“The consequences of covid in a child can remain for a lifetime” – how safe is vaccination of children and adolescents
This week, voluntary vaccination of adolescents aged 12 to 15 began – everyone, not just those at risk. The Yle news figured out why this happened right now, how safe the vaccines are for children and how the vaccination campaign has activated the opponents of vaccination.
Since Monday, all teenagers aged 12-15 years have the right to be vaccinated against the coronavirus. Previously, only children at risk for covid could be vaccinated. 12-year-old Otto Suksi from Vantaa was one of the first to receive the vaccine.
– I read in Helsingin Sanomat that vaccinations for my age group are starting. I immediately told my mother that I want to be vaccinated as soon as possible. Because if I suddenly get sick, then the illness will not be so serious, says Otto.
Otto’s mom agreed with her son’s opinion. In Finland, the decision to vaccinate was given to the children themselves, but the health worker must assess whether the child is able to make informed decisions about their health.
On Thursday, the Finnish government discussed an updated strategy to combat the coronavirus pandemic. It includes vaccinations for 80-90 percent of the population, including children over 12 years of age. But how safe are vaccines for children and is it worth spending the drug in this situation for the age group that is least susceptible to covid?
Delta changed everything
The European Medicines Agency (EMA) recommended Pfizer and Biontech’s Comirnaty vaccine for children over 12 years of age as early as 28 May. The decision was based on a placebo-controlled study in a sample of 2260 children aged 12 to 15 years. It showed that the immune response in these children was comparable to that in the 16-25 age group. Side effects were predominantly mild pain at the injection site, fatigue, headache and muscle pain, and fever. They were weak to moderate in strength and resolved within a few days after vaccination.
– Vaccine studies conducted in children and adolescents are as adequate as studies in adults. If we trust research on adults, then we must trust research on children, ”says an epidemiologist at the University of Tampere and a researcher at the European University at St. Petersburg Anton Barchuk .
On July 23, the EMA approved another RNA vaccine, Moderna’s Spikevax, for use in children over 12 years of age. The sample was one and a half times larger, but overall the study procedure and results were similar to Comirnaty.
In connection with these events, the THL Department of Health and Social Development allowed municipalities to vaccinate all residents over 12 years old from August 9th. Children can be given both vaccines, either Pfizer or Moderna. But the drug Comirnaty is now coming to Finland more, so most likely the child will get it.
Why did they get to the children right now? According to Anton Barchuk, this is due to the phased research of vaccines in different age groups, and to the emergence of the delta variant of the coronavirus.
– How clinical trials on covid vaccines are planned is related to the need for vaccines in specific age groups. Until there was a delta option, there was no need to vaccinate children, as there was a low risk of infection and severe consequences in children. Now, during the fourth wave in Finland, young people, adolescents and children are more likely to take positive tests, the epidemiologist explains.
With the advent and spread of the delta variant, the young really began to dominate the infection rate. Over the past two weeks, most cases have been identified in the age group 20-29 years old – almost three thousand. In second place are those in their thirties – about two thousand, in third place are children and adolescents from 10 to 19 years old – more than 1800 cases. Among residents over 70 years old, of which almost 90 percent were vaccinated with two doses, only a few dozen cases of coronavirus infection were recorded.
– Globally speaking, covid is, of course, a disease of the elderly. And the greatest damage is among the elderly, the greatest mortality is among the elderly. And nevertheless, now there is more and more evidence that some children may have, in particular, long-term consequences – the so-called post-covid. Such cases, most likely, will be few, but the more children get sick, the more in absolute figures the number of such cases will be.
This does not mean that the vaccine is free of any serious side effects. In the US, Pfizer has been approved for use in children 12 years of age and older since mid-May and has much more statistics on adverse effects. In 30 out of 10 thousand boys and young people, cases of myocarditis, that is, inflammation of the heart muscle, were identified. In the age group from 18 to 24, there were 4-5 such cases among women and 45-56 among men. Moreover, most cases passed after standard treatment or even just observation.
Globally speaking, covid is, of course, a disease of the elderly. And nevertheless, now there is more and more evidence that some children may have, in particular, long-term consequences – the so-called post-covid.
– Anton Barchuk
– Vaccination is always a balance of possible risks and possible benefits. It is imperative to be aware of this, it is imperative to communicate and it is necessary to weigh this balance of benefits and harms. Previously, the vaccination of children did not start, including because the risks from the disease were quite small, and when compared with the risk of side effects, the balance was … relative … Now more and more children get sick, and the balance is shifting in favor of vaccination, explains Anton Barchuk.
Research is currently underway on age groups under 12. At the same time, says the epidemiologist, it may happen that vaccination recommendations for younger children will not be issued.
– We may never reach the youngest age group, for example, for fear of some then long term adverse events. But the age from 12 to 17, it seems to me, is such when the risk of side effects is small, but the risk of getting sick is still there.
