Medical experts debate use of adult Pfizer COVID-19 vaccine formulation for kids

OTTAWA -

Parents and children are eagerly awaiting approval of Pfizer’s COVID-19 vaccine for children between 5-11 years of age but with little data to go, and indications that Canada’s excess doses will not be usable, some in the medical industry are wondering why current practice wouldn’t apply to the new vaccine. 

"If there is no pharmacologic reason, if there is no reason that we can’t dilute this or use the adult’s formulation we have, I think we do it," said Jennifer Lake, a pharmacist and assistant professor at the University of Toronto. 

Lake, along with other pharmacists and doctors have been posing the question since Canada’s Chief Medical Officer of Health made the announcement Friday. 

"I think that drawing out paediatric doses from the adult vials is not something that’s recommended at this point for a number of reasons," Dr. Theresa Tam said in her latest update. 

Although Dr. Tam did not go into specifics, she did note the new formulation. 

"We also understand from Pfizer that the formulation has shifted so this is their sort of mixed generation formulation so that is something that needs to be examined by the regulator," she added. 

Lake agrees that the data needs to be considered by Health Canada and NACI, acknowledging the importance of the new formulation, but is still hesitant, likening the situation to the pooling debate that occurred earlier in the vaccine rollout. 

"The company has a fiduciary reason for saying that, they sell us more if we don’t so this is where if the formulation is changing and they can explain it great, but if it’s just they’re diluting it more - they’re going to tell us to dilute it more - then we can dilute more what we’ve already got," Lake noted. 

Other doctors are urging caution in these discussions even at such an early stage. 

"I think we’re putting the cart before the horse. These types of things, which formulation is given, whether the adult formulation is given, all these things will be regulated by the proper authorities, I think we should wait for that," said Dr. Sumon Chakrabarti, an infectious-diseases physician. 

"This is a medical intervention. We want it to go through all the proper routes and procedures for this to be approved properly," he added. 

Ottawa parents say they are confident whichever decision is made, it will be properly reviewed.  

"For me it’s when it becomes available I trust that it’s been studied and looked at, and I’ll make sure I follow up on that, but I trust the people running these programs,” said Ottawa parent Grant McSheffrey. 

Lake says no matter what decision is made, it is important to consider timely protection for children. 

"We should be protecting school children as quickly as possible so that they can stay in school," she noted. 

Still, some parents say they are willing to wait if it means getting the proper vaccine. 

"I’m going to trust that when they give the guidelines they’ve done what they need to so if it means that we need to wait a little bit longer to be sure that it’s going to be effective and safe then that’s fine," Ottawa mother Frankie Nadeau said.