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expert reaction to five to 11-year-olds being offered the COVID-19 vaccine in Scotland and Wales

Both the Scottish and Welsh governments claim to have seen draft advice from the UK’s Joint Committee for Vaccination and Immunisation (JCVI).

 

Dr Peter English, Retired Consultant in Communicable Disease Control, Former Editor of Vaccines in Practice, past Chair of the BMA Public Health Medicine Committee, said:

 “The evidence is overwhelming that the vaccine is safe in children. Many other countries have been vaccinating children aged 5 upwards for months now; the evidence of safety is overwhelming. The UK has been dragging its feet on this issue (and other protections for children), as is described clearly in a recent BMJ article.

 “And, while COVID-19 deaths rates are much lower in children than adults, every such death is a tragedy; and many children may go on to suffer Long Covid. We also know that the virus can damage the kidneys, liver, lungs, brain and other organs in some severe adult cases. We cannot yet be sure of the long-term effects on children who are infected. However, due to studies showing organ damage (see citations below), I believe that late complications in some infected children are highly likely.

“And then there are the indirect effects on children. The virus has been transmitting rapidly in schools, meaning that children may bring the infection home and infect their carers. If the carer falls severely ill or dies from the infection this will of course have a large negative impact on the child. Additionally, vaccinating children will reduce disruption in schools, which is to their benefit.

“Of course, vaccination should be part of a layered approach. We should still be using facemasks and enhancing ventilation, at least while case rates remain at their current high levels.”

  1. Zhou F, Tao M, Shang L, Liu Y, Pan G, Jin Y, et al. Assessment of Sequelae of COVID-19 Nearly 1 Year After Diagnosis. Frontiers in Medicine 2021;8. (https://www.frontiersin.org/article/10.3389/fmed.2021.717194).
  2. Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med 2022 PMID: 35132265. (https://www.nature.com/articles/s41591-022-01689-3%20).
  3. Su Y, Yuan D, Chen DG, Ng RH, Wang K, Choi J, et al. Multiple Early Factors Anticipate Post-Acute COVID-19 Sequelae. Cell 2022. (https://www.cell.com/cell/fulltext/S0092-8674(22)00072-1).
  4. Forster V. Even Mild Covid-19 Can Cause Brain Dysfunction And Cognitive Issues. Forbes 2022; Updated 24 Jan 2022; Accessed: 2022 (24 Jan): (https://www.forbes.com/sites/victoriaforster/2022/01/24/even-mild-covid-19-can-cause-brain-dysfunction-and-cognitive-issues/).
  5. Jimenez J-L. @jljcolorado: Of course it is neurotropic, see eg: https://pubmed.ncbi.nlm.nih.gov/34189535/.  70 years ago this fellow would have told us that polio was not neurotropic, because only 1% of the cases have serious complications of that type. .. Twitter thread 2022; Updated 23 Jan 2022; Accessed: 2022 (24 Jan): (https://twitter.com/jljcolorado/status/1485369766093099014 or https://threadreaderapp.com/thread/1485369766093099014.html). [A twitter thread with links to relevant papers.]
  6. Fernández-Castañeda A, Lu P, Geraghty AC, Song E, Lee M-H, Wood J, et al. Mild respiratory SARS-CoV-2 infection can cause multi-lineage cellular dysregulation and myelin loss in the brain. bioRxiv 2022:2022.01.07.475453. (https://www.biorxiv.org/content/biorxiv/early/2022/01/10/2022.01.07.475453.full.pdf).
  7. Groff D, Sun A, Ssentongo AE, Ba DM, Parsons N, Poudel GR, et al. Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review. JAMA network open 2021;4(10):e2128568-e2128568. (https://doi.org/10.1001/jamanetworkopen.2021.28568).
  8. Becker JH, Lin JJ, Doernberg M, Stone K, Navis A, Festa JR, et al. Assessment of Cognitive Function in Patients After COVID-19 Infection. JAMA network open 2021;4(10):e2130645-e2130645. (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2785388).
  9. Bowe B, Xie Y, Xu E, Al-Aly Z. Kidney Outcomes in Long COVID. Journal of the American Society of Nephrology 2021:ASN.2021060734. (https://jasn.asnjournals.org/content/early/2021/08/25/ASN.2021060734).
  10. Torjesen I. Covid-19: Infection increases the risk of kidney disease even in mild cases, finds study. BMJ 2021;374:n2189. (https://www.bmj.com/content/bmj/374/bmj.n2189).
  11. Mullin E. How does COVID-19 affect the brain? A troubling picture emerges. National Geographic 2021; Updated 18 Aug 2021; Accessed: 2021 (19 Aug): (https://www.nationalgeographic.com/science/article/how-does-covid-19-affect-the-brain-a-troubling-picture-emerges).
  12. Prescott HC. Outcomes for Patients Following Hospitalization for COVID-19. JAMA 2021;325(15):1511-1512. (https://jamanetwork.com/journals/jama/fullarticle/2777784).
  13. Sivan M, Rayner C, Delaney B. Fresh evidence of the scale and scope of long covid. BMJ 2021;373:n853. (https://www.bmj.com/content/373/bmj.n853 or https://www.bmj.com/content/bmj/373/bmj.n853.full.pdf).