THL honestly warns of possible myocarditis in children and adolescents. And the choice in Finland is given to them. Vaccination remains free and voluntary for everyone.
Measure of maturity
Children are told about side effects by a medical officer. If the child has questions, the health worker should answer them. After that, if the child agrees, and the health worker believes that his decision was deliberate, the child is given a paper to sign that he is familiar with the possible symptoms after vaccination. independent decisions, so each case will be considered separately. According to the head physician of the THL Health and Social Development Department, Hanna Nohinek , children develop in different ways, and age is not always a measure of maturity.
– It always depends on how mature the child is and whether he understands what the issue is and whether he wants to make a decision on his own, explains Nohinek.
Nohinek says that very rarely a child wants to make a decision about his health without the participation of his parents: as a rule, this is a general decision the child and his parents or other guardians. If parents want a vaccine for a child, but he does not want, then health workers will try to come to a common denominator with all parties.
Anton Barchuk believes that in addition to warning about possible side effects from vaccines, it is imperative to remind of possible complications diseases. According to THL, from the start of the pandemic until June of this year, 0.2% of patients aged 10 to 19 years needed the help of specialized medical institutions due to coronavirus infection, and five even ended up in intensive care units.
– Vaccination is generally a fairly effective way to prevent not only covid, but many infectious diseases. Many vaccines are used in the first years of life in children. Therefore, it is logical, if we have at least some risk of illness in children, to use vaccination – the primary prevention of high efficiency. And if children have any consequences of covid, they can remain for life. That is, the quality of human life will be markedly reduced for many years.
If children have any consequences of covid, they can last a lifetime. That is, the quality of human life will be markedly reduced for many years.
– Anton Barchuk
In addition, children should be open about the effectiveness of vaccines. With the advent of the delta mutation, it decreased. The latest results show that Pfizer-Biontech is 76 percent effective in preventing infection and 85 percent effective in preventing hospitalization. For Moderna, these numbers are 86 and 92 percent. Against the delta variant , the efficiency of by Pfizer is 64 percent, while Moderna is 76.
Anton Barchuk urges not to be afraid of these numbers. According to him, earlier vaccines were aimed at preventing the spread of infection – now they are less likely to reduce the risk of getting sick, and to a greater extent reduce the risk of severe illness and hospitalization.
For being honest with children. talk about the efficacy and risks of vaccines, spoke last week by ombudsman for children Elina Pekkarinen. She said that no child should make the decision to get vaccinated under pressure because it is about their own health. Pekkarinen also recalled that the fact of vaccination refers to personal information that can not be disclosed to other people.
the juvenile campaign launched a new wave of the anti-vaccine movement. Several doctors from different parts of Finland formed the Pelastetaan lapset (Save the Children) group, which made an appeal against vaccination of children. According to Mika Ryamet, head of the University of Tampere Vaccine Research Center , these doctors deliberately make false or misleading arguments, such as that WHO has not approved the use of covid vaccines in children – although this is not the case.
The appeal was signed by two doctors working for the city of Helsinki. The administration said that the capital treats vaccination positively, but does not have the right to limit the freedom of opinion and speech of its employees as individuals. At the same time, the Save the Children group was sharply denied by a non-profit organization for the protection of children, which has a similar name – Save the Children (Pelastakaa lapset ry).
There were other examples. In Riihimäki this week, two unidentified men walked around schools trying to convince high school students about the dangers of vaccines. In Satakunta, a schoolteacher sent a link to an anti-vaccination website in Wilma to parents and guardians of children.
Anti-vaccination sentiments are also strong among Russian-speaking Finland. Anton Barchuk says this may be a reflection of the extremely low vaccine acceptance rate among the Russian population. Recently, a study was published in the British scientific journal Nature that showed that confidence in vaccines against COVID-19 in Russia is a record low at the world level – about 30 percent.
This is a unique indicator not only in comparison with the countries of the Western world (in USA almost 65 percent), but also with developing countries in Africa, Asia and South America. The main reasons why they do not want to be vaccinated against coronavirus, the Russians called the fear of side effects, the fear of contracting a coronavirus infection through the vaccine and disbelief in the effectiveness of vaccinations against covid.
Surveys in Finland have shown that around 87 percent of the population is supportive of coronavirus vaccination. Approximately 80 percent of the respondents said that the benefits of vaccinations outweigh the possible side effects. So in Finland, anti-vaccination remains a marginal phenomenon.
Anton Barchuk is by no means opposed to vaccination of minors, but believes that vaccinations for children should not be the main goal of governments at this stage.
– I am sure that now in those countries where vaccination coverage is not yet very large, for example, in Russia, priority should be given to reaching risk groups – people over fifty years old. Finland has more or less coped with this, but still only about half of residents aged 50 and over received both vaccine components.