While older, unhealthy people are at greatest risk of contracting a severe case of Covid-19 and possibly dying of it, vaccines for children and adolescents, who tend to have milder symptoms if infected and are more often asymptomatic, are being authorized around the world.
In November 2021, the European Medicines Agency (EMA) approved the use of Pfizer-BioNTech’s Covid-19 vaccine for children between the ages of 5 and 11.
Parents may be wondering whether to have their young children vaccinated, particularly considering the spread of more contagious variants of the coronavirus such as Delta and Omicron. So we’ve answered some questions about a Covid-19 vaccination for this age group.
What can be said for vaccinating children aged 5 to 11?
The seven-day average of new confirmed cases of Covid-19 in Germany is now especially high among children, says Germany’s Federal Ministry of Health (BMG). Other countries likely face a similar situation.
The BMG expects that a large number of unvaccinated children will become infected in the medium term. On the other hand, most infected children are asymptomatic, and the risk of severe disease in children without pre-existing medical conditions is very small.
During the entire course of the pandemic so far, not a single child in this age group in Germany has died of Covid-19, according to a recent statement by Thomas Mertens, chairman of the Standing Committee on Vaccination (STIKO) at the Robert Koch Institute (RKI), responsible for disease control and prevention in Germany.
Many experts argue that vaccination against Covid-19 also reduces the risk of its long-term effects, variously called “long Covid” or post-Covid conditions, as well as Paediatric Inflammatory Multisystem Syndrome (PIMS), an uncommon but potentially serious illness that can occur after a Covid-19 infection.
To date, however, the STIKO has advocated vaccinating only 5- to 11-year-olds with certain pre-existing conditions, including obesity, certain chronic lung disorders, tumour diseases and Down’s syndrome.
Vaccination is also recommended for children who have contact with people at increased risk of severe Covid-19, such as the extreme elderly or immunodeficient.
While the STIKO hasn’t recommended that all 5- to 11-year-olds be vaccinated, it says all children in this age group can be vaccinated if they and their parents so wish and have been informed of the possible risks by a doctor.
What are the possible side effects?
The benefits of a vaccine should outweigh its risks, of course. A vaccine should protect against (severe) disease and its possible long-term effects, and also reduce the chance of infecting people in a high-risk group.
One reason the STIKO cites for not recommending that all 5- to 11-year-olds be vaccinated is that the risk of rare side effects can’t be assessed at the present time “due to the limited data available.” It could issue such a recommendation in the future.
In the United States, more than 5 million children between the ages of 5 and 11 have received at least one dose of the Pfizer-BioNTech vaccine for children, and more than 1.5 million the second dose as well. There have been no reports of serious side effects so far. The same goes for Israel and Canada, where tens of thousands of children have received at least one injection.
Before the EMA approved the Pfizer-BioNTech vaccine for this age group, it concluded that its benefits outweighed the risks, particularly for children with conditions that increase the risk of severe Covid-19.
The BMG says there have been no known serious side effects to date, and that the most common reactions in the pre-approval study included pain at the injection site, headache and tiredness. Fever, diarrhoea, and muscle and joint pain occurred as well. The effects were usually mild or moderate and lasted just a day or two.
How is the vaccine for 5- to 11-year olds different?
The dose is lower than that used in people aged 12 and above (10 micrograms compared with 30). As in the older age group, it is given as two injections three to six weeks apart.
What post-vaccination recommendations are there?
Paediatrician Dr Jakob Maske, spokesman for the Cologne-based Professional Association of Paediatricians (BVKJ), discourages intensive sport activities for a week after the vaccination. His rationale: 12- to 17-year-olds are given this advice because data show that in rare cases they can develop myocarditis, or inflammation of the heart muscle, which can be very dangerous during such activities.
Although similar data on 5- to 11-year-olds aren’t yet available, says Maske, “I’d nevertheless recommend it as a precautionary measure.” He adds that children in this age group should also be careful during normal team games at school. Activities such as riding a bicycle to school are no problem, though.