 

Dr David Elliman, Consultant Paediatrician, Great Ormond Street Hospital, said:

“The announcements from Wales and Scotland that they are to introduce COVID-19 vaccine for children aged 5-11 are not unexpected. Other countries have already rolled out a vaccine programme for this age group and found the vaccine to be safe.

“When advising on vaccination of 12-15 year olds, the JCVI said that the evidence in relation to the direct effects of the vaccine was finely balanced. The Chief Medical Officers factored in such things as school disruption and the mental health effects of the pandemic and concluded that the vaccine should be offered to this group. One imagines the decision in relation to 5-11 year olds was equally evenly balanced. Presumably these wider effects were part of the JCVI deliberations. It is to be hoped that the JCVI recommendation and the evidence behind it will be made available soon.”

 

Dr Simon Williams, Senior Lecturer in People and Organisation, Swansea University, said:

“The fact that the UK government have lacked transparency in communicating their decision following the JCVI advice is problematic – transparency is key to building trust in public health decisions.  It is important for public confidence for authorities to be seen to be following the science, and scientific advice, on such matters.

“Also, the fact that Wales and Scotland have announced that they are to offer it, but the UK Government has not made an announcement, is likely to cause added confusion.

“A growing amount of data and research suggests that many parents, including parents of younger children, want the choice of a vaccine.  Therefore, by not making the offer of a vaccine for younger children, many parents likely feel they have not been given the choice, unlike parents in a growing number of other countries.  Some clearly have taken matters into their own hands and gone overseas to get vaccinated.  Research, including our own study, found that public and parents views on children’s vaccination are complex and often divided.  However, a number of polls, including one by Ipsos Mori last year, found that a majority of parents, including parents of younger children, would want their child to get vaccinated if possible.  The point is not that parents should be forced, pressured, or expected to have their child vaccinated – there is as we know much less risk of severe outcomes for children from COVID-19 – but rather that parents should be given the choice.”

 

Dr Brian Ferguson, Associate Professor of Immunology, University of Cambridge, said:

“The welcome announcement that both Wales and Scotland will offer vaccines to 5–11 year-olds comes, as I understand it, after the JCVI have made, but not yet formally announced, this recommendation. It is not yet clear why, assuming this announcement will be made, JCVI are now recommending vaccination of 5-11 year olds when they previously were not, but publication in January of the clinical trial evaluation of the BNT162b2 in children 5 to 11 years of age in NEJM is likely to have been considered, as this publication formalised the safety and efficacy of the Pfizer vaccine in this age group. Additionally, millions of children in this age group in other countries, such as USA and Germany, have now had this vaccine and suffered little or no side effects. As such the balance of risk/benefit may have been altered by the consideration by JCVI, who have remained exceptionally cautious in recommending childhood COVID vaccination, of this accumulated real-world data.

“There is an argument that it is now too late to offer the vaccine to this age group as COVID has torn through primary schools this winter, however, there are children who have not yet been exposed to COVID who will benefit from immunisation, and immunological data indicates that vaccination following infection generates powerful, broadly-neutralising antibodies that protect from most or all tested SARS-CoV-2 variants. COVID vaccination can also in some cases help reduce long covid symptoms. As such there remain good reasons to vaccinate children in this age group and I hope that England will follow the Welsh/Scottish lead to allow parents to make this choice.”

 

 

eg. https://www.bbc.co.uk/news/uk-scotland-scotland-politics-60402499

 

 

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

 

 

Declared interests

None received.

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