The case for and against vaccinating children
Two epidemiologists and three GPs are arguing that NZ should delay a decision on extending the Pfizer vaccine to 5 to 11 year olds. I’m not convinced by their overall conclusions, but there are some points they raise worth debating. I will be getting my five year old vaccinated, if Medsafe approves it. I trust the health experts at the FDA and Medsafe to weigh up correctly the benefits vs the risks.
The first and most crucial point is that the long-term safety and efficacy data from the trial will not be available until 2023. Although short-term safety and efficacy data looks promising, this has only been tested in a small cohort of children, with 1,131 children receiving the vaccine at the time of writing.
I am not persuaded by this as it is very very rare that side effects from a vaccine do not emerge within days or weeks. It is different to long-term effects in medicines you take every day.
Secondly the authors seems to be referring to the study of 12 to 15 year olds which had 1.131 children. The study of 5 to 11 year olds has 2,268 participants. Also worth noting that since the study of 12 to 15 year olds, millions of 12 to 15 year olds have had it with few consequences – so we are not just relying on the trial data for younger persons.
The second reason against vaccinating children is the very small risk that the virus poses to this group.22 There is a 1,000-fold difference in mortality risk between comparing children with frail elderly people after testing positive for covid-19. It is extraordinarily rare for a child to suffer any significant illness from covid-19 and orders of magnitude more rare for them to die from this virus.
This is a valid point, that very few children will due from Covid-19. The benefit to risk ratio is of course lower than in older people. But lower does not mean it is negative. Also many of us get our kids vaccinated against the flu, even though we don’t expect people to die from the flu. We’d rather they didn’t get it at all, or a very mild version of it.
And the deaths are not zero in children with Covid. Covid-19 was in the top 10 causes of deaths in the US for 5 – 14 year olds, with 143 deaths. And around 30 out of every 100,000 children with Covid-19 get hospitalised.
Reviewing the latest Covid-19 vaccine safety report from Medsafe (New Zealand Medicines and Medical Devices Safety Authority) published on 9 October 202134 – a total of 27,651 Adverse Events following Vaccination (AEFI) have occurred. With 982 of these being Adverse Events of Special Interest (AESI) which are paid greater attention due to their seriousness. Most concerning is the number of deaths that have occurred following vaccination which now totals 91.
This is where I think the paper is unhelpful. The 91 deaths within three weeks of getting a vaccination is less than the normal number of deaths in that period. Only 1 death is conclusively linked. If my polling company managed to phone 90% of over 12 year olds this month, then several hundreds of those polled would be dead by the end of December. But they would not be dead because we polled them.
So the paper has some valid aspects to it around the lower risk of children dying from Covid-19, but overall I’m pretty unimpressed with it.