Can Children Receive COVID-19 Vaccines?
By Buddhika Samaraweera
At a time when the whole world is fighting hard to curb the COVID-19 pandemic – which has claimed nearly 3.4 million lives so far – it is now becoming apparent that the COVID- 19 vaccines produced by various countries could control the pandemic to a considerable extent.
Currently, health authorities in almost every country are working to provide COVID- 19 vaccines to adults. In addition, there is a lot of talk about rolling out the vaccines not only for adults but also for children.
Health experts worldwide point out the COVID-19 vaccines may help protect children from getting COVID-19, and also help prevent the child from getting seriously sick if they are infected with SARS-CoV-2. Furthermore, COVID-19 vaccination of children may also help protect their families.
In general children infected with the SARS-CoV-2 virus develop mild symptoms. A few may get serious complications and vaccines may help to prevent this from occurring. Children who have picked up the SARS-CoV-2 infection, may also infect adults in their family and outside the house and thus it would be important to vaccinate children at some point to reduce this transmission.
Since this has become a much talked about topic today, Ceylon Today contacted Prof. Suranjith Seneviratne, Professor and Consultant in Clinical Immunology and Allergy at the Health Services Laboratories, London and Royal Free Hospital and University College London, to inquire into some important matters in this regard.
He pointed out that children with COVID-19 usually show mild or no symptoms, but some may have serious complications. He said, however, the children, with mild symptoms, could spread the virus to adults. Prof. Seneviratne noted that older children tend to transmit the virus more easily than younger children.
Rarely causes death
Speaking further he said, “Some children could get very sick and have complications or develop long-lasting symptoms that affect their health and well-being. The infection may rarely cause death in children although it is much less than in adults."
Prof. Seneviratne also said some children may get the condition called Long Covid, following a SARS-CoV-2 infection. This may have health impacting effects that may continue for weeks or months beyond the initial illness. It is therefore important to vaccinate children in order to prevent the occurrence of these kinds of outcomes, he said.
According to the National Institute of Clinical Excellence in the UK, two definitions of post-acute COVID-19 are proposed. They are ongoing symptomatic COVID-19 for persons who still have symptoms between 4 and 12 weeks after the start of acute symptoms and post-COVID-19 syndrome for people who still have symptoms for more than 12 weeks after the start of acute symptoms.
Researchers analysed data on people who reported their symptoms on a COVID Symptom Study application and identified two main groups of symptoms. One was mainly respiratory, such as a cough and feeling breathless, but also included fatigue and headaches. The second group of symptoms affected many parts of the body, including the heart, brain and the gut. In a study of 4,182 people, cardiac-type symptoms (such as palpitations) were commonly reported, as well as pins and needles, numbness and ‘brain fog'.
Another reason to consider a COVID-19 vaccine for children is to protect the health of the broader community. Each child or adult infected with the coronavirus provides a chance for the virus to mutate and create a viral variant that might prove to be more dangerous or more resistant, immunogenic to the available vaccines and treatments. Fewer infections among the population mean less potential for the appearance of new SARS-CoV-2 viral variants.
7 authorised vaccines
Currently seven COVID-19 vaccines have been authorised for use in adults. Initially, the Food and Drug Administration (FDA) in the United States (US), authorised the Pfizer vaccine for those 16 years and over and the Moderna and Johnson & Johnson vaccines for those 18 years and over.
Commenting on the COVID-19 vaccination programme for children at present, Prof. Seneviratne said in countries such as the US, the Pfizer vaccine has recently been authorised for children between the age of 12 and 15 years. In a study reported a few weeks ago, the Pfizer vaccine was found to have 100 per cent efficacy in children between the age of 12 and 15 years. According to him, the vaccine had been well tolerated and the neutralising antibody level was higher than that found in a slightly older group.
