Three million children aged between 12 and 15 will be able to get their first shot of coronavirus vaccine from next week. The UK’s four chief medical officers (CMOs) have said they should be offered a first dose of the Pfizer/BioNTech vaccine.
So what are the benefits, what are the risks, and do children need to be vaccinated?
What exactly has been recommended and why?
The UK’s CMOs are recommending vaccines for 12- to 15-year-olds on “public health grounds” because it is “likely vaccination will help reduce transmission of Covid-19 in schools”.
They added: “Covid-19 is a disease which can be very effectively transmitted by mass spreading events, especially with the Delta variant. Having a significant proportion of pupils vaccinated is likely to reduce the probability of such events which are likely to cause local outbreaks in, or associated with, schools.
“They will also reduce the chance an individual child gets Covid-19. This means vaccination is likely to reduce (but not eliminate) education disruption.”
The Joint Committee on Vaccination and Immunisation (JCVI) previously said Covid presented a very low risk for healthy children and jabs would only offer a marginal benefit.
How did the JCVI and CMOs reach different decisions?
The JCVI’s Prof Wei Shen Lim says there is “no conflict” between its advice and that of the CMOs, adding that the CMOs had looked at jabs from a much wider perspective.
England’s chief medical officer, Prof Chris Whitty, said the CMOs “think on balance the benefits both at an individual level and in terms of wider indirect benefits to education and through that to public health are in favour, otherwise we would not be making this recommendation”.
So do children need the Covid vaccine?
Since the start of the pandemic, evidence has repeatedly shown children are highly unlikely to become seriously ill with Covid-19. Data from the first 12 months of the pandemic in England shows 25 under-18s died from Covid.
However, that does not mean children are immune to the virus. Some will fall ill, and for those that do, there is the additional risk of long Covid, which could have lifelong consequences.
Even before the first lockdown, there have also been concerns about the indirect effects of the virus on children. The biggest has been the disruption to schools, which had a severe impact on their mental and physical health, as well as their education.
That, essentially, is why the four CMOs have said children aged between 12 and 15 should be eligible for the jab.
They believe that being vaccinated will reduce the risk of disruption to school and extracurricular activities and the effect of this on their mental health and wellbeing.
What are the benefits?
A single dose of Pfizer will significantly reduce the chances of a young person getting Covid and passing the virus on.
The Royal College of Paediatrics and Child Health says a jab is likely to benefit healthy children, irrespective of any direct health benefit, because it will enable them to have less interruption to school and allow them to mix more freely with their friends.
Getting vaccinated will also give more protection to friends and family members whose health may be at risk from the virus. This extra protection will not only benefit those around the children, but could also indirectly benefit them. For instance, a vaccinated child is less likely to pass the virus to a parent, which means there would be less of a risk the parent may become too sick to properly look after their child.
Offering vaccines to children could also help reduce the anxiety some children feel about Covid-19.
How much protection does one jab give?
Clinical evidence shows that a single dose of Pfizer cuts the risk of catching the Delta variant of Covid-19 by 55% and has a much greater effect on preventing severe illness and death. It also cuts transmission.
Will the jab hurt?
No. There could be some side-effects, though. The most common in children aged 12 to 15 are similar to those in people aged 16 and over.
They include pain at the injection site, tiredness, headache, muscle and joint pain, chills and fever. Any effects are usually mild and improve within a few days.
What are the risks?
The risks are minimal. The vast majority of children who have had the jabs worldwide have not suffered any serious side-effects.
Data from the US and Canada suggests a higher rate of the extremely rare event of inflammation of the heart muscle, known as myocarditis. However, this was only after a second dose.
The JCVI has been asked to look at whether second doses should be given to children and young people aged 12 to 15 once more data comes through internationally.
Could getting a jab affect a child’s future fertility?
There is no evidence the Covid-19 vaccines have any effect on the chances of becoming pregnant or having children. False and misleading claims about Covid vaccines and fertility are still circulating online, however, despite being unsupported by evidence.
Doctors are very cautious about recommendations during pregnancy, so the original advice was to avoid the jab. However, there is now so much safety data after a year of vaccines being administered that this advice has changed and the vaccine is now actively encouraged, particularly as getting Covid can itself put a pregnancy at risk.
The Medicines and Healthcare products Regulatory Agency (MHRA) has also said: “There is no evidence to suggest that Covid-19 vaccines will affect fertility and your ability to have children.”
The MHRA said it reached this conclusion because its “expert scientists and clinicians continually monitor the safety of Covid-19 vaccines and rigorously review all reports of suspected side effects, as well as other sources of safety information”.
What if a child has already had Covid?
More than half of children of secondary school age may have some natural immunity after having been infected.
However, although people do get an immune response after contracting Covid, this varies from person to person and it depends on whether they had a mild infection or a more severe infection.
Research shows many of those with a very mild or asymptomatic infection may only form very low levels of antibodies. That is why it is recommended that even if someone has been infected, they should still get a jab, because it then serves as a boost to the immune system.
How will the jabs be provided?
The School Age Immunisation Service will deliver the bulk of the programme in schools, with separate vaccination sites used for pupils where this is not possible.
Do parents need to give consent?
Yes. If a child is offered a vaccination at school, a consent form may be handed out to give the permission of a parent.
The nurse or GP will discuss the Covid-19 vaccine at the appointment and be able to answer any questions. But parental consent may not be the last word if the child is considered competent to make a decision by themselves.
What if a child wants to overrule their parent?
Children can overrule parents who do not want them to get the jab. However, Whitty said for the “great majority of cases, children and their parents come to the same decision”.
The vaccines minister, Nadhim Zahawi, said: “In the rare event that there is a situation a parent does not consent but the child or the teenager wants to have the vaccine, then there is a process by which the school-age vaccination clinician will bring initially the parent and the child to see whether they can reach consensus and if not, if the child is deemed to be competent, then the vaccination will take place.”
What about other children?
All 16- and 17-year-olds are already being offered a first dose, with the intention of having a second at a later date. Those aged 12 to 15 are eligible for two doses if they are at higher risk of a number of issues.
Whitty has said there are “no plans at the moment” to look at vaccinating under-12s.
Where can I find more information?
The government has published a guide for children and parents online.