After months of uncertainty, the UK’s four chief medical officers have said that Covid-19 vaccinations can be offered to all 12-to-15-year-olds. How was the decision made, how will the vaccines be rolled out, and what difference will they make?
What were the UK’s chief medical officers asked?
Ministers asked the CMOs for advice on whether to offer Covid vaccines to healthy 12-to-15-year-olds. The government’s vaccine advisory group, the Joint Committee on Vaccination and Immunisation, felt the benefit was too marginal and recommended jabs only for clinically vulnerable children in that age group, or those living with people at high risk from the disease. The CMOs looked at the wider impact of vaccinating all 12-to-15-year-olds, particularly on their education.
What did the CMOs decide?
The CMOs consulted a range of experts from the Royal College of Paediatrics and Child Health to regional directors of public health before reaching a decision. They advised ministers to press on with Covid vaccinations for all children aged 12 to 15. With cases expected to rise through the autumn and winter, the CMOs believe the vaccinations will help reduce Covid transmission and outbreaks in schools that would bring further disruption to children’s education.
What will vaccination involve?
Children in the age bracket will be offered a single shot of the Pfizer/BioNTech Covid vaccine. Further advice on any second doses will come from the JCVI once more data has been gathered internationally. If second shots get the green light, they will not be given before the spring term.
What difference will the jabs make?
A single shot of the Pfizer/BioNTech Covid vaccine is about 55% protective against Covid infection, and more so against hospitalisation and death, though severe Covid disease is rare in healthy children. So the vaccination programme will not stop Covid in schools, but should help to keep cases down and so reduce disruption from the disease.
How will the rollout work?
Covid vaccines have already been given to clinically vulnerable children aged 12 to 15, or those living with others at high risk, at vaccine hubs around the country. The broader inoculation of 12- to 15-year-olds is expected to start imminently and run through the secondary school vaccination system.
Are schools up to the task?
It will take some planning. Chief medical officers want Covid shots offered in much the same way as nasal spray flu vaccines are provided at schools, but the Pfizer/BioNTech vaccine must be stored at extremely cold temperatures and requires an injection rather than a spray. To further complicate the process, some schools and colleges have already received threats of legal action if they offer Covid vaccines.
Whose decision is it?
UK law is the same for coronavirus vaccines as for other immunisations. When a vaccine is offered to 12-to-15-year-olds, doctors require parental consent, or the child’s own consent, if they are deemed competent enough to provide it.
What is the risk of side effects?
Some concern has been raised about rare side-effects from the Pfizer/BioNTech and Moderna vaccines, in particular a condition called myocarditis, a swelling of the heart muscle that usually resolves after a few days of rest. Researchers are gathering data on the prevalence of the problem, but in the UK the rate of myocarditis after both first and second doses is six per million shots of Pfizer/BioNTech, according to the Medicines and Healthcare products Regulatory Agency. The majority of cases seen so far appear after the second shot. Doctors point out that myocarditis can occur in Covid patients too, with one study suggesting that for male teenagers, the risk of myocarditis is six times higher from Covid than it is from the Pfizer/BioNTech vaccine.
What are other countries doing?
Many countries, such as the US, France, Spain, Italy and the Netherlands, are pressing ahead with Covid vaccines for children aged 12 and over in the hope that it will help to keep schools open. After positive clinical trials in younger children, the US-based FDA and other regulators are expected to approve the jabs for primary school-aged children soon.
