COVID-19: Prioritising low-risk groups a 'moral catastrophe' - but should the UK vaccinate children?

·5-min read

Europe is starting to roll out vaccines to children - with 21 countries vaccinating those aged 12 and over or planning to do so in the near future - according to data gathered by Sky News.

A further six European countries have decided to only offer jabs to children with underlying health conditions.

The UK is one of the countries only offering jabs to those at very high risk of becoming severely ill from COVID. But recommendations on vaccinating other under-18s are expected from the Joint Committee on Vaccination and Immunisation (JCVI) imminently.

The national medicines regulator approved the use of the Pfizer-BioNTech vaccine for 12 to 15-year-olds earlier in June (it was already approved for 16 and 17-year-olds). This followed similar decisions from regulators in Europe and the US.

Outside Europe, Singapore, Japan, the UAE, Israel, the US, China, Canada and the Philippines have also decided to give jabs to all those aged 12 and over. The US is one of the countries that has made the most progress so far, with at least one dose given to almost eight million 12 to 17-year-olds up to 29 June, according to the Centers for Disease Control and Prevention.

But vaccinating children is a contentious issue.

The case for vaccinating children?

In recent weeks, younger age groups have seen COVID cases soar relative to the older population, which is more likely to be protected by vaccines. The infection rates for 10 to 19-year-olds were the second highest in England for the week ending 20 June, more than 17 times higher than for the over-70s.

Given the surge of the more transmissible Delta variant, which was first found in India, vaccinations are increasingly critical for supressing infections by reaching herd immunity within the UK population.

Recent Public Health England (PHE) data has shown that the spread is particularly concentrated in schools and universities. Outbreaks may reflect transmission, but they also reflect visits by existing cases to common public spaces.

Outbreaks in schools have a knock-on impact for the spread of the virus more widely. Dr Julian Tang, professor of respiratory sciences at the University of Leicester, said that the main motivation for vaccinating children is supressing infections in the wider community.

He said: "For the younger population… spreading the virus to those not yet vaccinated, together with long-COVID risks in those who are infected, and then the long-term community [and] social healthcare burden that goes with that becomes the main problem."

While children are less likely to suffer severe illness and death from the virus, scientists have warned about the threat of long COVID among the young. An ONS study estimated that 13% of children aged two to 11 and 15% of those aged 12 to 16 have at least one symptom in the five weeks after infection.

Children also risk losing out in other ways. The rapid spread of the virus in schools has led to a surge in the number of pupils missing out on face-to-face teaching. The rate of COVID absence in state schools increased to 5.2% on 24 June from just 1.1% a fortnight earlier.

This is especially concerning as vulnerable groups are disproportionately affected by this lost learning. The absence rate among students eligible for free school meals is consistently higher than for state schools as a whole, with as much as a 6.6 percentage point gap in the middle of May.

In addition to the education and health benefits from vaccinating children, Dr Stephen Griffin, a virologist at the University of Leeds, points to the critical role it plays in reaching herd immunity.

"A much higher proportion of the population being double-vaccinated is not only necessary to get on top of Delta, but would afford excellent protection to clinically vulnerable groups as well," he said.

The rapid spread of the Delta variant has pushed the threshold for herd immunity higher. Griffin puts the number at between "85 and 90%". Even if everyone over the age of 16 is vaccinated in the UK, only 81% of the UK population will have the necessary protection against the virus.

Arguments against vaccinating children

One argument against vaccinating children is that the risks are unknown, while the benefits are relatively small. Younger age groups are much less likely to suffer severe illness and death as a result of the virus.

A recent study across seven countries including the UK and US estimated that less than two in every million coronavirus cases in those aged 19 and under resulted in deaths.

Most experts believe that vaccines are safe for children. The World Health Organization's (WHO) Strategic Advisory Group of Experts has concluded that the Pfizer-BionTech vaccine is suitable for use by people aged 12 years and above.

But currently the WHO advises that it is "less urgent" to vaccinate children aged between 12 and 15 unless they are part of a high-risk group. In May, the WHO director-general Tedros Adhanom Ghebreyesus called the prioritisation of low-risk groups, such as children, in rich countries a "moral catastrophe".

He said: "I understand why some countries want to vaccinate their children and adolescents, but right now I urge them to reconsider and to instead donate vaccines to COVAX."

Many countries are struggling to control the spread of the virus with limited vaccine supply. Less than 30% of the population in Paraguay, Colombia and Peru have received even one dose and are recording some of the highest rates of COVID deaths.

However, Dr Stephen Griffin said: "Whilst I fully support the drive to address global vaccine inequality, the doses required to complete an effective population immunisation programme here in the UK represents a drop in the ocean."

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