Children are extremely unlikely to develop complications, severe disease or death due to COVID-19, unlike even the youngest adult, and panic created by any bad outcomes in children can in fact be counter-productive for the entire paediatric vaccination process, according to experts.
Speaking about balancing benefits and risks of COVID-19 vaccination in children in India, Dr. Rajeev Jayadevan, vice-chairman, research cell, Indian Medical Association (IMA), Kerala, said age was the most significant risk factor for COVID-19 complications. The important question was, is vaccination of crores of healthy children worth it just to prevent a few asymptomatic and mild infections for the first few months alone?
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“The short period of protection makes paediatric COVID-19 vaccination unattractive - when done for the purpose of preventing infection. The concept of ‘herd immunity’ is not valid any more for the virus, as sterilising immunity does not occur and reinfection/breakthrough infections are common,’’ he stated.
It did not make sense to vaccinate enormous numbers of children to prevent one rare complication. “We should prioritise children who need vaccines the most. These will be children with comorbidities, who are more likely to develop complications. An additional subgroup will be children who live with people with cancer and immunosuppressed or elderly relatives – these children also may be considered for vaccination on a case by case basis,’’ he noted.
There was need to keep a careful watch for any vaccine-related complications that may arise in the sub-group. “Vaccines produce different complications in different age groups and we should watch this carefully,’’ he stressed.
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Doctors also emphasised that vaccinating all children would help control infection spread and return of normalcy faster.
‘Only way forward’
Dr. Smita Srivastava, consultant, Pediatrics and Neonatology, QRG Super Speciality Hospital, Faridabad, asserted that the virus affected any age group and vaccination was the only way forward. “By vaccinating children we will be able to start schools in full strength and help them lead a normal life.’’
Dr. Akshay Budhraja, senior consultant, Pulmonology, Aakash Healthcare, pointed out that the move would be beneficial both for the child as well as people around them. “Children and adolescents are vulnerable groups and if the vaccine safety data is strong enough and we immunise them, it will have a big impact in reducing the transmission of COVID-19. This will be a major step as schools, coaching centres and sport centres are gradually opening. Since vaccination is yet to arrive for children and is at the trial stage, we need to see that we provide proper protection to them by giving them timely vaccination so that the severity of the infection significantly come down even in case they end up contracting COVID-19.’’
Dr. Rahul Nagpal, director, Paediatric and Neonatology, Fortis Hospital, Vasant Kunj, New Delhi, explained, “When made available, parents should not hesitate to give the vaccine to children and we doctors are always available to answer any queries’’.
Dr. Gauri Agarwal, gynecologist, highlighted that it was important to establish the efficacy of the vaccine by the time it was approved for administration. At the same time, efforts must be made to establish the efficacy of the vaccine globally so that children were not subjected to restrictive measures when they travelled abroad.