Harry Rakowski: Kieran Moore is right that kids' COVID vaccines should be recommended, but not mandated

Kieran Moore has done a highly credible job since taking over as Ontario’s Chief Medical Officer of Health. He has excellent medical credentials, tries to communicate medical facts clearly, and usually doesn’t run afoul of the politics of managing the pandemic.

Last week he made a major error. He had the audacity to tell the truth about whether to mandate childhood vaccinations. This led to Ontario Liberal Leader Stephen Del Duca and NDP Leader Andrea Horwath calling for him to be fired, i.e. cancelled, unless he walked back his remarks.

Moore said what the National Advisory Committee on Immunization (NACI) has said all along, namely that vaccination for children aged five to 11 is approved for use and available. It is recommended but not mandated, and parents should not be stigmatized for not opting to have their children vaccinated. His own words included that “It is a new vaccine … and as a result of it we want greater experience with it before we mandate it.”

Del Duca and Horwath argued that by recommending pediatric vaccination but not mandating it, as they wanted, Moore was playing into the false narratives of anti-vaxxers. But their desire to cancel anyone who doesn’t agree with them plays into the hands of the vaccine-hesitant who increasingly mistrust the politicization of vaccinations and the playing down of any risk.

As I know from decades of experience, a physician’s responsibility is to carefully explain the risks and benefits of any treatment and then offer a reasoned opinion as to choice. Dr. Moore has done just that.

I have advocated for pediatric vaccination for my precious grandchildren but not without careful consideration. The risk for serious complications of COVID-19 for children under 12 has been very low throughout the pandemic. Currently, while more children are being infected, presumably with Omicron, the number of children’s hospitalizations and need for ICU care has correspondingly increased, even though any individual child still has a very low personal risk. It is estimated that as with hospitalized adults, up to half of children in hospital who test positive for the virus do so as an incidental finding when admitted for something unrelated. Deaths from COVID-19 infection in children are rare and often are associated with those who have serious underlying illnesses.

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Thus any mandated medical intervention for children must itself have an extremely low likelihood of risk. Scientists who falsely exaggerate the risks of vaccination do so using such adverse-event data as that from VAERS (Vaccine Adverse Event Reporting System) in the United States, which lists any event without linking causality from vaccination. Thus they falsely claim that the risk of death from vaccinating children is 50 times the risk of death from infection. This is simply false.

Vaccinating young children appears on balance to be safe, effective and the right choice. While regulatory approval was made on data from a small sample size, other than the known risk of myocarditis, no other major new problems have been detected in millions of pediatric vaccinations. Of course we have no long-term data yet. This will require parents to take a leap of faith that some will embrace and others reject. Nothing in life is certain. Sometimes we have to take that leap of faith based on what appears to be most reasonable, hold our breath and hope we land safely. This is why vaccinating young children should currently be recommended but not mandated.

Vaccinating children aged five to 11 also has the potential benefit of reducing their risk of Long COVID, although this risk is now likely smaller given the lower risks of COVID-19-related pneumonia. Previously there was also a greater societal benefit. Young children were a potential repository for spread to their at-risk teachers, parents and grandparents. Given the highly contagious nature of the Omicron variant and its ability to pierce vaccine immunity, spread can easily come from anyone vaccinated even if asymptomatic.

As a result of political pressure Moore was forced to partly walk back his remarks about vaccine novelty to talk about the logistical challenges associated with mandating its use. It was a mea culpa to prevent the opposition from continuing to have a negative political talking point.

Mark Twain said that, “If you tell the truth, you don’t have to remember anything.” I suspect that Dr. Moore has learned his lesson that telling the truth has consequences. I hope he continues to have the courage to tell the whole truth in order to not have to remember the lies.

National Post

Dr. Harry Rakowski is an academic Toronto cardiologist.