Speaking further, Prof. Seneviratne said the possibility of vaccinating children between the ages of six months and 11 years was being studied. Plans are underway to vaccinate children as part of a trial in three age categories in several countries. These are children between the ages of 5-11 years, 2-5 years and 6 months-2 years. Vaccination of the first two age categories has already begun in certain countries, he said.
He said Canada was the second country to authorise and use the Pfizer vaccine for children between the age of 12 and 15 years, and this commenced from 12 May 2021. Algeria had already allowed the use of the Pfizer vaccine for this age group of children in April 2021. "In addition, a pathway has been put forward for the roll out of the vaccination programme for children in the US and this comprises of three phases.
Thereby, children over the age of 16 have been vaccinated since December 2020. In addition, children between the ages of 12 and 15 years are to be vaccinated during the summer of 2021 and in early 2022, the focus would be on vaccinating children between the ages of 6 months and 11 years, he said.
Moderna COVID-19 vaccine
In December 2020, clinical trials of the Moderna vaccine for children between the ages of 12 and 17 began. He said the results of those studies are to be released soon.
The KidCOVE study has also begun as a collaboration with the National Institute of Health in the US, where children younger than 12 years would be given the Moderna vaccine.
Accordingly, it is planned to vaccinate older children first and for smaller doses to be given initially and for the dose to then be increased, he said. He said this study was still including children in countries such as Canada and the US.
Oxford AstraZeneca Vaccine
Prof. Seneviratne said a phase II study to assess the safety and immune response of the Oxford-AstraZeneca vaccine, in healthy children aged 6-17 years old was started a few weeks ago. However, with the change in age-related guidance for receiving the Oxford-AstraZeneca vaccine in the UK (currently those under 40 years are offered either the Pfizer or Moderna vaccines), continued recruitment into this trial has been halted.
Johnson & Johnson Vaccine
He said the Johnson & Johnson vaccine was currently been tested in children 12 to 17 years of age and the expectation is that the results of this trial would be released soon.
He also said that a trial on the possible use of the Russian-made Sputnik V vaccine in children and teenagers is to begin from next month.
Meanwhile, when asked about the possibility of giving the Chinese-made Sinopharm vaccine to children, Prof. Seneviratne said that a report has been issued by the National Health Commission in China that the vaccine could be given to children between the ages of 3 and 17 years. "We are waiting for the results of the relevant studies," he said and added that information on the vaccine's safety profile and immune response in children should be included.
Parents' views on vaccinating children
A recent study In the US evaluated some parents’ views and thoughts on COVID-19 vaccines for their children. 1,258 parents were surveyed and 53 per cent of that said they hoped to vaccinate their children eventually. However, only 26 per cent said they would do so right now. Also, about one third of the parents stated they do not plan to vaccinate their children at all. Accordingly, the parents' hesitation to vaccinate their children in a background where such vaccines have been approved to be given to children, should be looked into and addressed, Prof. Seneviratne mentioned.
e added that when children are vaccinated against SARS-CoV-2, they would start their journey towards getting back to school and regaining the important aspects of their school and leisure activities that were severely curtailed because of the pandemic. Prof. Seneviratne said parents as well as children should be made aware of these benefits, especially the ability to take part in their normal activities such as going to school and playing with friends.
Prof. Seneviratne also added that COVID-19 vaccines do need to undergo appropriate clinical trials in children and then be authorised and approved for use by global regulatory bodies (FDA, MHRA, EMA, WHO) and then by the country-specific authorities. He stressed that the vaccination rollout must be carried out in all countries and all groups, in order for everyone to be able to return to normalcy in the face of this truly global pandemic.
As he mentioned, early data show that the COVID-19 vaccines help keep people from spreading the SARS-CoV-2 virus to others (that is it reduces viral transmission), and this aspect would become better defined as more people get vaccinated. Widespread vaccination is a critical tool to help eradicate or at least control the pandemic. It should go hand in hand with appropriate preventive health measures such as social distancing, washing hands and wearing masks. In this background, getting children vaccinated will bring us one step closer to enjoying the activities we have missed over the past year and a half.