Covid Q&A: What you need to know about child vaccinations

Were Covid-19 shots meant only for adults and the vulnerable?

So far they have been, but as the rollout proceeded and transmission of the disease remained relatively high the focus was inevitably going to shift towards younger people, particularly if the Republic is to achieve “herd immunity”.

In the past few weeks teenagers have accounted for about one-fifth of all new coronavirus cases. People aged 16 and 17 were invited to register for vaccination shots this week.

Will vaccinating those aged 12 to 15 be a big logistical undertaking?

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Yes and no. The rollout has steadily been making its way down through the age groups and this latest cohort is, well, just the latest. That said, moving down to people of these ages brings complications.

The Health Service Executive will have to tinker with its online registration portal to allow for a parental consent mechanism, given the medical age of consent is 16. And vaccination centres will have to be able to deal with extra numbers as younger people will have to be accompanied by adults. There will be an information campaign to address concerns and questions and vaccinations in this group could begin as early as next week with a view to having children inoculated before they go back to school.

What threat does the virus pose to younger people?

The research is ongoing but what we do know, broadly speaking, is that the risk to healthy children is very low.

Prof Russell Viner of the University College London Great Ormond Street Institute of Child Health, a senior author on two related studies, earlier this month said the virus increases the risks for vulnerable children to a higher degree than illnesses such as seasonal flu. But the risk of dying from Covid-19 for healthy children stands at about one in two to three million.

Dr Clare Smith of the University of Bristol said only 40 per cent of children and young people with a positive test at time of death actually died from the illness. Such outcomes have not changed with the Delta variant although, as ever, the impact of long-Covid remains a concern.

Dr Rachel Harwood of the University of Liverpool said research on obesity-related severe illness is "only now becoming evident as an important risk in children and young people".

Meanwhile, US experts have noted a “potentially severe and dangerous complication” known as multisystem inflammatory syndrome in children (MIS-C). This can lead to life-threatening problems with the heart and other organs.

Okay, but if the risks are relatively low why vaccinate my child?

Adults are often told that any risk of vaccines is far outweighed by the hazard posed by coronavirus, but this is not as clear-cut with younger recipients. Still, many health experts believe there is good reason to extend the programme into younger age groups.

The US Centers for Disease Control and Prevention puts it simply: while fewer children than adults have been sick, they can be infected, can get sick and can spread the virus.

Irish immunovirologist Prof Liam Fanning backs vaccination among 12- to 15-year-olds, noting the "spectre of long Covid" and a greater protection for the under-siege education system.

Prof Viner has made the same points about education, while long Covid effects “in children are unknown and need to be factored in”.

Harvard Medical School said while discomfort with vaccinating young people is understandable, spread of the Delta variant, combined with the protection offered by herd immunity, supports such an approach.

Might a vaccine harm my child?

This comes back to a common question: is it better to take a chance with Covid-19 or with the vaccine? The pharmaceutical companies, for those who trust them, are doing their utmost to ease concerns and expand our understanding.

Pfizer and Moderna, whose mRNA vaccines would be given to those aged 12 to 15, have been conducting "de-escalation studies" on children of descending age. Pfizer's recent trial of 2,260 children aged 12 to 15, half of whom were given a placebo, found the immune response in those vaccinated to be even stronger than in 16- to 25-year-olds. The vaccine was found to be 100 per cent effective in preventing the disease. Side-effects were described as mild and included arm pain at the injection site, tiredness, headache, chills, fever and muscle and joint pain.

In its May study, Moderna had similar outcomes. It enrolled 3,732 children ages 12 to 17 (one-third received a placebo). As well as a strong immune response, it said side-effects were mild and no significant safety concerns were identified. But according to Harvard Medical School there has been a “higher-than-expected” number of heart inflammation cases following mRNA vaccination, particularly among boys and young men.

What other countries are doing it?

In May, US authorities extended its emergency use authorisation for the Pfizer vaccine for 12- to 15-year-olds. As of last week this was the only vaccine authorised in the US for under-18s. The United Kingdom has been more reticent. By last June, other countries offering, planning to offer, or at least authorising vaccines for those as young as 12 included France, Austria, Hungary, Estonia, Italy, Spain, Lithuania, Israel, Norway, Japan, Brazil and Canada.