Explainer - The roll out of Pfizer's paediatric Covid-19 vaccine for children is beginning on 17 January and those aged five to 11 will have a chance to get a dose and reduce the risks of the virus.
There's a lot more for parents and caregivers to consider when it comes to vaccinating tamariki, so RNZ has put together some basic information to help people know what to expect with this roll out.
Photo: AFP / Ina Fassbender, Emmanuelle Pays / Hans Lucas, Jeff Kowalsky
On 16 December 2021, Medsafe gave provisional approval for the use of the paediatric Pfizer/BioNTech Covid-19 vaccine for those aged five to 11 years.
Cabinet then considered advice provided by the Covid-19 Vaccine Technical Advisory Group and on 20 December approved the decision to use it for children.
It is the only Covid-19 vaccine in Aotearoa/New Zealand that Medsafe has given approval for use among this age group.
Children under the age of 12 years are not included in the vaccine mandate and do not need medical exemptions if they do not take the vaccine.
What is the paediatric Pfizer vaccine for Covid-19?
More than half a million doses of the paediatric Pfizer vaccine for tamariki arrived in New Zealand on 8 and 9 January.
The dosage in this vaccine is different to the Pfizer vaccine dose for those aged 12 years and older, with this one having a lower dose, and is administered using a smaller needle.
When can children get their doses?
Immunisation of the five to 11 age group starts on Monday 17 January.
Children will need to take two doses to be fully vaccinated and it is recommended that these are given at least eight weeks apart, although the Ministry of Health says the interval can be safely shortened to a minimum of 21 days if needed.
"A shorter dosing interval is acceptable if for example the child is commencing significant immunosuppression treatment," operating guidelines released in December stated.
Importantly, the ministry notes that third primary additional doses for immunocompromised are not recommended for this age group.
"Advice for severely immunocompromised children who may need a third primary dose will be considered once further evidence is available on the need, safety, and efficacy."
If your child turns 12 years old before the date of their second dose, they should still complete their vaccination with a paediatric dose, according to the ministry.
Booking an appointment or going to a walk-in clinic
The vaccine is free. From 17 January, parents or caregivers can go to a walk-in clinic with their tamariki or use the BookMyVaccine website to book an appointment with a health provider, hauora, or general practice. Make sure you select the appropriate age range.
Some general practices are offering child vaccinations for their enrolled patients so contact your local doctor to find out more or visit Healthpoint.nz
Alternatively, Healthline on 0800 28 29 26 (operating 8am-8pm, seven days a week) can make the booking for you and answer any questions. Interpreters are available.
For a list of all the vaccination sites offering paediatric vaccines in each district, visit the Unite Against Covid-19 website.
For tamariki with disabilities, the Disability Team is available to help place bookings or answer questions on accessibility, free transport options, and vaccine effects from Monday to Friday, 8am to 8pm on 0800 28 29 26 (and push 2), or free text 8988, or email accessiblecovidvaccinations@whakarongorau.nz.
Currently, the Ministry of Health is not proposing a school-based Covid-19 immunisation service, but schools may decide to use their grounds as a community-based vaccination site.
Principals told RNZ in December 2021 that they have been asked to consider being part of the drive to immunise children.
What will happen when you bring in tamariki for a Covid-19 vaccine?
When you arrive, staff at the vaccination site will do Covid-19 screening to check if you or the child have symptoms or should be in isolation.
A parent, caregiver or legal guardian (or someone with a power of attorney) will need to accompany the child on the day of the vaccination to provide consent for them. The Ministry of Health says it also accepts verbal and/or written consent.
The consent, along with the name of the person providing it, will be recorded in the Covid-19 Immunisation Register.
Just like with the adult Covid-19 vaccine process, children will need to stay on site under observation for at least 15 minutes after taking their vaccine. If a child has a history of an immediate allergic reaction to other products, including food, medicines or other vaccines, they can still have this vaccine but may be asked to stay a little longer for monitoring.
You should be provided with a card when you are leaving to record the date/time of the first dose and the date when the child will be expected to receive their second dose.
Tips to prepare tamariki for a vaccine
The Ministry of Health advises parents/caregivers to give encouragement prior to the vaccination to help tamariki feel relaxed.
Make sure they have had something to eat and drink before as well.
Check they are wearing clothes that will make it easy to access their upper arm where the vaccine will be administered.
They can also take something to the appointment that will distract them, like a soft toy or phone.
At the appointment, both the adult and child can ask as many questions as they like.
Starship paediatric consultant Jin Russell has been involved in providing independent expert advice on protecting children from Covid-19 to the ministry.
"The best thing a parent can do to prepare their children to be immunised is to talk to them about what is going to happen," Dr Russell said.
"Tell them there will be a small needle and that they will feel a sharp scratch or sting briefly but then it will be over. They may have a sore arm, fever, headache or feel tired afterwards," he said.
