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Friday, January 28, 2022

Explained: As Indian teens await Covid jabs protocol, here’s the experience elsewhere

General guidelines from the WHO underline benefits; US regulatory recommendations flag no unusual or specific risks

By: Explained Desk | New Delhi |
Updated: December 27, 2021 6:33:36 pm
orona Vaccine for Kids in India, COVID-19 Vaccine for KidsA teenager receives a Pfizer COVID-19 vaccine at a vaccination center, in Anglet, southwestern France, Thursday, Dec.23, 2021. Vaccinations of children age 5 to 11 with medical conditions started earlier this month in France, and the government expects to expand that to all children in this age group. (AP Photo/Bob Edme)

Coronavirus Vaccine Registration for kids on CoWIN App: Vaccination for children ages 15-18 will start from January 3. Dr R S Sharma, chief of CoWIN, was quoted as saying on Monday (December 27) that potential recipients will be able to register on the platform from January 1.

The process of registration will be the same as the one followed for adult recipients, and children will be able to use their student ID cards in case they do not have Aadhaar or any other identity cards, Dr Sharma told ANI.

While the Ministry of Health is yet to come out with detailed guidelines with regard to the modalities for the vaccination of children, the protocol followed in the United States provides some indication of what to expect and look out for.

The US FDA authorised Covid-19 shots for children ages 5 and older in November.

Will children get a dose different from the one given to adults?

Two vaccines available in India have been granted regulatory approval for emergency use in children ages 12-18 years: Bharat Biotech’s Covaxin, and Zydus Cadila’s three-dose DNA vaccine, ZyCoV-D. For now, it appears that Covaxin will be the primary vaccine for use in children.

The US authorised Pfizer-BioNTech’s mRNA vaccine for children ages 12-17 years at a dose identical to that of adults: two 30-microgramme shots, administered three weeks apart.

Children in America ages 5-11 are receiving a third of this dose, with the use of needles that are smaller. This young demographic has not been cleared for receiving a Covid-19 jab in India yet.

What kind of side effects of the vaccine can children have?

This is one of the key questions on which the Ministry’s advice is awaited. Many adults reported adverse events following immunisation (AEFI) including mild fever, headaches, and pain or swelling at the site of the injection, and the vaccination protocol included a direction to recipients to wait at the vaccination centre for 30 minutes to watch for stronger possible side effects.

Studies of 12- to 15-year-olds considered by the US FDA showed a slightly higher incidence of fevers in children compared to adults. But in general, children in the studies reported vaccination side effects similar to those seen in adults — most commonly pain at the site of the jab, tiredness, headache, chills, fever and joint pain.

These side effects typically lasted between one and three days, the FDA said. The regulator cautioned against administering the vaccine to children with a history of severe allergic reaction to any ingredient in the vaccine.

How vulnerable are children to Covid-19 disease?

Studies as well as anecdotal evidence from two years of the pandemic show children are in general less vulnerable than adults. In an interim statement on Covid-19 vaccination for children and adolescents, the World Health Organization (WHO) said on November 24 that there are proportionally fewer symptomatic infections, and cases with severe disease and deaths in children and adolescents compared with older age groups overall.

“Age-disaggregated cases reported to WHO from 30 December 2019 to 25 October 2021 show that children under five years of age represent 2% of reported global cases and 0.1% of reported global deaths.

“Older children and younger adolescents (5 to 14 years) account for 7% of reported global cases and 0.1% of reported global deaths, while older adolescents and young adults (15 to 24 years) represent 15% of reported global cases and 0.4% of reported global deaths.

“Deaths for all ages less than 25 years represented less than 0.5% of reported global deaths,” the WHO said.

Also, children and adolescents usually demonstrate fewer and milder symptoms of SARS-CoV-2 infection compared to adults, and are less likely than adults to experience severe Covid-19, the statement said.

What is the role of children and adolescents in transmission of the virus?

Multiple population-based seroprevalence and viral shedding studies seeking to investigate whether children and adolescents are infected at the same rate as adults, have produced mixed results, the WHO said.

The statement referred to a serosurvey done in India during June-July 2021 after the second wave, which showed that seropositivity in children ages 6-18 was similar to that in older age groups — except in those older than 60 years, in whom the immunization rate was high.

“Overall, it appeared that whether schools were open or closed, infection rates in children and adults were similar. Thus, it appears that children of all ages can become infected and can spread the virus to others,” the WHO statement said.

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So what is the WHO’s advice on vaccinating adolescents and children?

“Vaccines which have received authorization by stringent regulatory authorities for the age indication of children and adolescents are safe and effective in reducing disease burden in these age groups,” WHO said in its statement.

It said that vaccinating children and adolescents may also help advance other highly valued societal goals, such as maintaining education for all school-aged children. “School attendance is critical to the well-being and life prospects of children and to parental participation in the economy. Vaccinating school-aged children may help minimize school disruptions by reducing the number of infections at school and the number of children required to miss school because of quarantine requirements,” the statement said.

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