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By Elia Abi-Jaoude, Peter Doshi and Claudina Michal-Teitelbaum
As most adults in many affluent countries now receive at least one dose of a single COVID-19 vaccine, the focus is on children.
While there is a widespread recognition of the risk in children being severe COVID-19 is UNDER, many believed in that mass vaccination of children could not only protect children from severe COVID-19, but also prevent further transmission, indirectly protect vulnerable adults and help end the pandemic.
However, there are several hypotheses that need to be examined in judging calls to vaccinate children against COVID-19.
First, children’s pain is usually mild, and severe sequelae remain rare. Despite the “high COVID” recently getting more attention, that has been shown in two large studies of children. chronic symptoms are uncommon and generally similar or milder in children who tested positive for SARS-CoV-2 compared with those with symptoms from other respiratory viruses. The U.S. Centers for Disease Control and Prevention (CDC) estimates that the fatality rate ranges from COVID-19 among children 0 to 17 years of age. 20 per 1,000,000.
The hospitalization fee as well very low, and probably already exaggerated. In addition, many parts of children are infected with SARS-CoV-2. The CDC estimated 42% on US children ages 5 to 17 years set for March 2021.
In clinical trials undergoing approval Pfizer-BioNTechVaccine mRNA in children aged 12 to 15, of nearly 1000 children who received placebo, 16 were positive for COVID-19, compared with none in the fully vaccinated group.
Due to this small incident, the fact that COVID-19 is usually asymptomatic or mild in children, and the high rate of adverse events of those vaccinated (e.g. in the Pfizer trial 12-15 years of age, 3 in 4 children were tired and had a headache, almost half had colds and muscle aches, and about 1 in 4 to 5 had a fever and joint pain), a comparison of The adjusted quality life years in the trial preferred the placebo group.
The potential benefits from the vaccine, including protecting children against severe COVID-19 or high COVID, or COVID-19 months in the future, may affect this balance, but such benefits do not. show to test and remain hypothetical.
Even if one considers protection against severe COVID-19, due to the shortest incidence in children, a much higher number will need to be vaccinated to prevent a severe case. Meanwhile, many children at very low risk for serious illness are put at risk from the vaccine, both known and undetected.
To date, Pfizer’s mRNA vaccine has been ruled out by the Israeli government as possibly associated with symptoms. myocarditis, with an estimated incident in between 1 in 3000 to 1 in 6000 of men aged 16 to 24. In addition, the long-term effects of gene-based vaccines, involving new vaccine platforms, remain unknown.
In terms of the risk of transmitting SARS-CoV-2 from children to adults, it is also short-lived and reduced, even if left untreated. School teachers are more likely to get SARS-CoV-2 from other adults than they are from their students. The contribution of schools to community transmission has already been made consistently low across jurisdictions.
In addition, estimates are considered that 42% of those aged 5 to 17 years in the U.S. now post-COVID, only need to reduce the risk of transmission from children. Add to this the fact that the majority of adults in rich countries have received at least one dose of COVID -19 vaccine – around 80% of adults in the UK now have SARS-CoV-2 antibodies, whether from past infection or from vaccination – and there seem to be diminishing opportunities for children to become vectors of transmission into adults.
Given all of these considerations, the statement that vaccinating children against SARS-CoV-2 will protect adults remains hypocritical. Even if we assume that this protection is available, the number of children who need to be vaccinated to protect only one adult from severe COVID -19 – when considering the short shipping fees, the high proportion of children who are post- The COVID, and most adults who are vaccinated or post-COVID- are much higher. Moreover, this number may compare poorly to the number of children who are injured, including rare severe events.
A separate, but important question is behavior. Should society consider vaccinating children, putting them at any risk, not for the purpose of benefiting them but to protect adults? We believe the task is up to adults to protect themselves.
In many jurisdictions around the world, most adults, including those with at-risk conditions, have not been vaccinated against COVID-19. If the goal is to protect adults, shouldn’t efforts be focused on ensuring that adults are fully vaccinated rather than targeting children? In addition, it would never make sense to vaccinate the lowest -risk children in rich countries while many vulnerable adults in low -income countries do not get doses.
There is no need to rush to vaccinate children against COVID-19-the vast majority are less beneficial, and it is ethical to follow a presumptive adult protection while exposing children to harm, knowingly and unknowingly. to know. the risk / benefit considerations may be different in children who have a higher risk of serious illness, such as those who are obese or immunocompromised.
Otherwise, the focus should be on ensuring safe and effective vaccines are available for adult populations that are more vulnerable to benefit, especially those at high risk. In the meantime, there should be an ongoing active assessment of the risks of young people, including research on risk factors for severe COVID-19 and the impact of new strains, as well as ongoing evaluation of vaccine effectiveness and safety. There should also be ongoing evaluation of protection provided by infection -induced infection in relation to vaccine-induced resistance, especially in adolescence.
Originally published on The BMJ July 13, 2021, wrote:
Elia Abi-Jaoude, Department of Psychiatry, University of Toronto, ON, Canada
Peter Doshi, Department of Pharmacy Health Services Research, University of Maryland School of Pharmacy, Baltimore
Claudina Michal-Teitelbaum, Preventive Medicine, Independent Researcher, Lyon, France
Made herein under the license terms of CC BY NC.
Competing interests: Peter Doshi received travel funding from the European Respiratory Society (2012) and Uppsala Monitoring Center (2018); grants from the FDA (via University of Maryland M-CERSI; 2020), Laura and John Arnold Foundation (2017-22), American Association of Colleges of Pharmacy (2015), Patient-Centered Outcome Research Institute (2014-16) , Cochrane Approaches to Changing Approaches (2016-18) and UK National Institute for Health Research (2011-14); an unpaid member of the IMEDS management committee of the Reagan-Udall Foundation for the FDA (2016-20) and an editor of The BMJ. Elijah Abi-Jaoude and Claudina Michal-Teitelbaum had no related financial interest disputes to declare.
Acknowledgments: The authors thank Jennie Lavine for her comments regarding this article.
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The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of Children’s Health Defense.