To vaccinate or not to vaccinate children aged 5-12 against COVID-19?
Very soon, the results of the Pfizer study of safety and efficacy of the COVID-19 vaccine in children aged 5-12 years will be published and the company will ask FDA approval for this age.
In many houses, the question whether to vaccinate these young children will be asked.
Many of my arguments here are almost identical to a similar chapter in this site dealing with vaccination of children aged 12-16 years.
So again, the answer depends on many factors.
Is there a difference between children aged 5-12 years to those aged 12 and more, and who chose these age limits?
Obviously, there is a difference between these age groups which is mostly related to the developmental and growth stages.
Who chose these specific age limits in the beginning? I believe that from the practical point of view, Pfizer started in adults and children aged 16 and more since it was easier to enroll children in this age group than in younger children. Next stage was 12-16 years and now 5-12 years.
So while there are big differences between these age group, I believe it all started from a more practical point of view.
Next stage off course would be a trial even in younger children (6 months to 5 years).
What are Pro’s for vaccination children aged 5-12 years?
Direct protection for the vaccinated child – children are infected with COVID-19 as adults, however, they are not as sick with COVID-19 as adults. Here and there we see children who do get sick, mainly children who suffer from chronic diseases. These children can benefit more from getting vaccinated. Also, there are children which develop late complications such as multisystem inflammatory syndrome (PIMS – link) or long corona (Long – link). So, vaccinating children could be a strategy to prevent potential unknown short and long-term effects of the infection.
Protection of the close environment of the vaccinated child – children are part of the current epidemic and serve, as well as adults, as spreaders of the virus. A vaccinated child will be protected from getting infected and will not transfer the virus to his grandparents, vaccinated or not. On a more national level, vaccinating this age group will help in controlling the virus outbreak.
Safety of the vaccine – in adults and in children above 12 years, it seems that the Pfizer vaccine is safe. Only minor and rare adverse events are reported while millions of vaccines have already been given safety with a great efficacy.
Getting the children back to normal life – children, all over the world, are having one of the most difficult and challenging times in modern era. Instead of having a regular social life together with normal school life, they are staying at home, moving from quarantine to quarantine as well as other restrictions. Vaccinating these age group would get those children back to normal children’s life which is a major goal!
What are Con’s for vaccination children aged 12-16 years?
Direct protection for the vaccinated child – Severe disease in children is rare. most of the children infected with COVID-19 are asymptomatic and rates of complication are very very low. PIMS as a complication is also rare and specific long COVID-19 effects are yet to be determined in children. So one might ask if there is truly a massive direct impact on children’s health if the virus does not affect most children.
Protection of the close environment of the vaccinated child – the question of vaccinating one population in order to protect other population can be discussed in many ways, maybe even ethical. However, it is not the first time – vaccinating males against Rubella in order to prevent maternal infection during pregnancy, vaccinating with live weak strains of polio drops (in combination with injections) in places when there is no clinical polio in order to eliminate the virus and more. While the ethical question may be asked on the national level, I remind you that many child has close family members and protection within the households could be beneficial.
Safety of the vaccine – first, we have to wait for the official results of Pfizer vaccine study which will be published soon. Nothing can be said for sure before we see the results of the 5-12 years study. Second, let’s remember what happened with the 12-16 years Pfizer study which tested 1131 and found no safety issues. Post marketing of that vaccine in this age group did reveal and unrecognized adverse effect which happened in this young population, mainly myocarditis (immune inflammation of the heart). So, I think we can wait not only for the results of the study but also for post marketing data. Currently, before the approval for vaccinations of young children, there are already more than 200 thousand children aged 12 years and less who were vaccinated off label. No big safety issues were published up to date.
Getting the children back to normal life – if children are not sick due to COVID-19, why do we need to tie things like school reopening to vaccinations? Why do children need to get hurt by a diseases that does not affect them? Some experts say that children could get back to normal lives without any restrictions (or vaccine) as soon as possible.
Priority of the vaccines – again more ethical point of view. Due to the fact that there is a worldwide shortage of vaccines, it is prudent to vaccinate the most vulnerable ones, meaning older people or those with chronic diseases. Talking about vaccination healthy children aged 5-12 years is privilege in only some countries around the world.
What would be the dose in the children’s vaccine?
The dose in children aged 5-12 years is expected to be 10 micrograms, which is third of the dose in older children and adults.
As adults, children are expected to need two doses separated by 21 days.
So what is my opinion on vaccinating children aged 5-12 years?
Soon, the FDA will probably approve the Pfizer vaccine in children in this age group.
I think there are children aged 5-12 years who should get vaccinated as soon as possible. Mainly three populations:
1. Children with any chronic diseases which put them in danger for severe COVID-19 infection.
2. Children living with a family member with a chronic disease which puts him in danger for severe COVID-19 infection. Vaccinating the children will help in protection of the vulnerable family member.
3. Children living in regions where there is still a massive outbreak of the COVID-19 virus. Vaccinating these children will help in controlling the viral spreading rate.
Children not in these three positions – I think that every family could decide for herself. We can of course wait for more safety results specific for this age group.
Your child’s healthcare provider can be also used as a trusted source of information about COVID-19 vaccine for your child.
I promise you to keep on tracking the literature and update you in every new relevant data regarding this interesting issue of COVID-19 vaccine in this age group.