"A key thing is to tell them why they are going to be vaccinated. I say to my boys, you are going to be vaccinated to protect yourself against Covid-19, and to protect our family, your grandparents, our community, and other kids at school who may be more at risk from Covid-19 if they catch it.
"It is also important that as a parent you stay calm and reassuring as children take their emotional cues from parents and caregivers. If you can, make a plan to do something fun afterwards so they have something to look forward to."
Auckland Covid-19 vaccination programme clinical director Anthony Jordan said communities in Tāmaki Makaurau were well prepared for the roll out.
"We’re looking forward to welcoming families along to our vaccination centres, and will have activities available to help make children feel more comfortable and keep them busy, like word finders, colouring in, stickers and certificates.
"All our staff have been specially trained in childhood immunisations and are ready to answer any questions from parents or kids."
Possible side effects of the paediatric Pfizer vaccine
If your tamariki have had previous reactions to immunisations, let your vaccinator know, speak to your whānau doctor prior to the appointment, or talk to a trained adviser on the Covid Vaccination Healthline - 0800 28 29 26.
As with any immunisation, children are likely to have a sore arm and get redness, pain or swelling at the injection site.
Other reactions that can occur, usually within the next day or two, include headache, fever, nausea, vomiting, diarrhoea, fatigue, general discomfort (feeling unwell, aches and pains).
The Ministry of Health states these are common side effects and show that the vaccine is working. It recommends taking plenty of fluids and resting to help.
Severe reactions to the Pfizer Covid-19 vaccine are very rare and usually occur within a few minutes of the vaccination. Hence the reason for staying behind for monitoring at the vaccination site.
If your child has any of the following myocarditis and pericarditis symptoms in the days or weeks after being vaccinated, get medical help right away: discomfort, heaviness, tightness or pain in their chest, difficulty breathing, feelings of having a fast-beating, fluttering, or pounding heart, feeling faint, light-headed or dizzy.
Signs of severe allergic reaction can include difficulty breathing, swelling of the face and throat, a fast heartbeat, a bad rash all over the body, dizziness, and weakness. If you notice your child experiencing any of these symptoms, let clinical staff know immediately. If you are not at a vaccination site, call 111.
Is it safe for children?
"International evidence shows that the paediatric vaccine has a favourable safety profile and children aged five to 11 years who received two paediatric doses of the vaccine had an immune response similar to people in the 16 to 25 year age group who received the standard adult doses," the ministry's policy statement read.
The trials in five to 11 year olds with a paediatric dose of Pfizer vaccine showed it was safe and side effects were similar to those observed with the full dose in 12 to 15 year olds.
The vaccine is still being recommended for tamariki with food allergies because unlike some other vaccines, there is no food, gelatin or latex in the Pfizer vaccine.
However, if a child has had a severe allergic response (anaphylaxis) to an ingredient in the vaccine they may not be able to get it. (Full list of ingredients can be found here.)
Starship paediatric consultant Jin Russell said he had confidence this vaccine is very safe for children.
"We now have real-world safety data from over eight million doses of the Pfizer vaccine administered to children aged 5–11 years in the United States."
Why should I vaccinate my child?
While Covid-19 is generally believed to have milder effects in children, some tamariki can become severely ill and require hospitalisation.
Auckland Covid-19 vaccination programme clinical director Anthony Jordan said getting tamariki vaccinated now was a great way to help protect them before they went back to school.
"The evidence shows that while children may have milder symptoms, some will still get very sick and end up in hospital if they do get Covid-19. Getting vaccinated also helps to prevent them from passing it on to more vulnerable members of the whānau, like babies and elderly family members."
An international study observed more than 3000 children (under the age of 18) who presented to emergency departments and tested positive to the virus from 10 countries, and found nearly a quarter of those were hospitalised.
While immunisation of children will help protect adults too, by reducing risk of transmission, University of Auckland study author Stuart Dalziel said the findings dispelled the myth children were being vaccinated solely to protect adults.
For children aged five to 11, clinical trial results for the paediatric Pfizer vaccine showed it was 90.7 percent effective against getting Covid-19 symptoms, and no participants developed severe Covid-19.
Although 'long Covid' is less common in children and adolescents, studies have reported long-term symptoms in children with mild and severe acute Covid-19, including children who previously had Multisystem Inflammatory Syndrome (MIS-C).
Long Covid (also called post-Covid conditions) describes signs and symptoms that continue or develop after acute Covid-19 infection (four weeks on from the initial infection). Symptoms include fatigue, difficulty thinking or concentrating (or 'brain fog') headache, anosmia (loss of smell), and sore throat. Young children may have trouble describing the problems they are experiencing.
*This article was updated on 18 January 2022 to provide more information released by the Ministry of Health.
