Chief medical officers recommend Covid jab for children aged 12 to 15

·6-min read
Professor Wei Shen Lim, Chris Whitty, and Dr June Raine speak to the media (Hannah McKay/PA) (PA Wire)
Professor Wei Shen Lim, Chris Whitty, and Dr June Raine speak to the media (Hannah McKay/PA) (PA Wire)

Children aged 12 to 15 should be offered a first dose of the Pfizer BioNTech vaccine, the UK’s four chief medical officers (CMOs) have said.

The decision takes into account the “extremely powerful” evidence on the impact of the pandemic on children’s education as well as the risks to their mental health from missing school.

The move means that around three million children could be eligible for the jab and comes despite the Joint Committee on Vaccination and Immunisation (JCVI) deciding not to recommend mass vaccination of 12 to 15-year-olds.

It is expected the vaccinations could be given through schools as soon as possible once the advice has been considered by the Government

The JCVI had said Covid-19 presents a very low risk for healthy children and vaccination would only offer a marginal benefit.

But they suggested that the wider issues, such as education, should be taken into consideration and examined by CMOs.

At a Downing Street press conference, Professor Wei Shen Lim, from the JCVI, said there was “no conflict” between the advice provided by the JCVI and that from the CMOs, adding that the JCVI had looked at jabs from a health perspective.

England’s chief medical officer Professor Chris Whitty said it had been a “difficult decision” regarding vaccinating children but CMOs would not be recommending the jabs “unless we felt that benefit exceeded risk”.

He added: “In a sense, what we’re not trying to do is say to children ‘you must, must, must, must, must’ but what we’re saying is that we think on balance the benefits both at an individual level and in terms of wider indirect benefits to education and through that to public health are in favour, otherwise we would not be making this recommendation.”

He agreed that the CMO advice was “not in conflict” with that from the JCVI, saying it was “very much in line” with it but had also looked at issues such as education. He added there were “no plans at the moment” to look at vaccinating under-12s.

In their advice to the Government, the UK’s CMOs said they were recommending vaccines on “public health grounds” and it was “likely vaccination will help reduce transmission of Covid-19 in schools”.

They added: “Covid-19 is a disease which can be very effectively transmitted by mass spreading events, especially with Delta variant.

“Having a significant proportion of pupils vaccinated is likely to reduce the probability of such events which are likely to cause local outbreaks in, or associated with, schools.

“They will also reduce the chance an individual child gets Covid-19. This means vaccination is likely to reduce (but not eliminate) education disruption.”

(PA Graphics) (PA Graphics)
(PA Graphics) (PA Graphics)

The CMOs have asked for the JCVI now to look at whether second doses should be given to children and young people aged 12 to 15 once more data comes through internationally.

This will not be before the spring term.

Data from the US and Canada has indicated a higher rate of the extremely rare event of inflammation of the heart muscle, known as myocarditis, after a second dose, which was considered in the decision-making.

The US has collected a large amount of safety data on vaccinating children aged 12 and over with Pfizer.

The AstraZeneca vaccine is currently not recommended for anyone under the age of 18.

The CMOs think a single dose of Pfizer will reduce significantly the chance of a young person getting Covid and passing the virus on.

Clinical evidence shows that a single dose of Pfizer cuts the risk of catching the Delta variant of Covid-19 by 55% and has a much higher effect on preventing severe illness and death. It also cuts transmission.

(PA Graphics) (PA Graphics)
(PA Graphics) (PA Graphics)

After seeking advice from a range of experts, including the Royal College of GPs and the Royal College of Paediatrics, the CMOs said they consider education “one of the most important drivers of improved public health and mental health”, adding that poorer children had been particularly disadvantaged during the pandemic.

They added: “The effects of disrupted education, or uncertainty, on mental health are well recognised.

“There can be lifelong effects on health if extended disruption to education leads to reduced life chances.

“Whilst full closures of schools due to lockdowns is much less likely to be necessary in the next stages of the Covid-19 epidemic, UK CMOs expect the epidemic to continue to be prolonged and unpredictable.

“Local surges of infection, including in schools, should be anticipated for some time. Where they occur, they are likely to be disruptive.”

During the briefing, Prof Whitty said that vaccination “will reduce education disruption” but “we do not think this is a panacea, it is not a silver bullet”.

He added: “We think it is an important and potentially useful additional tool to help reduce the public health impacts that come through educational disruption.”

(PA Graphics) (PA Graphics)
(PA Graphics) (PA Graphics)

The NHS in England had already been asked to prepare to roll out vaccines for all 12 to 15-year-olds in the event that the CMOs recommend the programme.

The JCVI has already recommended that children and young people aged 12 to 17 with specific underlying health conditions, and children and young people who are aged 12 years and over who are household contacts of people who are immunocompromised are offered two doses of a vaccine.

The JCVI has also investigated the effects of myocarditis, after Pfizer or Moderna vaccines.

While the condition can result in short periods of hospital observation, followed by typically swift recoveries, the JCVI has concluded the medium to long-term outcomes are still uncertain and more follow-up time is needed to get a clearer picture.

The UK’s CMOs – including Dr Frank Atherton in Wales, Dr Michael McBride in Northern Ireland and Dr Gregor Smith in Scotland – said myocarditis can also be caused by Covid-19 and resolves itself in most cases.

During the Downing Street briefing, Dr June Raine, from the Medicines and Healthcare products Regulatory Agency, said the side effects for 12 to 15-year-olds being vaccinated are “mild”.

On myocarditis and heart issues, she said: “We’ve undertaken a very thorough review, both of the UK and the international reports, there is a consistent pattern, slightly more often frequently do we see cases in young males and after the second dose.

“But, overall, the conclusion of our expert advisers is these are mild cases, individuals usually recover within a short period of time with standard treatment.

“Our advice remains that the benefits outweigh the risks of getting vaccinated, and this includes those aged 12 to 15.”

When it comes to consent for the new wave of vaccines, parental consent will not be needed if the child is considered competent to make a decision by themselves.

Prof Whitty said for the “great majority of cases, children and their parents come to the same decision”.

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