I know some parents are reasonably worried about the risk of myocarditis following COVID-19 vaccination for children 5 to 11

Here's what we know about the risk and why experts think it will be much LOWER in this age group than with teens/adults 🧵
First, it seems that kids have a lower predisposition for myocarditis and pericarditis.

Ontario data show the natural incidence of myocarditis and pericarditis (pre-COVID) was much lower for those <12

(data courtesy @DrJeffKwong via Dr. Upton Allen)
Second, experts believe the risk of myocarditis is dose-related. That's one of the explanations for why we saw higher rates for the Moderna vaccine compared to the Pfizer vaccine

The kids covid vaccine dose is 1/3 that of the teen/adult dose which hopefully means less risk
Ultimately, the risk of myocarditis will become more clear only as more children get vaccinated.

But remember that even in teens 12-15, it occurred in less than 1 in 10,000 kids. For the reasons above, we think the risk will be lower for kids <12
It's also important to remember that with teens/adults, myocarditis following vaccination was generally mild with symptom improvement 1-2 days after starting treatment

if your child has chest pain, shortness of breath or a racing heart after the vaccine, have them see a doctor
You can find more information about myocarditis post-vaccine here: uwaterloo.ca/pharmacy/sites…

(A terrific resource pulled together by colleagues @AndreaChittle @DrKateJMiller @NoahIvers @SabiVM @kgrindrod @DrSamiraJeimy @PharmacistMama + others)
If you're a primary care clinician, check out Dr. Upton Allen speak about this issue in more detail during our past session recording from November 5th available here: dfcm.utoronto.ca/covid-19-commu…
Finally, to fellow parents of children age 5-11, please make sure you weigh the potential risk of myocarditis with the benefits of COVID-19 vaccination outlined by @picardonhealth @SabiVM so articulately here

theglobeandmail.com/opinion/articl…

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More from @tara_kiran

30 Sep
Like many parents, I'm struggling to understand why the Ontario government is so strongly against using rapid testing to prevent the spread of #covid in schools.

THREAD 🧵
Is it because the tests are in low supply or too expensive to purchase?

No. My understanding is the feds are purchasing and distributing the rapid tests to provinces
Is it because we don't have the person-power to package/distribute the kits and interpret/action the results?

No. Even if PHUs are stretched, it seems like there are many eager community volunteers
Read 10 tweets
29 Sep
Let’s prevent a junior-edition of the vaccine “hunger games”

Instead, let take a schools-based approach so every child age 5-11 has a chance at getting the #covidvaccine once approved

New oped @TorontoStar from @SabiVM @NoahIvers and I

thestar.com/opinion/contri… via @torontostar
A schools-based approach would be most EFFECTIVE

Studies estimate that uptake of the HPV vaccine was almost 4 times higher in school-based programs compared to community-based ones

ncbi.nlm.nih.gov/pmc/articles/P…
A schools-based approach is EFFICIENT

No wasted time booking and travelling to appointments. We are bringing vaccines to where kids are already congregating
Read 8 tweets
18 Jun
I want to start by acknowledging the confusion and frustration that the latest NACI statement has caused those who got the AZ vaccine—and the pharmacists and primary care clinicians supporting them

As I write, I know many are on the phone rescheduling appts

A few thoughts 🧵1/
NACI has said that an mRNA vaccine is preferred as the 2nd dose for those who received AZ for their 1st

They also reassure folks who got AZx2 that they have very good protection against severe death and hospitalization 2/

canada.ca/en/public-heal…
Their recommendations are based on emerging data on immunogenicity and safety

@SabiVM does a great job of summarizing the immunogenicity data here. Note we have no data on effectiveness (ie Covid outcomes) 3/
Read 11 tweets
16 Jun
1. Data is still emerging on myocarditis post-vaccination and whether it's a consequence of the vaccine or coincidence

At this time CDC/PHAC still encourage vaccination in those 12+

Here's a short thread on what you should know 🧵

(More details here: cdc.gov/coronavirus/20…)
2. When has myocarditis been reported?

Myocarditis after vaccination has been noted
-more commonly with 2nd dose
-usually within a few days after vaccination
-mostly in males, 16+ or older
3. What should you look out for?

Contact your doctor if, within a few days of receiving the vaccine, you or child have
-chest pain
-shortness of breath
-palpitations (fluttering or fast-beating or pounding heart)
Read 8 tweets

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