NewsCorona vaccination in children - a risk-benefit assessment?

Corona vaccination in children – a risk-benefit assessment?

Corona vaccinations will also soon be available for children and adolescents. Experts see this as an opportunity in the fight against Corona. But you have to be absolutely sure, is emphasized again and again.

Berlin (dpa) – The pace of vaccination in Germany has recently increased significantly – and vaccination against the corona virus should soon also be very fast for the youngest people.

The European Medicines Agency (EMA) will probably decide in May on the recommendation to approve the vaccine from Biontech / Pfizer from the age of 12. So far, the vaccine has only been approved in the EU from the age of 16, and there is still no Covid-19 vaccine for younger minors.

Federal Health Minister Jens Spahn (CDU) is optimistic: The over-12-year-olds could be vaccinated as early as the summer, provided they are approved. Younger children could soon follow suit. Many experts say: This can be a big step in the fight against Corona.

Vaccinating children is important in several ways in coping with the pandemic, says Thomas Mertens, head of the Standing Vaccination Commission (Stiko). First of all, children with previous illnesses in particular could be protected – these should be vaccinated first after approval.

According to the current state of knowledge, children are dramatically less likely to be seriously ill with Covid-19, but such courses cannot be ruled out. The Berlin virologist Christian Drosten recently said in the NDR podcast “Coronavirus Update” that a corona infection may not be as harmless in children as it has been shown in public. We do not yet know what it is like when large groups of children are infected.

Because children are also involved in its circulation as possible carriers of the virus, they play a role in herd immunity, explains Stiko boss Mertens. There must also be as little virus replication as possible – because during this time, potentially dangerous mutants could arise.

Nevertheless, the Stiko warns against too much hurry: According to Mertens, before a general vaccination recommendation for children is a very precise examination of the data on safety, tolerance and effectiveness of the vaccination. Mertens emphasizes that they absolutely need their own approval, because “children are not little adults”.

The Association of Researching Drug Manufacturers (vfa) points out that a vaccine can only be approved for minors if it has also been tested with them. Manufacturers usually work their way up to younger and younger age groups with their studies, explains vfa spokesman Rolf Hömke. In adolescents, testing is easier and faster because they usually receive the same dose as adults. In the case of younger children, however, different dosages would have to be tried in some cases.

The president of the professional association of paediatricians, Thomas Fischbach, criticized the schedule of the federal and state governments in the “Rheinische Post” as “overambitious”. According to Spahn, the countries are already planning to organize the vaccinations. Admission is a prerequisite. The pediatricians would be involved. And there will be no compulsory vaccination, stressed the CDU politician several times.

The federal government promises a thorough examination of the corona vaccination for children. After the emergency approval of the vaccine from Biontech / Pfizer in the USA, in contrast, there should be regular approval in Germany, according to Spahn. For many, however, the question remains: Should children be vaccinated and thus exposed to the risk of possible side effects, even though their risk of a serious disease course is so much lower?

The fact that children could react particularly violently to a vaccination because of their particularly active immune system cannot be ruled out, says Stiko boss Mertens. “Overall, a slightly different spectrum of side effects is possible.” According to Mertens, vaccination reactions are more common in younger adults with corona vaccines than in older people. The immunological experience with other human coronaviruses is much lower in children.

The Berlin epidemiologist Timo Ulrichs is convinced that children can basically expect “very good protection for very rare side effects” after vaccination, similar to that of adults. After the vaccination, slight and temporary vaccination reactions such as a slight fever, headache and fatigue are possible even in children.

He does not believe that children could react more violently to the vaccine than young adults, for example. “And here, too, something like this is tolerable in view of avoiding the actual illness,” says Ulrichs, referring to the very rare but possible serious illnesses and long-term consequences in children. Because of the low risk in the course of an infection, a particularly safe test of the vaccines is indicated.

The Berlin pediatrician Jakob Maske also points out that adolescents and children must carefully check which dose is necessary, whether side effects can occur – and whether the vaccine induces the same immunity as in adults. “A vaccine has to be particularly safe for children,” he emphasizes. Even the slightest side effects should be ruled out.

The fact that children and adolescents react more violently to vaccinations cannot be said in general terms – often they actually tolerate them much better. “But here, too, you have to wait for the examinations, after all, an mRNA vaccine is also something new for children,” explains Maske. Rash expectations that all children will soon be vaccinated should be viewed with great caution. “The most important thing is that we have an approved, absolutely safe vaccine that also has the Stiko recommendation. Only then do we vaccinate children and adolescents. “

Mask emphasizes that the driving factor behind the vaccination of children should not be the need to establish herd immunity. “You can’t ask that of them. The children have already put so much back in order to protect the adults. They should be vaccinated in order to be protected themselves. ”The fact that a far-reaching vaccination in the age group may eventually result in herd immunity is just the positive side effect.

The debate among young people is also about the much-discussed relief for those who have been vaccinated, says Maske. Families, for example, were already thinking about what a vacation with an unvaccinated child might look like. “Here the children are already disadvantaged in terms of everyday life,” criticizes the doctor. “We are in favor of children and young people regaining their rights – also completely independent of the vaccination.”

If there is a vaccination approval for children from 12 years, the vaccination could quickly go backwards in terms of age, as vfa spokesman Hömke says. Biontech / Pfizer started a study in March with children from 6 months to under 12 years, in which different age groups are differentiated. According to the manufacturer, first results for children from 5 years of age could be available in the summer.

Other vaccine manufacturers such as Moderna have already entered clinical studies with children and adolescents, according to vfa. Hömke believes: “In the course of this year we will get into the situation where, if everything goes well, there will be approved vaccines for both young people and younger children – and several at the same time.”

© dpa-infocom, dpa: 210517-99-625985 / 2

Information from the vfa on vaccines for children

RKI on vaccinations for children

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