COVID-19 vaccine update: Pfizer-BioNTech Comirnaty COVID-19 vaccine now available for children aged 5 to 11

Advisory Alert

November 23, 2021

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To: Local Health System Partners


COVID-19 vaccine now available for children 5 years of age and older

The purpose of this Advisory Alert is two-fold. First, this advisory notifies of Health Canada’s authorization of the Pfizer-BioNTech Comirnaty vaccine for children aged 5 to 11 as well as Government of Ontario’s announcement indicating provincial eligibility for children aged 5 to 11. Second, this advisory alert shares information on how patients can receive the COVID-19 vaccine and how primary care providers can request vaccines for their practice.

On November 19, 2021, following Health Canada’s approval, the National Advisory Committee on Immunization (NACI) issued a statement (PDF, 1028 KB) outlining recommendations for the use of a pediatric dose of the Pfizer-BioNTech Comirnaty vaccine for children aged 5 to 11. Following Health Canada’s approval and NACI guidance, the Ontario Ministry of Health announced the provincial rollout of COVID-19 vaccines for children ages 5 to 11 including the opening of the provincial booking system starting November 23, 2021, at 8 a.m. with local vaccine appointments available as early as November 26, 2021.

Vaccine safety and efficacy

After a thorough and independent scientific review of the evidence, Health Canada has determined that the benefits of the Pfizer-BioNTech Comirnaty vaccine for children born in 2016 and earlier outweigh the risks. The National Advisory Committee on Immunization recommends that a complete two-dose series of the vaccine be offered to all children 5-11 years of age who do not have contraindications to the vaccine. The vaccine will help protect children against severe illness associated with COVID-19 and can help reduce the spread of COVID-19 in the community, keeping schools open. Children 5-11 years old are recommended to receive two doses, 8 weeks apart for optimal, long-lasting protection.

Pediatric dose recommended for children 5 to 11 years of age

When compared to the Pfizer-BioNTech Comirnaty COVID-19 vaccine for those 12 years of age and older, the product for children aged 5 to 11 years old requires a different dose.

The pediatric dose of 10 micrograms (1/3 of the adult dose) is to be given intramuscularly to children born in 2016 (i.e. turning 11 years old this calendar year) and earlier. According to Health Canada, recent evidence shows that younger children’s immune systems provided a more robust immune response to a vaccine with a smaller dose and had comparable immune response as the higher doses (30 micrograms) needed for adolescents and adults. The vaccine was 90.7% effective at preventing COVID-19 in children aged 5 to 11 and no serious side effects were identified1.

In alignment with NACI guidance, the Ministry of Health is recommending an 8-week interval between the first and second dose of the pediatric Pfizer product to ensure optimal immune response, decreased risk of myocarditis and pericarditis, and long-lasting protection. The Ontario Ministry of Health provides fulsome details in the COVID-19 Vaccine Administration Guidance for the administration of the new vaccine.

Vaccination consent

Before an individual, including children and youth, can receive the COVID-19 vaccine informed consent must be provided. If an individual is unable to provide informed consent, their parent or guardian must provide it on their behalf.

Parents or substitute decision makers of children aged 5 to 11 will usually have to provide consent on behalf of their child at the time of the appointment or fill out a paper consent form for their child. The consent form (PDF) must be completed before vaccination can occur.

Potential side effects of COVID-19 vaccine in children

Like any other vaccine or medication, there are potential side effects of the COVID-19 vaccine, although not everyone experiences them. Individuals who experience side effects mostly report mild signs and symptoms and within the first two days after vaccination. The most common are the same as observed in adults and youth: pain at the injection site, tiredness, headache, muscle pain, joint pain, chills, and mild fever.

In the clinical trial of this age group, there were no reports of myocarditis or pericarditis three months after receiving the second dose of the pediatric Pfizer-BioNTech Comirnaty vaccine. The rare cases of myocarditis and pericarditis have been reported more typically in males 18 to 39 after their second dose (Public Health Ontario, PDF 1694KB) of the Moderna Spikevax vaccine.

Reporting adverse events following immunization

All cases of any adverse event following immunization, should be reported to Public Health Sudbury & Districts:

Supporting patient decision making

As a trusted source of information in our communities, local health system partners are asked to facilitate discussions with parents or guardians of children 5 to 11 years of age to ensure informed decisions are made with respect to COVID-19 vaccination.

To assist patients who may be reluctant for specific reasons, this Vaccine Hesitancy Guide addresses hesitancies related to the COVID-19 vaccine, providing user‑friendly prompts and ways to engage, affirm, ask, share, and evoke, using motivational interviewing principles.

The Quick Reference Tool: COVID-19 Vaccine Minimal Contact Intervention (PDF) provides a user‑friendly format for engaging your patients/parents/guardians in discussions around topics such as the safety and importance of the COVID-19 vaccine, vaccination opportunities, along with information dispelling some common misconceptions.

The Government of Ontario also has multiple resources including fact sheets and more that parents and guardians can access on their website at or by calling the Provincial Vaccine Confidence Line that can be accessed by calling the Provincial Vaccine Contact Centre at 1.833.943.3900.

Other resources for health care providers to help support patient decision-making or inform on the administration of the vaccine include:

For more information on vaccination in this age group visit:

Local Vaccination Opportunities

Starting 8 a.m. Tuesday, November 23, 2021, appointments can be booked for children aged 5 to 11 years old through the provincial online booking system at and through the local call centre at 705.674.2299 (toll-free: 1.800.708.2505). The call centre is open Monday to Friday between 8 a.m. and 6 p.m. and is closed on statutory holidays.

Public Health Sudbury & Districts is planning to offer the pediatric vaccine in Public Health led clinics beginning November 26, 2021. Locally, children aged 5 to 11 years will be able to receive the Pfizer-BioNTech Comirnaty COVID-19 vaccine through a variety of delivery channels, including mass immunization and pop-up clinics, and participating pharmacies and primary care offices. Special considerations are also given for hosting school-based clinics for students attending special needs schools, select schools that service at-risk populations, and where schools may have reduced access or transportation concerns. All school clinics will be determined in collaboration with school board partners.

The full COVID-19 vaccine clinic schedule will be updated regularly and is available at Families are encouraged to book an appointment before attending a clinic.

Requesting pediatric COVID-19 vaccine

It is anticipated that the pediatric formulation of the Pfizer-BioNTech Comirnaty will be available locally by the end of the week. Per traditional distribution channels, participating local pharmacies will receive supply directly from the Ministry. Primary care partners are encouraged to vaccinate their pediatric patients. If you are interested in requesting the Pfizer-BioNTech pediatric product for administration in your office, please contact Public Health at

For additional information on the COVID-19 vaccines, as well as for specific answers to your frequently asked questions visit our FAQ web page or call Public Health Sudbury & Districts at 705.522.9200 (toll-free 1.866.522.9200).


Original Signed By

Dr. Penny Sutcliffe
Medical Officer of Health and Chief Executive Officer

Please note that email addresses of some recipients were provided to Public Health Sudbury & Districts by the College of Physicians and Surgeons of Ontario (CPSO) for the purpose of communications related to COVID-19. If you prefer to no longer receive Advisory Alerts from Public Health, please reply to this email requesting to be removed from our distribution list.

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This item was last modified on November 23, 2021