While Germany is still discussing corona vaccinations for children, millions of 12 to 15-year-olds have already been vaccinated in the USA and Canada. Behind this is a clear strategy and the fear that the coronavirus could become increasingly dangerous for children in more and more immunized adults.
In the USA and Canada, younger children have been vaccinated with Biontech since the beginning of May, after the US drug authority FDA and the health authority Health Canada approved its use for 12 to 15 year olds in early May. In the meantime, the European Medicines Agency (EMA) has followed suit. Nevertheless, vaccinated children are still a rarity in Germany, mainly because of the continuing shortage of vaccines, but also because it is not clear whether vaccination is recommended for children.
In the USA it looks different. More than two million 12 to 15 year olds have already received the first dose, according to the US Center for Disease Control and Prevention. it still involves the 16- to 18-year-olds with one, the number is as high as nearly 5.8 million Erstgeimpften. In Canada, almost 200,000 people in the 0 to 17 age group had been vaccinated once as of May 22nd. That comes from Canadian government information.
In their justifications for the emergency approvals, all authorities rely on the study that Biontech / Pfizer had carried out on the efficacy and tolerability in this age group. According to this, 2,260 people between the ages of 12 and 15 years had participated in the clinical study in the USA. 1131 young participants received the vaccine and 1129 a salt placebo. More than half of the participants were followed for at least two months after the second dose. None of the children who had received the vaccine contracted Covid-19, while 16 adolescents in the placebo group had symptoms of the disease.
Laboratory tests also showed that the vaccination produced a stable immune response. According to the scientists working with Robert Frenck from the Cincinnati Children’s Hospital, it was even better than in the group of adolescents and young adults between 16 and 25 years of age. After the vaccination, there were at most slight vaccination reactions such as pain at the injection site, fatigue or headaches, the scientists wrote in the “New England Journal of Medicine”. The complaints, which were more frequently after the second dose than after the first, but had disappeared usually within a few days. More severe unwanted effects such as thrombosis or anaphylactic shock had not occurred. are so far even with the now millions of vaccinations of teenagers not yet been reported from the United States from Canada Impfvorfälle.
Study place with all the trimmings
After approval, US President Joe Biden had expressly called for this age group to be vaccinated. “I encourage parents to make sure they get the vaccination,” said Biden. Even in this age group could be infected with the coronavirus and connect friends, siblings, parents and grandparents. Experts like doctor Kavita Patel, who was Health Policy Director in the Obama administration, never tire of praising vaccinating children as the next step in the fight against pandemics. There is great concern that the coronavirus is still a long way from being defeated.
The vaccination incentives in the USA are therefore now targeted specifically at younger people. In the state of New York, for example, 50 free places will be raffled off among all 12 to 17 year-olds who have received at least one dose of vaccine and are registered by their parents. According to Governor Andrew Cuomo, the total package of a study place at one of the public universities in New York State, including tuition fees, books and other necessary materials, as well as room and meals, is worth tens of thousands of dollars each.
Both in the US and Canada, public health authorities advertise specifically for the vaccination of older children. The CDC states that the vaccine could protect children against infection and also prevent transmission to others. “You can also help prevent your child from getting seriously ill, even if they get Covid-19. Help protect your whole family by vaccinating yourself and your children from the age of 12 against Covid-19.”
Contribution to herd immunity
Canada and the USA are pursuing a double strategy with regard to vaccinations: on the one hand, children should be protected from serious illnesses. While children rarely develop severe forms of Covid-19, deaths from the disease are even rarer. But in around 1 in 1,000 cases, children who have mild infections can develop multisystem inflammatory syndrome (MIS-C), a disease that can also be fatal. There are also chronic diseases in children that make a more severe course of Covid-19 more likely. These include heart disease, but also trisomy 21. This is where the protection of vulnerable groups comes into play, which could certainly also be transferred to Germany. At the same time, children should also protect family members from being infected with their vaccination protection. Immunizing children is seen as an indispensable part of a strategy to achieve herd immunity.
However, there is also the fear that in the case of an increasing number of vaccinated adults, the infection process could increasingly shift to the as yet unvaccinated children. Especially the Berlin Virologist Christian Drosten showed in a study that all age groups had roughly equal numbers of viral genome copies. Accordingly, children between 0 and 5 years had the lowest viral loads; in older children and adolescents, the values became more similar to those of adults with increasing age. This could also affect the progress of vaccination in Germany after the summer and make the vaccination for children attractive.
In the meantime, Moderna’s vaccine is also about to be approved for adolescents, after a study shows that the vaccine also reliably protects children and adolescents from Covid-19 disease. The vaccine was also safe and well tolerated will of children and adolescents, the US company announced in late May. Applications should be made the world not only with the US Food and Drug Administration, but by authorities for this age group.
Younger children in view
Vaccine manufacturers are slowly working their way into the younger and younger age groups. Studies have long been in progress and applications are in preparation. A study with 5- to 11-year-olds is already running at Biontech / Pfizer. A study with under 5-year-olds is also to be started this year. Moderna is already investigating the effectiveness and tolerability of its vaccine in a clinical study called KidCove in around 6,750 children between the ages of 6 months and 11 years. At least 3,000 children between the ages of 12 and 17 should be included. The Astrazeneca vaccine is already being tested on 300 UK children aged 6-17. Johnson & Johnson has indeed been no results yet known, but tests by its own account since August 2020 subjects aged 12 years. The Chinese manufacturer Sinovac Biotech also is testing his product to children aged 3 to 17 years, but has no results.
Even more than in teenagers it’s still in the younger age group is to find the right dosage. For other vaccines, a different composition or different vaccination intervals had to be found. The experts agree that smaller children’s immune system reacts differently to the vaccines than that of adolescents or adults. Whether these vaccines are eventually released only for those at risk, or all, will surely also depend on the further course of the pandemic.
In any case, the example of the USA and Canada now seems to be setting a precedent worldwide. Romania started vaccinating children over the age of twelve with Biontech on Saturday. The official approval from Brussels was not yet available, it only took place on Monday. In Singapore, the first 12-year-olds should be vaccinated from Thursday.