Children in England, Scotland, and Wales will be issued a nonurgent offer to receive two 10-mcg doses of the Pfizer/BioNTech paediatric vaccine 

Production line for COVID-19 vaccine vials

All children of primary school age in England are now eligible to undergo vaccination against COVID-19.

The decision follows a recommendation by the Joint Committee on Vaccination and Immunisation (JCVI) advising a nonurgent offer to all children aged 5–11 years of two 10-mcg doses of the Pfizer/BioNTech paediatric vaccine.

Despite children in this age group being at low risk of serious illness from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a small proportion of children who contract the virus go on to develop severe disease.

The latest evidence suggests that offering the vaccine ahead of another potential wave may protect this cohort from serious illness and hospitalisation, the UK Health Security Agency said, and would also provide some short-term protection against mild infection.

Vaccinating this age group would also limit the risk of infection for surrounding adults. According to Office for National Statistics data released on 16 February 2022, people working in the education sector are more likely to test positive compared with adults in other jobs, likely because of the recent high prevelance of infections among school children.

Scotland and Wales endorse roll-out to children

The Scottish and Welsh Governments have already announced that they will be offering a vaccine to 5- to 11-year olds after they saw the draft guidance.

Dr Peter English, a retired Consultant in Communicable Disease Control, said that the UK had been ‘dragging its feet’ on the issue, and welcomed the decision. He told the Science Media Centre: ‘The evidence is overwhelming that the vaccine is safe in children.’

Commenting on its advice, Professor Wei Shen Lim, Chair of COVID-19 Immunisation for the JCVI, said: ‘The committee has carefully considered the potential direct health impacts of vaccination and potential indirect educational impacts.

‘The main purpose of offering vaccination to 5- to 11-year olds is to increase their protection against severe illness in advance of a potential future wave of COVID-19.’

The two doses of vaccine should be given at least 12 weeks apart, the JCVI advised.

England’s Health Secretary, Sajid Javid, said on 16 February that the NHS would ‘prepare to extend this nonurgent offer to all children during April.’

‘At-risk’ 5- to 11-year olds started receiving a COVID-19 vaccine earlier this month, following a recommendation by the JCVI in December.

In a statement, the Royal College of Paediatrics and Child Health said that the COVID-19 vaccine has been certified as safe by the Medicines and Healthcare products Regulatory Agency, and that it would encourage all those who are eligible to have the vaccine to consider doing so.

It called for careful planning to ‘ensure a favourable experience for children’, and ensure that all children had equal access to a vaccine.

Logistical problems

Professor Lim said that broadening the COVID-19 vaccine roll-out to more young children must not impede catch-up in the childhood immunisation programme.

‘Other important childhood vaccinations, such as MMR and HPV, have fallen behind due to the pandemic. It is vital these programmes continue and are not displaced by the rollout of the COVID-19 vaccine to this age group’, he said.

Professor Matt Keeling, Professor of Populations and Disease at the University of Warwick, who sits on the JCVI, said that members ‘had to weigh the potential longer-term benefits of vaccinating 5–11-year-olds—generating additional immunity against future variants—against the potential disruptions that a new vaccination program could have on other immunisations and on the educational system in general.’

Professor Keeling cautioned that the logistical problems of offering a COVID-19 vaccine to children in this age group were ‘considerable’. ‘It has recently been revealed that uptake of the MMR vaccine has dropped, and to young children measles is generally far more harmful than COVID-19—so it is important that vaccination against COVID is not prioritised over other existing programmes’, he said.

Professor Adam Finn, Professor of Paediatrics at the University of Bristol, who is also a JCVI member, agreed: ‘It will be important that the deployment of this part of the COVID vaccine programme does not result in children failing to receive doses of other important vaccines, for example against meningitis, cervical cancer, and measles, in a timely way.’

Dr Brian Ferguson, Associate Professor of Immunology at the University of Cambridge, said that improving protection against new variants of SARS-CoV-2 could be an important outcome of the latest programme, particularly as many children of primary school age have had COVID-19 this winter. ‘We know that vaccination on top of prior infection generates an increased breadth of neutralising antibodies, which will very likely help to protect from future variants, should they arise and circulate in the UK’, he commented. ‘Giving parents the choice to vaccinate their child with this safe, effective vaccine is reasonable, and many will be left wondering why it has not happened sooner.’

This article originally appeared on Medscape, part of the Medscape Professional Network.

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