Q&A: What is happening with Covid-19 vaccinations for children?

The HSE is currently finalising a plan for the vaccination of children aged five to 11

The National Immunisation Advisory Committee (Niac) last week approved the provision of the Pfizer Covid-19 vaccine to children aged five to 11. What happens next?

When and how will these shots be rolled out?

These details are still being clarified as Niac’s advice was somewhat nuanced. It said priority should be given to children with underlying conditions, children who live with a younger child with complex medical needs, and children living with a person who is immunocompromised.

Hospital Report

Children aged five to 11 who do not fall into the above categories would be offered the vaccine once people in those categories have had their shot.

Paul Reid, chief executive of the HSE, has acknowledged identifying those priority groups within the age group will be a challenge.

The HSE is currently working on a plan to operate the recommendation, and it is expected this plan will be published later this week, on Thursday or Friday.

There are an estimated 480,000 children within the five-to-11 age group.

Will they receive the same vaccine as adults have?

The paediatric doses are a third of the quantity of the Pfizer vaccine administered to people aged over 12. A first delivery of these is due to arrive this week.

Is the vaccine safe for kids?

The European Medicines Agency (EMA) gave approval for the weakened dose for children on November 25th. Niac made the recommendation to extend it to this age group due to what it described as the "favourable risk profile" of the vaccine. Kingston Mills, a professor of experimental immunology at Trinity College Dublin, said the vaccines were tested in phase-three clinical trials in that age group and "there wasn't anything significant" in terms of concerns. He said it is all about weighing up the risks of contracting the virus versus the vaccine.

What are the risks?

There are risks of side-effects with every vaccine. These are similar to those that adults have reported such as a sore arm, headache, slight fever and fatigue.

However, Prof Mills also noted the experience of the swine flu vaccine in 2009 and 2010, with which the risk of narcolepsy was not discovered during clinical trials, and was only identified after millions of doses had been administered.

“That’s an unusual thing and it’s very, very rare for that to happen, but it can happen,” he added.

Are children being asked to do something for the sake of society?

There are benefits for children too, particularly given the high incidence of Covid-19 in the age group. According to the most recent figures from the Health Protection Surveillance Centre (HPSC), children aged five to 12 accounted for 21.5 per cent of new Covid cases in the previous week.

Prof Mills said the “significant number” of cases had seen an increase in the number of children being hospitalised. “It’s not huge, but I think 20 cases in two weeks ended up in hospital. If you add that up over winter, that would be well over 100 in hospital in that age group. That’s not trivial,” he said.

Furthermore, Christine Loscher, professor of immunology at Dublin City University, said children are vaccinated against rubella, despite it being "a really mild illness in kids". " But we get them vaccinated because if a pregnant women gets it, it's really, severely damaging for the baby," she added.

Do children only get a mild illness due to Covid-19?

There is a lot of unpredictably about the disease, Prof Loscher said.

“You can’t really predict what way the illness is going to present in your child. We do know that high percentage of children have a very mild illness, but you’ve no way of telling that beforehand,” she said.

For those that are hospitalised, they can experience “severe respiratory issues” or contract the inflammatory syndrome that is “really quite serious”, she added.

Prof Loscher said vaccination also has the potential to reduce the chance of a child developing long Covid, or from having lingering symptoms “that might have an impact on their lives”.

“They can happen in children who have mild symptoms,” she added.

Given the uncertainty around how future variants may clinically affect people of various age groups, it also acts in a way to “future-proof” children in terms of immunity, Prof Loscher said.

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