By Gavin Mackintosh-
Children between the ages of 5 and 11 can be registered for the vaccine as from today under plans made by the British government.
Parents of such high risk children are being invited to register their children for vaccination amid concern they could be prone to falling seriously ill if they contract the virus, and/or infecting other children.
The British Joint Committee on Vaccination and Immunization has recommended jabs to be offered to vulnerable children between the ages of five and eleven years old.
The JCVI issued a statement on the vaccination of children and young people, saying that children aged five to 11 in a “clinical risk group” or who are household contacts of someone who is immunosuppressed should be offered two 10 micrograms doses of the Pfizer-BioNTech Covid-19 vaccine.
However, the scientific group fell short of making the recommendation to children in that age group generally, stating that more data is necessary.
The advise stated that children aged between 5 and 11 who are in clinical at-risk groups as defined in the Green Book, or who are a household contact of someone who is immunosuppressed, should receive two 10 microgram doses of the Pfizer/BioNTech vaccine, eight weeks apart. This is a smaller dose than the standard 30 microgram dose adults and older children receive.
The JCVI said it would be publishing further advice on vaccination for other children in this age group after it had considered ‘additional data’. This included information on the proportion of children who had already had COVID-19 and data on the level of protection a previous infection provided against the Omicron variant.
Meanwhile, the committee also recommended that children aged 12- to 17-years old should receive a booster dose of the Pfizer/BioNTech vaccine at least three months after their second dose, or third dose if they are immunosuppressed.
Benefits of vaccination
The committee said that when deciding on whether to vaccinate children aged 5 to 11, it had focused on the potential ‘benefits and harms of vaccination to children and young people themselves’.
‘The benefits and risks from COVID-19 vaccination in children and young people are finely balanced largely because the risks associated with SARS-CoV2 infection are very low,’ the JCVI said. ‘Of all age groups, children aged 5 to 11 years are those at lowest risks of serious COVID-19.’
However, the committee concluded that ‘at the current time the balance of potential benefits and harms is in favour of offering vaccination to children aged 5 to 11 years who are in a clinical risk group’.
‘Children aged 5 to 11 years old who are not in a clinical risk group but are household contacts of a immunosuppressed individual (of any age) should also be offered COVID-19 vaccination on the understanding that the main indication for vaccination is to indirectly increase protection of the person who is immunosuppressed,’ it added.
It comes after the Medicines and Healthcare products Regulatory Agency approved a new paediatric formulation of the Pfizer vaccine for children aged 5 to 11, after it was found to have met the required safety, quality and effectiveness standards.
It also comes after the latest Office for National Statistics infection survey estimated that around one in 20 primary-aged pupils tested positive for Covid in the week to December 11. In recent weeks younger children have overtaken secondary-age pupils to become the age group with the highest rate of infection.
The JCVI has also recommended that a booster dose of the Pfizer vaccine be offered to children and young people aged 16 and 17, those aged 12 to 15 who are in a clinical risk group or live with someone who is immunosuppressed, and to 12 to 15-year-olds who are themselves severely immunosuppressed and who have already had a third primary dose.
They have called for doses to be offered no sooner than three months after teenagers completed their primary course.
The committee said it would issue advice after seeking updated data on the proportion of children who have already been affected, and information on the level of protection against the Omicron variant given by previous infection.
The committee added that it would also consider “post-marketing adverse event reporting data” from the international use of the Pfizer-BioNTech COVID-19 vaccine in those aged 5 to 11 years”.
It will also look at considerations from the Department of Health and Social Care and other departments on the “potential educational impacts (both benefits and disbenefits) of Covid-19 vaccination in those aged 5 to 11 years.
Paul Whiteman, general secretary of the NAHT leadership union, which mostly represents primary heads, said: “We know that there are many families with medically vulnerable children who have been waiting for this decision and so they will be pleased that there is now a sense of clarity.
“Of course, vaccination for children, and particular younger children, will always be a choice for parents to make.”
Paul Whiteman Image:schoolsandacademiesshow.co.uk
Whiteman’s latter comments are not fully accurate because the current position of the Uk government is that where a pupil under the age of 16(bit over 11) wants to be vaccinated against the wishes of the parent, the wishes of the child prevails(if he is deemed mature enough) after mediation between mother and child has been explored and failed.
Risk/Benefit Analysis
When formulating advice in relation to childhood immunizations, JCVI’s position is that the main focus of its considerations should be the potential benefits and harms of vaccination to children and young people themselves. The benefits and risks from COVID-19 vaccination in children and young people are finely balanced largely because the risks associated with SARS-CoV2 infection are very low. Of all age groups, children aged 5 to 11 years are those at lowest risks of serious COVID-19.
JCVI has considered data on the risk of hospitalization, paediatric intensive care unit (PICU) admission, mortality and paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) following SARS-CoV-2 infection, the effectiveness of COVID-19 vaccination in preventing infection, symptomatic disease, hospitalisation, intensive care admission and mortality, and the prevention of PIMS-TS and ‘long COVID’ through protection against infection and disease.
Also considered was the incidence and severity of suspected adverse events following vaccination including available data on the risk of myocarditis following vaccination estimates of the proportion of 5 to 11 year olds with prior SARS-CoV-2 infection in the UK
Findings
Immune responses in vaccinated 5 to 11 year olds were reportedly at least as good as those measured in 15 to 25 year olds who received 30 micrograms of Pfizer-BioNTech COVID-19 vaccine. Vaccine efficacy against confirmed COVID-19 was noted to be 90.7%, although with considerable uncertainty in this estimate due to the relatively small numbers involved. Adverse reactions due to vaccination were mainly low-grade local and systematic reactions lasting one to 2 days.
Compared to adults and older children studied in previous trials, children aged 5 to 11 years reported more injection-site redness (15 to 19% vs 5 to 7%) and local swelling (10 to 15% vs 5 to 8%), but less fever (3 to 7% vs 1 to 20%) and less chills (5 to 10% vs 6 to 42%). Children aged 5 to 11 years were just as likely as 12 to 15 year olds to experience swelling of local lymph glands (0.9% vs 0.8%). No cases of myocarditis were observed.
Initial safety data from programmatic use of COVID-19 vaccination in 5 to 11 year olds in the United States indicates no new or unexpected concerns. More data is expected to accrue over time as experience with vaccination of this age group of children increases internationally.