More than 910 million vaccine-19 doses have been received and the number is climbing daily. So far, however, the vast majority of those who target campaigns have one thing in common: they are adults. That was the right place to start the world’s biggest vaccination, but we don’t have to stop.
Children, really, have been shown to be less sensitive to the coronavirus so far. It is one of the few pitfalls of the pandemic, even if underreporting plays a role. But not everyone escaped unscathed, and we know that infected young people unknowingly transmitted the disease to others. As with shots for diseases such as measles and rubella, vaccines against covid-19 for children are about protecting them – and protecting everyone else. Even if children are not “super” propagators, but only disseminators, the return to a kind of normalcy remains a mirage without them.
Unfortunately, this is a corner of the global vaccination campaign where problems such as access and hesitation will be most acutely felt. Trials on children are just beginning and are necessarily slow, given safety concerns, which means researchers are declining by age groups and decreasing infection rates. We will have to wait to know which immunizations are safest and best to prevent transmission. The good news is that the interval before launch provides an indispensable few months to deal directly with the misconception that these shots bring lower rewards.
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Children accounted for about 8% of all cases of covid-19 last year, according to World Health Organization figures, although they represent 29% of the global population. Few ended up in intensive care and most escaped with fever, fatigue and coughing. Below 0.2% of greedy deaths were people younger than 20, according to WHO figures from September.
Basically this can change during periods when the disease flares up. It is alarming to note that Brazil’s devastating current wave is killing younger people. Pregnant women and children under 10 get sick, some of whom have different symptoms and are therefore misdiagnosed. Kirsty Short, a virologist at the University of Queensland, points out that we know a lot about other play factors, including social behaviors, or how children, in particular, respond to variants. But there are good reasons to be cautious – not least because of the rare but potentially deadly multi-system inflammatory syndrome that shares symptoms with toxic shock and Kawasaki disease, such as eczema and vomiting, and appears a few weeks after infection. We also know little about the long-term consequences of covid-19.
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Avoidable deaths and possible aftermath are reason enough to ensure shots into the arms of the world’s children, but there is more. First, figures like Anthony Fauci, President Joe Biden’s medical adviser, point out that it will be difficult to achieve levels of herd immunity – which he estimates require 70-85% of people to be vaccinated or immune – without children, who make up about a quarter of the American population. And while restrictions remain, young people suffer the most, carrying the burden of limited education, play and sport, as advances in health and nutrition go backwards. Many who have suffered such interruptions may never return to the classroom.
We are approaching the point when childhood vaccines will be available. Modern Inc., for example, began clinical trials with more than 12-year-olds in December, and said last month that the first children received a dose in a trial of its vaccine with younger children. Pfizer Inc. and partner BioNTech SE want regulators to allow use of their vaccine at 12- to 15-year-olds after a study found it was 100% effective in preventing disease during a final phase trial with that age group. We know that Israel has already vaccinated about 600 young people in at-risk groups with the BioNTech vaccine and has not seen any major side effects.
The downside is that while vaccine hesitation has a variety of causes and is spreading worldwide, parents generally have more doubts. Pew research in 2017 found that Americans overwhelmingly supported vaccine requirements against measles, mumps, and rubella for public school students, but parents of young children saw lower benefits and higher risks. So it is with covid-19. Research conducted by major U.S. universities published last month found that when it comes to coronavirus, younger mothers are especially reluctant: Roughly two-fifths are somewhat or extremely unlikely to seek vaccination for their children. Part of it, in the developed world, is the ongoing, damaging legacy of misinformation around vaccines like MMR. In the developing world, there are also competing health priorities – even when shots are available.
A treatment that requires a coordinated global effort focused on education, dissemination, and, critically, communication around the risks and rewards, especially after bloody events that have stopped shots of some vaccines. Strong safety test data will help, as many people simply have doubts, usually reasonable, and are not unconditionally opposed.
It is an opportunity to build trust, especially in communities and among parent groups that have been more vulnerable to Covid-19 but also skeptical of official statements. Success with these campaigns is spreading in such a way that there is no need for mandatory discs. Convincing families to protect themselves can now improve their willingness to receive other childhood vaccines. That’s a win, as immunization programs have been hit in much of the world due to last year’s more extensive disruptions.
The alternative to vaccinating children is to let greed stay, like measles. The highly contagious disease was officially eradicated in 2000 in the United States. But in 2019, a total of 1,282 cases were reported, most in more than a quarter of a century, thanks to people not vaccinated. It’s an unpleasant prospect.
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