Vaccinating young children: Omicron raises pressure on policymakers
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As Omicron-led infections surge across Europe, a drive to vaccinate children aged five to 11 against Covid-19 is dividing opinion: while some parents welcome the opportunity to protect their young, others are unconvinced of the benefits to their health.
Regional opinion polls show 70 per cent of parents in Denmark and Spain plan to vaccinate their younger children, but only 40 per cent in Germany, Italy and the Netherlands. Fewer than a third of French parents say they are willing to do so.
So far, vaccination is not mandatory for children and no country has demanded five- to 11-year-olds be jabbed before taking part in any activity.
But governments have taken a markedly different approach to vaccinating the young. Some, including Denmark, France, Spain, and Italy recommend all children get the jab, while the UK opts to immunise only vulnerable children.
The lack of a common message means Europe may struggle to convince parents to vaccinate their children, depriving the region of a tool to fight the latest Covid surge.
But differing national policies reflect the fast-evolving debate among scientists over whether children derive enough individual health benefits from the vaccine to outweigh the risk of very rare side effects.
Some experts, especially in the UK, have been reluctant to push for vaccination of the young because children suffer milder Covid symptoms and are far less likely to be hospitalised. Others argue that they still need protection, especially when the spread of the virus is as high as it is now.
The risk-benefit equation also depends on whether policymakers take into account the gains for society of lower transmission, such as keeping schools open and protecting older and vulnerable people.
Andrew Pollard, a paediatrician and director of the Oxford Vaccine Group, said the decision on whether to vaccinate five- to 11-year-olds was “finely balanced”, because very few suffered severe illness.
“If you are talking about a 70-year-old, it is absolutely clear that every country believes we should be vaccinating older — and now almost all adults — because of their increased risk. But for young children, more are on the fence about whether to vaccinate or not,” he said.
The EU’s medicines agency approved the BioNTech/Pfizer vaccine for five- to 11-year-olds in November, following approval for older children in May. Deliveries of the lower-dose vials began to arrive this month.
In the US, one of the first countries to inoculate younger children, uptake has been sluggish and varies widely from state to state. About 6m, or 22 per cent, of five- to 11-year-olds have received at least one dose since early November.
Denmark, which began inoculating around the same time, has given at least one dose to 40.4 per cent of that age group.
Some public health officials have urged parents to act because some children do develop serious cases of Covid and the rapidly spreading Omicron coronavirus variant could sicken more of them. On December 24, New York state said paediatric hospitalisations had risen from 22 to 109 in a two-week period in New York City, where Omicron is rife, and called on parents to “take urgent action” to vaccinate their children.
Last month, Anthony Fauci, US chief medical adviser, said he had hoped parents would move faster. “What are they waiting for? The infection is here now — protect your children,” he said.
In France, which started to vaccinate five- to 11-year-olds on December 22, health minister Olivier Véran argued that children would benefit on an individual basis from the jab especially as the country was experiencing an unprecedented rise in infections. When asked if he would give it to his own children, he responded: “Yes, without hesitation and as quickly as possible.”
“There were 145 children in hospital last night for Covid-19 and 27 in intensive care,” Veran said. “It is true that such serious cases are very, very rare, but when it happens to your kid, the statistics do not matter.”
The Haute Autorité de Santé, a panel of independent scientists which advises the French government, this month reported that 1,399 children had been hospitalised — out of 5.8m French children aged five to 11 — between March 2020 and mid-December this year. There were 238 cases needing intensive care, three deaths and 350 cases of multi-system inflammatory syndrome, a rare but dangerous complication that affects some children who get Covid.
The HAS also said it had reviewed reports of side effects from the roughly 10m children up to age 14 who had so far been vaccinated globally, and found the data “still limited but reassuring in the short term”.
From a European database, it identified about 30 serious adverse effect reports in children, including 12 cases of myocarditis, a rare cardiac side effect to the messenger RNA jabs that tends to affect young boys more than girls. In the US where 7m doses have been given to children, 14 cases of myocarditis were reported through December 10, and most were treated and resolved, it said.
But the risk of myocarditis was higher if a child develops Covid, according to the HAS analysis, so the overall balance of risk and benefit of vaccinating children was favourable when the infection incidence rate in the community was moderate to high. When it was low, the side effect risk outweighed the benefits, especially for young boys.
Even if only half of eligible children were vaccinated, the HAS estimated it would reduce infections in that age group in France by 75 per cent over three months, which would help schools stay open.
Having read the HAS report, Olivier Chappe, an engineer who lives near Lyon, said he was leaning towards having his eight-year-old son vaccinated, having already let his 12-year-old daughter be jabbed.
“The risk of my kids getting very sick or dying from Covid-19 is very low, but we don’t know the risks of long Covid for them,” he said. “Children will keep being infected if they’re the only ones in society not vaccinated, and who knows if the next variant will be scarier.”
In Dublin, Ben Lyons, a father of two, has decided against immunising his five- and eight-year-old children.
“My answer is a very vehement no,” he said. “We’re not buying into the conspiracy theories but most kids aren’t affected by Covid anyway.” Lyons, who works in a pet shop, said he was also put off because his daughter had a severe reaction to a vaccination when she was a toddler.
Despite other European countries moving ahead with children’s vaccination, the UK’s Joint Committee on Vaccination and Immunisation (JCVI) has decided only the most clinically vulnerable should be jabbed. It only signed off on second doses for 12- to 15-year-olds in late November after anxiety began to mount over Omicron. In contrast, France started vaccinating that age group in June and Germany in August.
Adam Finn, a professor of paediatrics at Bristol university who sits on the JCVI, said it was “50:50” whether the committee would give the green light to vaccination for all children in the coming months.
“If we do go on immunising all children aged five to 11, we do need to be convinced that we are doing good to somebody by doing that,” he said. “And not just doing it because it’s something we can do and we’re so desperate to do something.”
Additional reporting by Richard Milne in Oslo, Kiran Stacey in Washington and Joe Miller in Frankfurt
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