Written by By Alexis Lovato, M.D. The Children’s Hospital at Montefiore Medical Center
The first physician-administered vaccines for the flu is being offered to children this month in Toronto, and there are plans to extend the program to children across Ontario.
Dr. Andrew Cohen, infectious disease specialist at Sunnybrook Health Sciences Centre, and his colleagues have begun to vaccinate children with COVID-19, the first pediatric shot against the coronavirus.
COVID-19 is a type of an injectable vaccine developed for the trivalent influenza vaccine known as FluMist. A nasal spray vaccine is still being researched, according to the World Health Organization.
Cohen started working on a nasal spray vaccine in 2015 and has had to adjust his vaccine design several times due to scarce supply, he said. With the new vaccine, “We’re trying to get it to the real potential of being a serious flu vaccine for children.”
The children “take it like water” and do not get sick while being vaccinated, said Cohen, as opposed to children who get sick after the flu vaccine. Since flu vaccines have no safety profile at this time, it is too early to know if the nasal spray vaccine is safe, he said.
There have been three cases of respiratory syncytial virus or RSV, in children within days of receiving the vaccine at the University Health Network, according to the Canada Public Health Agency. Seven of the 19 children who are vaccinated continue to have symptoms one to two days after receiving the vaccine, according to Cohen.
The number of patients who present flu-like symptoms has varied with each round of vaccinations, which began early in April, according to Cohen.
“What we saw from the beginning is that probably the majority of the patients who came in with the influenza-like illness were predisposed to the virus,” he said.
The day after Cohen first began administering the shots, he started to see five patients with influenza-like symptoms. The four children were discharged home and no longer have the virus in their systems, according to Cohen.
Cohen and colleagues will receive the results of the co-analysis of the effects from different settings before deciding to expand the program to other provinces, he said.
Florida is not one of the provinces that will be receiving the COVID-19 vaccine.
“At this time, there are no plans to expand the program in Florida,” said Cami Abraham, a public health nurse with the Florida Department of Health in Miami-Dade County. Abraham previously served as a spokeswoman for Cohen.
As far as other programs goes, “Camellia State and Tennessee have already started programs, and while we don’t have a data set, the results that are coming back are promising, and we will be expanding programs very soon,” Cohen said.
“For children in Florida, the second recommended immunization against H1N1 (swine flu) was U10. While U10 worked well for some children, with the arrival of H3N2, U10 started to fail,” Cohen said. Cohen may be working on a needle-free, antigenic formulation for the U10 flu vaccine.
In a statement, NBC News said the broadcaster is encouraging its staff and contractors to get vaccinated for the flu this year as part of a public health campaign. “In addition to getting inoculated, many NBC employees have joined many others in a Facebook group to swap tips and symptoms and to ask questions about coping with the flu, all while they focus on covering important news stories,” NBC News said.
UNICEF and MD Anderson Cancer Center, among other organizations, have also started programs to vaccinate children in Texas. On Thursday, a federal advisory committee unanimously recommended approval of the nasal spray, titled FluMist.
The nasal spray would be an alternative to the quadrivalent flu vaccine, and therefore it would not be covered by the new “no cost.”
“In the future, nasal spray should not be considered as the only vaccine option, as a new quadrivalent vaccine is scheduled to be introduced in the fall,” the subcommittee said in its final report, which would guide the flu vaccine program guidelines to the Centers for Disease Control and Prevention.