As coronavirus infection levels and hospitalisations drop in the UK, there’s still a worrying possibility that mutant variations like the Indian strain may lead to a resurgence of the pandemic. The question is, should we look at local restrictions or even a new national lockdown, or could we rely on the effectiveness of the vaccinations programme? And if we are to rely on vaccination, should we extend it to children?
While children have not proven to be particularly susceptible to coronavirus, it’s certain that they can be carriers of the infection, so vaccinating them could be more for the benefit of the adults around them than for the children themselves. But some experts are questioning the ethics of this approach, and the idea of vaccinating the younger population of countries while some parts of the world are struggling to vaccinate thier adult population.
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The major vaccine manufacturers have trialled their treatments on young people, including babies in some cases, and some such as Canada have approved vaccines for children, in this case the BioNTech/Pfizer formula, which the company says is 100 per cent effective in adolescents, for those aged 12-15.
Robert Frenck, principal investigator for trials on under-12s of the BioNTech/ Pfizer vaccination at the Cincinnati Children’s Hospital Medical Center, said he expected children over the age of 12 to be vaccinated in the US before schools reopen in September.
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Immunising
But does it make sense to vaccinate children at this stage? In England and Wales, just 37 under-20s have died of coronavirus, compared to more than 130,000 adults. In the US, the figures are 332 people under the age of 18 dying, compared with more than 560,000 adults.
“You would be immunising children not for their own benefit but for the benefit of the rest of the society,” said Anthony Harnden, a professor at Oxford university who advises the UK government on its vaccine policy. “That’s a really complicated problem.”
Vaccine sceptics reluctant to have their children treated may make it difficult to roll out a widespread programme of vaccination, and in any case, argue the experts, in terms of global action, it would make more sense to assign available vaccines to the adult population of less well treated countries.
Global
The US has about 74m children aged under 18. If each received the two shots recommended for most vaccines it would take 150m from the global pot. So far the US has administered about 250m doses to adults. By contrast, the whole of Africa has received 32m doses for 1.2bn people living across 54 countries, with only 18m vaccinations administered so far.
Even philanthropists like Melinda Gates believe that vaccines should be given to the international aid programme Covax rather than being used on the teenage population of Western countries, and Andrew Pollard, chief investigator for the Oxford/AstraZeneca vaccine, says that the “jury is out” on the potential benefits of inoculating children.
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“The reality is we have got plenty of adults [around the world] at risk who need to be prioritised,” he said. The median age on the African continent is 19, so millions would have to be vaccinated to reach herd immunity.
However, it is tempting to offer children vaccinations in search of the much regarded ‘herd immunity’ which would make a significant difference to the spread of the disease. This would certainly allow society to move closer to normal, taking the pressure off institutions such as schools and universities as we move into next winter and the possibility of another wave of infection.
Contingency
The NHS is drawing up contingency plans to vaccinate secondary school children, and Pfizer has sought approval from the European regulator to use its Covid-19 vaccine in children over the age of 12 and is testing on younger age groups, and Moderna is submitting data on clinical trials of its vaccination in 12-17 year olds in early summer, and is also testing on younger age groups including babies.
Vaccine side effects on young people can be acute as their immune systems are highly active, so work can be slow, as trials have to begin with low doses in older age group, and work their way up to larger doses in younger patients.
But Health Secretary Matt Hancock, announcing that the vaccination rollout in England has been extended to everyone aged 36 or older, also said that British children could be vaccinated against Covid-19 from this summer.
Regulators
The Health Secretary said that the Government had secured enough doses of the Pfizer vaccine to cover teenagers, if the UK’s medical regulators decide that the treatment is safe for under-16s. This could allow schoolchildren to get their first dose before the start of the new term in September.
But he told MPs that a rollout of vaccines for children would not start before July, when all adults have been offered their first dose and most will have had their second. The question remains how uptake can be increased among all age groups amid fears that vaccine hesitancy could allow the Indian variant to continue spreading.
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