Vaccination against COVID-19 — risks and benefits in children

Abstract

Countries in Europe and around the world have taken varying approaches to their policies on COVID-19 vaccination for children. The low risk of severe illness from COVID-19 means that even small risks from vaccination warrant careful consideration. Vaccination appears to result in a decreased risk of severe illness including the paediatric multi-system inflammatory syndrome known to be associated with COVID-19. These risks have already decreased significantly with the emergence of the Omicron variant and its subvariants, and due to widespread population immunity through previous infection. There is a relatively high risk of myocarditis following second doses of mRNA vaccines in adolescent males, although the general course of this condition appears mild. Conclusion: COVID-19 vaccination only provides a transient reduction in transmission. Currently, insufficient evidence exists to determine the impact of vaccination on post-acute COVID syndromes in children, which are uncommon. What is Known:• Vaccines against COVID-19 have significantly reduced morbidity and mortality around the world.• Whilst countries have universally recommended vaccines for adults and continue to recommend them for vulnerable populations, there has been more variability in recommendations for children. What is New:• In the setting of near universal existing immunity from infection, the majority of the initial benefit in protecting against severe illness has been eroded.• The risks of myocarditis following mRNA vaccination for children is low, but an important consideration given the modest benefits.

Messenger Rna Covid-19 Vaccination in Brazil: Uncertain Benefits and Risks Should Lead to Informed Choice by Health System Users, and Not to Imposition

“…With the NNH ranging between 50,000 and 900,000, it could affect the outcome of mortality due to an adverse effect between 20 and 200 children. As it is impossible to determine when one or the other will predominate in population size, the decision to make vaccination mandatory in this age group becomes reckless [14].…”

“…Another child who, after the rst dose of BNT162b2, showed signs or symptoms of a serious adverse reaction may be at risk of a worse adverse reaction when receiving the second dose of the same product. Therefore, vaccinating them would bring little or no bene t from a population point of view, since the reduction in the risk of transmission of infection by the vaccine is small and eeting [14], not justifying the use of the vaccine as a means of containing viral spread in the population. Unlike infectious diseases such as measles, whose virus does not commonly circulate in the population and for which natural immunity has been replaced by vaccine-induced immunity (which makes vaccination necessary even in low disease incidence scenarios), COVID-19 has wide circulation in the population and the available vaccines do not demonstrate the potential to interrupt the transmission chain.…”