Dr. Katharine Smart. (www.cma.ca)

Dr. Katharine Smart. (www.cma.ca)

Canadian Medical Association president fields COVID questions from Okanagan parents

Pediatrician Dr. Elizabeth Smart says vaccines help curb spread of COVID

The president of the Canadian Medical Association reinforced the public health message that a COVID-19 vaccine recently approved for 5-11 year olds is safe in a virtual forum organized this week by a trio of parent advisory councils.

Dr. Elizabeth Smart, a Yukon pediatrician, said while concerns raised by parents about the safety and necessity of the vaccine for young children are legitimate concerns, she said existing evidence indicates they are a safer option to catching the virus itself.

Smart said the health side effects are far more significant to those who get sick with the virus compared to the vaccine, which does not prevent someone from catching COVID but restricts the imposition of side effects that could land a person in the hospital intensive care ward.

Smart said the fluid impact nature of COVID, amplified by the introduction of the Delta variant of the disease in North America, has created the need to alter existing public health care policies initiated at various stages over the last 19 months and will be a fact of life in our immediate future.

“We all have to get used to the realization this is an evolving situation with an ebb and flow…there is going to be peaks and valleys and outbreaks and lower exposure around the country, so strategies will come in and out to reflect the level of transmission,” Smart said.

“It can be confusing for people but COVID is like any other infectious disease that has changes and we need to be fluid with that.”

Smart explained there is no magic single solution to curbing the pandemic, that vaccines are one of many tools that provide layered protection for a community along with mask-wearing, staying home if symptomatic, test reporting, physical distancing and stepped up hygiene practices such as washing hands.

“Layered protection is effective as not one intervention on its own offers a perfect solution. That can cause confusion for people looking for that single solution. But there is a lot of grey area here and COVID is a shifting target so the numbers change as we continue to learn more about this virus,” Smart said

She referred to this layered protection public health concept as the “Swiss cheese model,” but it has proven effective in high inoculation communities, with hospitalization rates being aggravated by COVID patients who have not been vaccinated.

The forum, co-sponsored by the Vancouver, Surrey and Central Okanagan parent advisory councils, involved a presentation by Smart and a follow-up q&a session from more than 200 questions submitted by parents.

Among the issues that Smart addressed:

Is there an off-ramp where kids won’t have to wear masks in school?

Smarts said multiple factors play into that decision such as the level of community transmission, impact on hospital and health care service utilization, rate of vaccination.

“I think masking in that layered approach will be one of the last things to go,” she said. “It is easy and accessible for most people to do and it does offer that layer of protection.”

She acknowledged mask wearing for students is not that perfect solution, because youngsters take the masks on and off throughout their day in school and don’t always wear them properly, but it is still effective.

“I think for kids you want them to wear a properly fitted mask not sliding off their face, to keep it on their face as much as they can, and recognize when it gets wet or soiled it needs to be replaced, so kids should always go to school with more than one mask.”

Would you get your own children vaccinated?

Smart has two children, a 13-year-old who is two-dose vaccinated and an 11-year-old about to become eligible for the shot.

“It was not hard for me to make that decision. For me, the risk/benefit analysis, as a parent and a doctor, is the vaccine is safe and effective, and I am confident in my own view the risks of adverse side effects are lower than similar risks associated with getting COVID.”

Are the clinical trials done so far for the COVID vaccine for 5-11-year-olds sufficient?

Smart said 3,000 children were involved in the testing for the latest approved Phizer vaccine by Health Canada.

There were no serious side effects in that test sampling, Smart said but acknowledged a wider sample will be more effective at uncovering rare negative responses if they exist.

“That is why post-vaccine surveillance is important and ongoing to make sure nothing rare comes up that hasn’t otherwise been anticipated or come forward,” Smart said.

“We have a big advantage in that the U.S. is ahead of us on this having already done more than three million doses. So coming in behind them gives us the advantage of seeing the impact from that in higher numbers than we generate in Canada.

“We keep knowing more about this vaccine every day and hopefully that surveillance is reassuring to people that have those concerns.”

Long-term health impact of COVID vaccine?

Smart said common concerns have been expressed related to impact on fertility and reproductive organs for girls, or impacts on an individual’s DNA or hormone levels.

She said the vaccine is injected into the bloodstream, not directly into cells, and absolves into the body two to three days after the point of vaccination.

She said it ignites the body’s cells to kick-start an immune system reaction to counter the COVID infection.

“The long-term impact is another piece of misinformation out there that continues to linger…we don’t anticipate any long0-term impact from the vaccine because after interacting with our immune system it disappears.”

Should children with underlying health issues be vaccinated?

Smart said she envisions a few situations where the COVID vaccine would be a negative where other medical conditions such as allergies, cancer treatment or arthritis are involved.

“It is important to have that conversation with your health professional. Your doctor will better understand the full history of your child and provide an informed risk/benefit analysis.”

The forum is still available to be watched on the Central Okanagan Parent Advisory Council website at www.copac.sd23.bc.ca.

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