Vaccinating the young: On priority groups

India must continue to prioritise vaccination of the adult population

Updated - July 30, 2021 12:05 am IST

Published - July 30, 2021 12:02 am IST

As India’s vaccination drive chugs along with sporadic bursts of frenetic inoculation, there are possibilities of administering vaccines to children soon — as early as next month. At present, two Indian vaccines may be eligible for administration to children. Zydus Cadilla’s ZycoV-D, a three-dose plasmid DNA vaccine, with a 66.6% efficacy in phase-3 trials, has also been tested in adolescents (12-18 years), data for which has been submitted to the regulator. The company has also requested permission to test in children over five. Covaxin’s Bharat Biotech is also testing the vaccine in a cohort of children below 12. Though none of these studies has been completed, the expectations are that these vaccines may be ready by September. Pfizer’s mRNA vaccine has been authorised in those above 12 and Moderna’s too may be similarly approved in the U.S. Both companies are reportedly in discussions with the Indian government. Young children are at the least risk of hospitalisation and death from COVID-19 but are capable of being infection carriers and putting older caregivers at risk. This undergirds the difficult decision by governments to continue with school closures that has brought forth unprecedented challenges such as denying many Indian children access to quality education.

From the global experience so far, the broad principle is that if an effective vaccine is available, it must be administered irrespective of age. However, it is also true that the vaccines are far more effective at protecting from disease than infection. Because children and adults respond to the virus differently, it still remains to be seen whether vaccinating children as a pre-requisite to opening schools actually brings down overall rates of infection. Countries that have vaccinated those above 12 and have fully opened up are also those boasting high rates of adult vaccination. In India, only around 10% of all adults have been fully vaccinated. India already has a challenging target of fully inoculating all adults — 94.4 crore — by the end of the year. A key constraint has been Covaxin; its manufacturer has been unable to ramp up monthly production to its stated nearly six crore doses. Put together, this implies that if the aim of universal vaccination is to protect from disease, then the thrust must be on prioritising adults over children. Government and independent experts have advised that schools can open in a staggered fashion. This again underlines that reopening should not be contingent on vaccination alone. There is also the worry that prioritising vaccines for children would mean diverting already limited stocks. Rather than blindly emulate the West, India must decide on what policy works best for its entire population, including children.

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