Children & Young People Covid - 19 Vaccinations

News - 3 August 2022

Children and young people who are eligible for a Covid -19 vaccine should take up the offer to gain the best possible protection.

Vaccinating children and young people helps protect them from Covid-19 and reduces disruption to education, which is good for their welfare and mental health.

While Covid-19 is usually mild in most young people, it can be very unpleasantfor some, and a Covid-19 vaccine provides the best protection against severe illness and hospitalisation.

If you catch the virus, there’s also a chance you might get ‘Long Covid’, which can have serious and debilitating long-term effects.

The vaccine has been given to millions of children and young people in countries around the world, data from these countries shows that the vaccine is safe and effective

Is the vaccine safe for children? What about myocarditis risks?

The Medicines and Healthcare products Regulatory Agency (MHRA) has confirmed the Pfizer/BioNTech vaccine is safe and effective for five- to 17-yearolds and the Moderna vaccine is approved for use in six- to 17-year-olds. This followed rigorous reviews of the safety, quality and effectiveness of the vaccines for these age groups.

When formulating advice in relation to childhood immunisations, the JCVI has consistently held that the main focus of its considerations should be the potential benefits and harms of vaccination to children and young people themselves.

At the current time, JCVI advice is that the balance of potential benefits and harms is in favour of offering vaccination to children and young people. • Myocarditis risk is higher in children that have been infected with Covid-19, than it is in those who have been vaccinated (instances in both are very rare).

Serious adverse events following vaccination are extremely rare in children aged 5-11.

International data from adult programmes suggest that a longer interval between doses (greater than the 3 to 4-week schedule widely used in the US) is associated with a lower reporting rate of myocarditis following vaccination. This association is expected to also apply to the paediatric dose and formulation when used in children.

Vaccinating young people helps reduce the need for them to have time-off school and reduces disruption to their education, which is good for their welfare and mental health.

What assessment has the JCVI made of reports of myocarditis as an adverse event following vaccination with mRNA vaccines in younger people?

Worldwide, there have been rare cases of inflammation of the heart called myocarditis or pericarditis reported after mRNA Covid-19 vaccines. Most of these people felt better following rest and simple treatments.

The available data indicates that the clinical manifestations of myocarditis following vaccination are typically self-limiting and resolve within a short time. There is some data to suggest that a longer interval (more than 8 weeks) between first and second doses, as used in the UK, is associated with a lower myocarditis reporting rate following the second vaccine dose.

For those under the age of 18, who are not in a high-risk group, a 12-week interval is preferred. This is based on precautionary advice from the JCVI based on emerging evidence of a lower rate of myocarditis in countries that use schedules of 8 to 12 weeks. The intervals may be shortened to eight weeks in periods of high incidence or where there is concern about vaccine effectiveness (for example a new variant).

What extra monitoring has the MHRA put in place to monitor side effects in children and young people?

MHRA has put in place a safety surveillance strategy for monitoring the safety of all UK-approved Covid-19 vaccines. This safety surveillance includes agespecific monitoring of potential safety concerns.

Any information indicating a possible new safety concern in this age group, will be thoroughly evaluated, including review by the independent expert working group for Covid-19, and updated advice for healthcare professionals and patients would be issued where appropriate.

In addition to requesting reporting of any side effects experienced via the scheme, we are encouraging all parents, guardians and carers to register for Yellow Card Vaccine Monitor prior to their child’s vaccination. We will then follow up with registered individuals at specified intervals, post vaccination, for relevant information.

If a young person has allergies, can they have the vaccination?

There are very few young people who cannot receive the vaccine.

Prior to vaccination all individuals are issued with a leaflet that outlines safety information about the vaccine. This will include a link to more detailed information about any health conditions that may prevent a young person from receiving vaccination. You can read the Information for UK recipients for more information. All young people and their parents or carers should consult their clinician if they have concerns regarding allergies and Covid-19 vaccination.

Why has JCVI now advised offering vaccination to all children aged five to eleven?

The intention of this offer is to increase the immunity of vaccinated children against severe COVID-19 in advance of a potential future wave of COVID-19.

Vaccination of children aged five to eleven years who are not in a clinical risk group is not expected to have an impact on the current wave of Omicron infection. The potential benefits from vaccination will apply mainly to any future wave of infection - the more severe a future wave, the greater the likely benefits from vaccination.

If it is estimated that 85% the cohort of children aged five to eleven years have been previously infected with COVID-19, could be argued that there is no need for vaccination given they do not get severe infection and have some natural immunity?

JCVI carefully considered the benefits and risks of COVID-19 vaccination in this population, especially given the very high levels of prior infection.

Overall the Committee agreed that there remained a marginal benefit and a future potential benefit, even though there were high levels of prior infection.

Can you explain what is different about a paediatric COVID-19 vaccine?

A new paediatric formulation of the Pfizer BioNTech COVID-19 vaccine has been approved for use in the UK for children aged five to eleven years by the MHRA after meeting the required safety, quality and effectiveness standards. The formulation is specially designed for children aged five to eleven and is at a lower dose compared to that used in individuals aged 12 and above (10 micrograms compared with 30 micrograms).

Several countries are already using the new formulation in children aged five to eleven, including the US, Israel and Canada.

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