COVID vaccine for the under 12s?

Talking to a friend the other day, I was asked the question ‘Is it really necessary to vaccinate young children?’  She followed, with a mother’s tenderness ‘After all, Henry has only been in this world for such a short time.’

Indeed, this is such a fine balance. While more than 90% of the adult population and 60% of those aged between 12 and 15 have been vaccinated, the decisions become tougher when it comes to the youngest group. On the one hand, we would do everything we could to protect our children. On the other hand, we dread the thought of accidentally introducing them to harm. There is no simple answer, when the whole world is confronted with a powerful virus and an extraordinary illness. 

But let’s look at some evidence.

As of 19 November, we have in Australia a total of around 28,000 COVID positive cases in children below the age of 10, and 2.5% of them required hospitalisation. Sadly, there has been one death last Saturday. 

We know that children tend to be less severely affected by the COVID virus. Most of the positive cases have little or mild symptoms. However, children with obesity and chronic diseases, including asthma and type 1 diabetes, are 3 to 4 times more likely to get very ill, compared to their peers. In the US, over 5000 cases of a rare but serious inflammatory complication called MIS (Multisystem Inflammatory Syndrome) have been reported in children infected with COVID, presenting with heart, kidney, and brain injuries. Furthermore, ‘long COVID’, although far less frequent compared to the adult population, can affect children. In the UK, about 10% of children aged 2 to 11 reported at least one lingering symptom, five weeks after a positive diagnosis.

In addition, asymptomatic COVID positive children carry as many viral particles as adults, and can potentially spread the virus to others, including older people.

So, what do we know about the COVID vaccine in children under the age of 12?

Firstly, the benefit of vaccination is the benefit of protecting the individual child. None of us wants our child to be one of the seven hundred children who have required hospitalisation, and the dozen who were admitted to ICU, here in Australia since the Pandemic. 

Secondly, it has been suggested by some modelling systems that vaccinating younger children and adolescents will be important if Australia is to achieve ‘herd immunity’, that is, to eradicate the reservoir of the virus, thus protect those who are unable to be vaccinated. 

The big question is, then, ‘Is it safe?’ 

On 2nd November, the US CDC became the first health regulator to recommend the Pfizer COVID vaccine among children aged 5 to 11. Pfizer’s clinical trial of 2,268 children showed 90.7% efficacy against symptomatic infection among young children. During the 3-month follow-up after two doses, none of the children in the trial experienced the rare heart inflammation side effects known as myocarditis and pericarditis, which have been linked with the mRNA vaccines in very rare cases, particularly in young men.

In October 2021, Moderna has also released interim analysis of their study in 4,753 children aged 6 to 12, showing its vaccine is also safe and effective. 

In Australia, our process to assess a vaccine is robust. Currently the TGA is still evaluating the Pfizer trials, the US vaccination data, and the doses required for children aged 5 to 11. Once it is approved, ATAGI will then make its own assessment. We’re not sure when this will complete, but assuming it passes successfully though our own safety regulators, under 12s vaccine rollout probably won’t be till early 2022.

Finally, getting back to our purpose -to keep everyone as safe and healthy as possible. We know there are abundant vaccine efficacy and safety data in the adult population, having vaccinated over seven billion people worldwide. Before the younger children can be safely vaccinated, fully vaccinated adults are their best protector. 

In Foster Medical Centre, we’re still running vaccine clinics for anyone over the age of 12, with either Astra Zeneca or Pfizer vaccine. 

Due to the waning of vaccine’s efficacy over time, a third dose is recommended for people over the age of 18 who have had their second dose 6 months ago. However, if you have certain conditions that severely compromise your immunity, you should talk to your doctor and have the third dose much earlier, ie. 2 months after the second dose.

By Dr Ruyu Yao, Foster Medical Centre