Should We Delay COVID-19 Vaccination in Children?

Should we delay covid-19 vaccination in children?

The net benefit of vaccinating children is unclear, and vulnerable people worldwide should be prioritized instead, experts say in The BMJ on July 8, 2021.

But others argue that Covid-19 vaccines have been approved for some children and that children should not be disadvantaged because of policy choices that stand in the way of global vaccination.

Dominic Wilkinson, Ilora Finlay and Andrew Pollard say that if a health system wants to offer a child a vaccine, there are two important ethical questions to ask. First, do the benefits outweigh the risks? Second, if the vaccine is scarce, does anyone else need it more?

“Careful attention to both questions suggests that we should not yet roll out Covid-19 vaccination to otherwise healthy children.”

They recognize that in older adults, the benefits of covid vaccines clearly outweigh the rare side effects. And in children with certain chronic or acute serious illnesses they probably do, and these children should therefore have access to a vaccine. “But in otherwise healthy children, no one can be sure at this point.”

But they say we can be sure of one thing: In the UK, some people are currently at much higher risk of Covid-19 than healthy children. And most low-income countries have less than 5% of their communities fully vaccinated.

Some may wonder: why do we have to choose? Can’t we vaccinate children as well as those abroad? But to put it simply, there is currently a limited number of vaccine doses.

“As adults, we have had to wait our turn for the vaccine. We understand that given its scarcity, the vaccine should be prioritized for those most at risk of dying.” These clear and inescapable ethics now apply to our children, they conclude. Their turn will come, but not yet.

But Lisa Forsberg and Anthony Skelton say vaccinating children against Covid-19 protects them – and others – from the risk of harm and death from infection, and is the best way to promote children’s well-being through the need for limitations or disruptions to their lives as a result of not properly controlling the spread of infection.

They say the argument that children are less likely to be seriously harmed by Covid-19 infection, and therefore benefit less from a vaccination that protects them against it, is incorrect.

“It exposes children to unknown risks of serious illness and long-term health complications. In addition, we now know that exposing children to those risks disproportionately harms already disadvantaged children.”

Another argument for delaying childhood vaccination is that priority should be given to older adults in developing countries where vaccine supply is limited.

Still, they point out that the current global vaccine shortages are the result of policy choices.

“The ethically defensible choice is to use every possible pressure to minimize vaccine hoarding and distribute vaccines to developing countries, while releasing patents and enabling the production and delivery of vaccines on a larger scale, to promote vaccination of adults and children everywhere.” to write.

They believe that accepting the ‘austerity narrative’ that children have to wait until the most vulnerable people in other countries can be vaccinated diverts attention from the real problem: that profit is valued over lives. “Here, as elsewhere, we are failing in our responsibility to avoid exacerbating existing injustices,” they conclude.

Reference: “Should We Delay Covid-19 Vaccination in Children?” by Dominic Wilkinson, Andrew J Pollard and Lisa Forsberg, July 8, 2021, BMJ.
DOI: 10.1136/bmj.n1687

Funding: The Wellcome Trust and the Arts and Humanities Research Council as part of the UK Research and Innovation’s rapid response to covid-19