Vaccination is not mandatory in Australia for the general population and parents are currently faced with the challenging task of making the decision on whether or not to vaccinate their children. Making decisions on behalf of our children is a significant responsibility and most parents wish to make these decisions based on what will provide the best outcomes for their children.
With the option to vaccinate 5–11-year-olds now available, The Echo took the time to talk to local Byron Shire Dr Joel Hissink about vaccinating children.
According to the Australian Technical Advisory Group on Immunisation (ATAGI): ‘Most children with SARS-CoV-2 infection are asymptomatic or experience a mild illness. Those who are symptomatic typically have a short illness with a median duration of five days’, so why vaccinate?
The primary aim of vaccination is to give the body an opportunity to develop strategies to respond quickly and effectively to the COVID virus, in advance of getting infected.
‘Children receive a third of an adult dose of the vaccine,’ Dr Hissink told The Echo.
‘This produces equivalent immune cover to adults while reducing the incidence of mild and short-lived side-effects such as fever, muscle aches, headaches, and fatigue. As is the case for adults, these mild symptoms are a result of the body mounting an immune response to the vaccine.
‘Evidence-based, peer-reviewed and published data from the US Phase II/III trials of Pfizer for 5–11-year-olds showed that adverse events were mild and transient with 6.5 per cent of children experiencing mild symptoms such as fever, headache, fatigue, and muscle aches after dose two.’
Adverse events
There is significant commentary in the community around the impact of adverse events from vaccination but the real question is: Is the risk of taking the vaccine more dangerous than catching the COVID virus when unvaccinated?
Australian data reveal that the overall reported rate of myocarditis and/or pericarditis following Pfizer COVID-19 vaccine (adult dose being three times the children’s dose) for males aged 12–17 was 6.8 per 100,000 doses while in females it was 1.4 per 100,000.
‘Early signs out of the US, where more than five million doses have been given to 5–11-year-olds, suggest that the incidence of myocarditis and/or pericarditis following the Pfizer vaccine is even less in this age group. Probably in part because of the lower dose as well as the increased gap between doses being eight weeks instead of three weeks.’
‘It is true that a much smaller percentage of children get severe COVID disease compared with adolescents and adults so there is a view that we should be holding out until they are older,’ said Dr Hissink.
‘Of course this would make sense if the vaccine caused frequent and severe side effects in children but the data do not demonstrate this. The data demonstrate that the overall health burden on children is greater in an unvaccinated paediatric population compared with a vaccinated paediatric population.
‘Paediatric Multisystem Inflammatory Syndrome temporally associated with SARS-CoV-2 (PMIS-TS), also referred to as Multisystem Inflammatory Syndrome in Children (MIS-C) has an estimated incidence of one in 3,200 paediatric COVID cases. Severity can be mild to life-threatening and usually requires hospitalisation. Studies from the US and France in 12–18-year-olds demonstrated that the incidence of this complication of COVID-19 is significantly reduced in those vaccinated. The US study showed a 91 per cent reduced likelihood of MIS-C. While similar studies in the 5–11-year-old age groups are pending these results are certainly encouraging.’
Dr Hissink also said that there is increasing evidence that those who are vaccinated have a reduced risk of long COVID. Long COVID is when the symptoms of COVID continue for more than four weeks and often persists for months.
‘The UK’s Office for National Statistics published data in April 2021 that demonstrated 9.8 per cent of unvaccinated 2–11-year-olds continued to have symptoms five weeks after contracting COVID-19. At 12 weeks post-infection 7.4 per cent of unvaccinated 2–11-year-olds still had symptoms. As is the case in adults and adolescents, it is expected that vaccination will similarly reduce the incidence of long COVID in children,’ said Dr Hissink.
‘A small study conducted in Rome and published in the international peer-reviewed journal Acta Paediatrica (Nurturing the Child) in April 2021 also found that one-third of children 6–16 years old reported symptoms at four months, most commonly insomnia, fatigue, muscle pains, and persistent cold-like symptoms. These are typical symptoms reported by adults with long COVID.’
Transmission reduction
School is due to go back next week and the virus has been raging through the community with infections and deaths at unprecedented levels in Australia.
‘The vaccination of 5–11-year-olds is also likely to reduce transmission rates of SARS-Cov2 within schools and beyond into homes and the wider community,’ Dr Hissink explained.
‘While we often hear that the reduction in transmission of SARS-Cov2 following vaccination is low, even a 50–60 per cent reduction in transmission would have a significant effect on the burden of disease in our community. While we are yet to see Australian data on the impact of transmission within primary schools, there is good evidence that transmission of COVID from healthcare settings to the home by healthcare workers is significantly reduced when the healthcare worker is vaccinated.
‘Evidence also suggests that the current vaccines offer broader immunity against COVID variants while the limited immunity one develops following infection with Omicron in the absence of vaccination offers only very little immunity to Delta and possibly future variants,’ he said.
‘Of course vaccination is only one strategy to minimise the burden of COVID-19 on our community. Another public health measure that has been highlighted by experts and should be of a similar priority to government and business is improved indoor air quality, particularly in our schools.’
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