Considerations for vaccinating children against COVID-19
Issued Date
2023-07-24
Resource Type
eISSN
23999772
Scopus ID
2-s2.0-85166434913
Pubmed ID
37487674
Journal Title
BMJ Paediatrics Open
Volume
7
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ Paediatrics Open Vol.7 No.1 (2023)
Suggested Citation
Hart J.D., Ong D.S., Chokephaibulkit K., Ong-Lim A.T., Vereti I., Crawford N.W., Russell F. Considerations for vaccinating children against COVID-19. BMJ Paediatrics Open Vol.7 No.1 (2023). doi:10.1136/bmjpo-2023-001964 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/88291
Title
Considerations for vaccinating children against COVID-19
Other Contributor(s)
Abstract
COVID-19 vaccines have been introduced in children and adolescents in many countries. However, high levels of community transmission and infection-derived immunity make the decision to introduce COVID-19 vaccination of children in countries yet to do so particularly challenging. For example, other vaccine preventable diseases, including measles and polio, generally have far higher childhood morbidity and mortality in low-income and middle-income countries (LMICs) than COVID-19, and coverage with these vaccines has declined during the pandemic. Many countries are yet to introduce pneumococcal conjugate and rotavirus vaccines for children, which prevent common causes of childhood death, or human papillomavirus vaccine for adolescents. The Pfizer and Moderna COVID-19 vaccines that have been widely tested in children and adolescents have a positive risk-benefit profile. However, the benefit is less compared with other life-saving vaccines in this age group, particularly in LMICs and settings with widespread infection-derived immunity. The resources required for rollout may also pose a considerable challenge in LMICs. In this paper, we describe COVID-19 in children, with a focus on LMICs, and summarise the published literature on safety, efficacy and effectiveness of COVID-19 vaccination in children and adolescents. We highlight the complexity of decision-making regarding COVID-19 vaccination of children now that most of this low-risk population benefit from infection-derived immunity. We emphasise that at-risk groups should be prioritised for COVID-19 vaccination; and that if COVID-19 vaccines are introduced for children, the opportunity should be taken to improve coverage of routine childhood vaccines and preventative healthcare. Additionally, we highlight the paucity of epidemiological data in LMICs, and that for future epidemics, measures need to be taken to ensure equitable access to safe and efficacious vaccines before exposure to infection.
