for children this same day, making it the first in the country to receive regulatory approval for that age group.

NACI says that while there is no direct evidence regarding an optimal interval for children, it cited evidence in adults that a longer gap may improve immune response.

Pfizer has said that the vaccine doses can be offered three weeks apart for children, and the U.S. has been following this guidance since the first shots went into kids' arms there on Nov. 3.

"We see that NACI has made a different recommendation based on … their own analysis of the data," Fabien Paquette, vaccines lead for Pfizer Canada, told CTV News in November.

"So at the end of the day, either from a NACI standpoint or for any … provincial jurisdictions, it remains their decisions to apply the immunization programs the way they feel is most appropriate for their population."

Paquette said through discussions with federal authorities, particularly the U.S. Food and Drug Administration, a three-week interval was agreed upon for Pfizer's clinical programs, as was the case for adolescents and adults.

However, when asked whether it would make any difference to the effectiveness of the vaccine, he said that data isn't available.

When booking her son in for a second dose appointment at three weeks, Raymer Bishop said a nurse read her a statement about the potential risks of a three-week interval, and outlined NACI's stance on the eight-week dose schedule.

Raymer Bishop said she acknowledged the risks and consented to going against public health recommendations. Her son's second dose appointment was then booked for the afternoon of Dec. 16.

Upon arriving for the appointment, Raymer Bishop was told that she will again be read a statement on NACI's reasoning for the eight-week interval and will have to sign a waiver saying she understands the risks.

Raymer Bishop, who is a teacher, said she has done extensive hours of research and has spoken to various doctors, with many even suggesting a three-week interval for Henry given his health situation.

"Because of Omicron, we have to do whatever we can to protect our kid. The most protection we can offer him right now is more important to us than the long-term protection," she explained.

Now, Raymer Bishop said she is relieved to know that her son will soon be fully vaccinated.

"This poor kid just has had such a small world… and I'm just looking forward to him being safe. I'm looking forward to exhaling as a mom, and I can finally relax."

While a three-week interval schedule is not for all families, Suleman said it may make sense for those who have kids with certain medical conditions, or are considering travelling to a high risk area.

Suleman noted that the data from Pfizer and out of the U.S. shows that vaccinating for the second dose after three weeks is "still very safe for children."

While two doses are better than one, a shorter interval may not be necessary for all children, Suleman said.

She does not advise going against public health recommendations, but said it is important that parents and their family physicians understand a child's "specific needs" so they can "make the decision that's for them."

"I'm really glad to hear that parents are getting their children vaccinated because I think step one is getting dose one so that's excellent, especially right now," she said.

With a file from CTV News' medical correspondent Avis Favaro and CTVNews.ca writer Michael Lee