If all goes to plan, Erica Perry’s two-year-old son will soon attend his very first birthday party.

Surrounded by a crowd of his pint-sized peers for the first time, he’ll probably be a little nervous, she imagines.

“That’ll be his first real interaction with other little kids,” she says. “We’re really excited for that.”

When she became pregnant in early 2020, the Vancouver mother pictured taking her child to playdates and to the library for reading time, and to drop-in programs at the community centre. Those dreams had only just begun to take form when the world shut down.

“It’s been very different from what I expected,” she says. “Just keeping him so isolated, trying to protect him.”

That’s why Perry was recently among the Canadian parents who headed for the border after the United States became the first country to authorize a vaccine for kids under five.

(Perry is her maiden name and the Star is not naming any children mentioned, as everyone interviewed for this story expressed concerns about backlash from vaccine opponents online, as the discussion around vaccination becomes increasingly polarized.)

Perry and her son waited a couple of hours in a walk-in clinic just over the border, and when it came time to get a shot, she fed her son raisins to distract him from the quick poke. The vaccine itself was free, aside from a small administrative fee.

When the COVID vaccines initially rolled out across Canada, the first recipients were the seniors and long-term-care residents who were at highest risk of complications from COVID. As the year ticked by, eligibility thresholds got lower, as increasingly younger cohorts got in line for vaccine.

But for over three months now, one group has been left waiting — those under age five.

While COVID is significantly less dangerous for young children than it would be for seniors, for example, experts stress that it affects them nonetheless. According to data from Health Canada, kids under 11 in Canada have seen twice the number of hospitalizations from COVID — about 4,300 have ended up in hospital — as those aged 12 to 19.

Not to mention, that while the pandemic has dragged on for adults, for small children it has been their entire life, robbing them of the normal childhood parties and experiences that most take for granted, and prompting concerns about long-term effects on social skills and mental health.

As vaccination rates in the general population rose, governments began to lift public health protections, such as masking and capacity restrictions.

And as officials pointed out that most cases were now among those who hadn’t gotten a shot — the phrase often used was “a pandemic of the unvaccinated” — many parents of those too young to be vaccinated seethed, and struggled to protect their children from a virus in a world that had seemingly moved on. (Later, vaccination became less protective against infection but was still effective against hospitalization.)

“If you’re not vaccinated, then that’s your choice,” says Katrina, a mother of two from a central Alberta town, who asked to go by first name online because of concerns about online attacks from speaking about vaccination.

“If a 35-year-old decides they don’t want to get vaccinated, then they’re aware of those risks, and they know that there’s potential that they could end up in the hospital,” she added. “But we haven’t had that choice with our kids.”

Katrina and her husband recently packed their children, ages four and one and a half, into the truck and drove the six hours to Great Falls, Mont., in search of vaccine.

They stayed a couple of nights at a campground with a waterpark to give the kids a break from driving and, on their last day, drove to a clinic where she says staff were “over the moon excited” to see people keen on getting their kids vaccinated, she says.

The shot of Moderna cost roughly $20 (U.S.) per child.

It’s been a lonely couple of years adhering to COVID guidelines, Katrina says. She and her husband work together and have been lucky to be able to keep their kids mostly at home. But rules they’ve put in place to protect their unvaccinated children — such as continuing to ask visitors to take a rapid test — have caused rifts with family.

The differences in childhood experiences between her kids is striking, she says. As a baby, they took their daughter everywhere. By the time she was a toddler, she’d been out of the country multiple times.

In comparison, her son has been to the grocery store a handful of times.

For two years, Perry and her son mostly stayed home.

If there were lots of kids at the playground they kept their distance; if there were too many they would leave. But they both got COVID a week after the mask mandate in their building was dropped — her only guess is they contracted it during a trip to the mail room.

It was the first time he’d been ill, she says, and he woke up one morning screaming. They both ended up vomiting and enduring a high fever.

“Two months later, I still can’t smell so I don’t know if he can, because he can’t tell me.”

Any potential long-term issues are unclear.

A Facebook group advocating for authorization of the vaccine for kids under five in Canada suggests they’re not the only parents weighing a trip to the border. There are dozens of comments from parents wondering about the logistics of crossing the border and which U.S. clinics are willing to book Canadians.

According to a spokesperson for Health Canada, a decision on the Moderna vaccine is expected here by mid-July.

The American pharmaceutical company applied to Health Canada for authorization of its shot, which is for those aged six months to five years, at the end of April. Pfizer, meanwhile, applied just last week, and Health Canada says the timeline for that decision isn’t yet known.

In an email, a spokesperson for Health Canada said the regulator is reviewing both “on a priority basis.”

The lag has frustrated parents desperate for protection for their youngest kids as the pandemic heads into another fall in which some are predicting another surge.

Each country is responsible for making its own decision about vaccines, and in previous stages of the vaccination campaign, the Canadian decision has come a few weeks after an American green light.

The Star has previously reported on a Toronto doctor who vaccinated hundreds of children under five under what’s known as “off-label” use, when a health-care provider uses a drug or medication for a purpose for which it’s not authorized.

In an email, a spokesperson said that the “timing for the completion of Health Canada’s review depends on many factors, including but not limited to, the need for additional data, discussions with the sponsor, and requirements for updates to safety information.”

“Any Canadian regulatory decision will only be made once all required information has been submitted by the manufacturer and thoroughly evaluated by Health Canada.”

The spokesperson also noted that anyone who receives a vaccine outside of the country would not be eligible for Canada’s Vaccine Injury Program if they experience a serious side effect.

That risk wasn’t enough to stop her family from going south, Katrina says. The American Food and Drug Administration has released more information than Health Canada about their decision, and she spent a day at her kitchen table listening to their discussion and looking at the data, she said.

She points out that there’s far more information available about the COVID vaccines than the typical childhood shots that most kids get.

“I wanted to know the information just to feel more confident with that decision,” she said.

While she’s hopeful that Health Canada will decide soon, going to the States meant returning to normal life just a little bit sooner. Her daugher, at four years old, is big enough to understand the concept of a vaccine and that it means she’ll get to do more things.

So far, her kids have had little to no side effects. Driving away from the clinic, she says she asked her daugher how she was feeling.

“She said, ‘Oh, my shot arm just hurts.’ And I said, ‘Oh, yeah, that’ll happen.’ And then she lifted up her wrong arm,” she said with a laugh.

By August, her kids could have two shots, at which point their parents would be more comfortable with the birthday parties and family gatherings and the day camp their daughter is already signed up for at the end of summer.

Alex Boyd is a Calgary-based reporter for the Star. Follow her on Twitter: @alex_n_boyd