Portraits of Professor Anna Taddio and Professor Jean Wilson

From left: Professor Anna Taddio, Leslie Dan Faculty of Pharmacy, and Assistant Professor Jean Wilson, Bloomberg Faculty of Nursing

Experts in pharmacy, nursing and vaccine clinics address key concerns about vaccinating children against COVID-19 and offer strategies to improve vaccination experience

As COVID-19 vaccine clinics for five-to-eleven-year-olds open across the province, many parents have questions about the vaccine or are unsure about how to speak to their kids about it.

U of T’s Leslie Dan Faculty of Pharmacy and Lawrence S. Bloomberg Faculty of Nursing co-hosted a panel discussion last week to help address some of these questions. Featuring clinical leaders in nursing and pharmacy, the discussion addressed some of the main concerns that parents and children may have about receiving the vaccine and provided practical strategies to counter needle fear and pain.

Jean Wilson, nurse practitioner and assistant professor at the Lawrence S. Bloomberg Faculty of Nursing, first described how vaccines, specifically the COVID-19 vaccine, work and highlighted the data about the Pfizer vaccine’s efficacy and safety in the pediatric population. She also described some of the key reasons why kids should be vaccinated against COVID-19.

“In the third and fourth waves, we’ve actually seen more children become sick with COVID,” she said, showing data that 21 per cent of all COVID cases in Canada were in people under 19 years old. “While severe disease is a small risk in children, it can happen.”  

Children who do get COVID-19 may also experience complications, and many have suffered psychological and social impacts from time away from extended family, school and social activities.

But about two-thirds of children are afraid of needles, which can cause more pain and immunization stress­–related responses such as dizziness and nausea. And a negative vaccine experience can contribute to future vaccine hesitancy, said Anna Taddio, pediatric-trained pharmacist and scientist at the Hospital for Sick Children and professor at the Leslie Dan Faculty of Pharmacy.

Several years ago, Taddio led the development and validation of the CARD (Comfort, Ask, Relax, Distract) system, a set of evidence-based strategies to reduce immunization stress-related responses and improve the vaccination experience. It was originally developed for use in school-based vaccination programs but has since been adapted for COVID-19 vaccines and anxiety in children.

Taddio described how parents and kids can use CARD to prepare for the vaccine and cope with pain to improve the vaccination experience, allowing children the opportunity to exercise some autonomy by “playing their own cards” to decide how they will cope.

“CARD is teaching kids about coping. It’s not just about pain or fear of vaccination, it’s actually useful for anxiety in general,” she said. “We want kids to be prepared and confident, and they can use these skills in managing other stresses in their life.”

CARD has positive impact in real-world settings

The next two speakers provided examples of how CARD has been used in clinical settings to improve the vaccine experience in different populations.

Leslie Alderman from Niagara Public Health helped to pilot the CARD system for school-based vaccinations in the Niagara region. She described how CARD works in practice and the benefits for students.

Erin LeDrew, manager of the vaccine clinic at the Centre for Addiction and Mental Health (CAMH), also described how its clinic implemented CARD for children and adults with high levels of needle fear and neurodevelopmental conditions. The modifications they used to create a more positive experience are useful for everyone getting a vaccination.

The event concluded with questions from the audience and final thoughts from the speakers that reinforced the positive effect of empowering parents and kids through CARD. And Wilson emphasized the importance of parents “playing their ‘Ask’ card” and health care providers being knowledgeable enough in vaccine development to answer the questions.

“Health care providers who provide vaccinations are highly encouraged to be extremely knowledgeable on all aspects of vaccine … and by being that knowledgeable, it makes it easier to explain to patients who have questions,” she said. “For the parents, engage your health care providers in asking any questions that you have… Give them the opportunity to answer anything that you want to know in order for you to make an informed decision and be comfortable with the decision that you’re making for your children.”

A video of the panel discussion is available here.

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