Do We Need to Vaccinate Children Against COVID-19?

Salvador Macip, MD, PhD


November 03, 2021

The beginning of the academic year at the end of summer brought forward an issue that has been on the cards for months: Should young kids also be vaccinated against COVID?

The United States recently joined Chile, China, Cuba, El Salvador and the United Arab Emirates in becoming the first to approve the vaccination for children, thus also becoming the first big Western country to do so. Discussions are already ongoing in Europe, which is likely to follow suit sooner or later, particularly now that the US has paved the way. Under-12s will be vaccinated worldwide — there's little doubt about it — but do they really need to be?

I already discussed in a previous blog the ethics of not prioritizing, above all, vaccination in countries where less than 5% of the population has received full immunization. We will not spend more time here defending a globally coordinated vaccination program that we know will never happen. The reality is that developed countries have the tools to vaccinate their kids and they are already starting to do so. What is the scientific evidence behind it?

It has been estimated that, in the US, 40% of children aged 5-11 got COVID by June — a really substantial figure, although some dispute it. In the United Kingdom, where schools reopened in September without having yet vaccinated the under-16s (big mistake), there is evidence that the 5-14 age group led the autumn surge of cases and then passed it on to the other well-vaccinated groups.

On the other hand, a recent paper reached the conclusion that schools in the US do not substantially increase community case rates. There are, as we can see, conflicting data on what role the youngest play in keeping the pandemic alive, but there is at least reason to doubt that their contribution is as negligible as some may claim.

We know that kids get infected but are mostly asymptomatic, and very rarely develop severe COVID. But rarely doesn't mean never. The American Academy of Pediatrics says that 500 children have died of COVID in the US since the beginning of the pandemic, which makes the coronavirus the eighth-highest killer in this age group over the past year.

We need to remember that kids can also get long-haul COVID, which is something we don't often talk about but has an important social toll, as I mentioned before. There is clearly a personal risk for the youngest — as low as it may be. Moreover, the first clinical trials show that the Pfizer vaccine is perfectly safe and effective in children, as it was expected. Nothing suggested that the response would not be similar to that seen in adults, and the early reports of potential serious side effects have not been substantiated.

Having reviewed all this, what are the pros and cons of vaccinating the under-12s? No cons, really. This vaccine is as safe as any other that they routinely get at these ages and, it seems, is very effective. We already have the jabs in our freezers and the logistics in place. The campaign will require an effort, for sure, but it shouldn't be too onerous in countries where vaccination speed has already reached its maximum.

Pros? Perhaps there are not as many as in adults, but there are certainly a few. Having the young ones immunized to COVID should slow down contagion in schools and support face-to-face learning (with all the positive and necessary social interactions involved), reduce the chances of spreading the virus to adults (however low that is), and save some lives and suffering (even if those cases are rare). Vaccinating children may not be a priority from the point of view of global health, but it should certainly be useful in countries where the adults are already well-protected.

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About Dr Salvador Macip
Salvador Macip, MD, PhD is a doctor, researcher and writer. He obtained his MD/PhD at the University of Barcelona (Spain) in 1998, then moved to do oncological research at the Mount Sinai Hospital (New York). Since 2008, he has led the Mechanisms of Ageing and Cancer Lab at the University of Leicester (UK). Macip has published over 30 books, including Where Science and Ethics Meet (2016) and Modern Epidemics (2021). Connect with him on Twitter: @DrMacip


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