The EU, UK and US have all approved a COVID-19 vaccine for children over the age of 12. Independent regulators agree that the benefits outweigh any known risk, but authorities are expected to keep a close eye on the safety and effectiveness of the vaccines in this age group.
The approval holds potential to protect young people from illness, including possible long-term complications of COVID-19. (Vaccines Today is funded by Vaccines Europe, a trade association whose members include Pfizer, Moderna, AstraZeneca & Janssen.)
New research from the US shows that while hospitalisation rates for adolescents are lower than in adults, the proportion of 12-17 year olds hospitalised with COVID-19 was higher than in those infected with flu. Nearly one third of hospitalised adolescents required admission to an intensive care unit, with 5% requiring invasive mechanical ventilation.
Vaccinating adolescents will also help to reduce the risk of outbreaks in the community, potentially bringing Europe closer to herd immunity – the point at which the vaccine can no longer easily find new people to infect.
However, experts note that it is important to continue emphasising the vaccination of adults, who experience higher risk of hospitalisation and death from COVID-19.
Health professionals in the spotlight
The HPV vaccine, another vaccine commonly available to adolescents, has experienced uneven uptake in some European countries where inaccurate rumours and natural parental
concerns have circulated online. Addressing parents’ and teenagers’ questions about COVID-19 vaccine will be essential to ensuring strong uptake.
That’s where doctors, nurses, pharmacists, dentists and other trusted health professionals will be key. As vaccine supplies catch up with demand from adults, and a new school year begins in September, attention will begin to turn to vaccinating people aged 12 and upwards.
IMMUNION, a new two-year EU-funded project that brings together members of the Coalition for Vaccination, intends to play an active role. While the initiative is not specifically focused on COVID-19 vaccines, it is committed to a lifecourse approach to vaccination which ‘maximises the benefits of vaccines for individuals and society’.
Alison Maassen of EuroHealthNet, and Project Manager of IMMUNION, said expanding the population eligible to receive COVID-19 vaccination will support the fight against the pandemic by increasing overall vaccine coverage. ‘It will control circulation in this age group, facilitate intergenerational contacts, and limit the possibility of creating virus variants in this age group,’ she said.
The added benefits of reducing anxiety about the disease and facilitating more social activities were highlighted by Professor Pierre Van Damme, Center for the Evaluation of Vaccination, University of Antwerp. ‘When schools start in September 2021, having adolescents vaccinated will ease the normal functioning of the schools, avoid outbreaks with all the consequences they bring, and, as such, improve mental health of young people,’ he said.
Professor Frank Ulrich Montgomery, President of the Standing Committee of European Doctors emphasised that, as with all COVID-19 vaccines, rigorous monitoring of safety and efficacy in this age group will be essential – particularly as the risk of severe complications of COVID-19 in adolescents is extremely low. ‘Expanding vaccine coverage and addressing vaccine hesitancy in adults, who are at higher risk of severe COVID-19 infection, must remain a top priority.’
In a statement to Vaccines Today, IMMUNION said its members, who represent millions of health professionals across Europe, will actively encourage COVID-19 vaccine uptake among adolescents in several three ways: by providing information to health workers; by collaborating with experts and civil society to address vaccine hesitancy; and by studying the drivers of vaccine inequality in the project’s target countries Italy, Greece, Latvia and Romania.
‘The use of youth role models in a number of communities should also be considered,’ said Prof Van Damme. ‘It would be great to see some football players from the national teams competing in the European Championship being vaccinated, for instance, as they represent an important role model.’
Experts leading the IMMUNION project accept that tackling misinformation could become a major challenge as vaccines are rolled out to younger age groups. They hope to help health professionals engage with parents and teens to answer their questions on vaccine safety, and to combat common myths that may arise about the vaccine.
‘Communication around COVID-19 vaccines has been a different challenge overall, as compared to communicating about routine immunisation,’ said Prof Montgomery. ‘We have seen this in communication about all COVID-19 prevention measures, including mask wearing, for example, as rapid action has been required in the face of incomplete evidence.’
The unprecedented pace at which vaccines were developed, approved and rolled out have created unease among some sections of the public at a time of great uncertainty in society. ‘In this context, some vaccine ‘hesitancy’ could be considered normal, particularly on the part of parents who are taking decisions on behalf of their children,’ said Alison Maassen. ‘As with other vaccines, it will be critical to remain empathetic to concerns, to be transparent about what is not yet known, and to make data accessible – particularly when interpreting risk.’
However, she said COVID-19 vaccines may be less likely to face the same stigmatisation as HPV vaccines. And, whereas the significant benefits of HPV vaccines may come decades after vaccination, COVID-19 vaccines are likely to be associated with fresh opportunities to travel and return to social activities.
Meanwhile, clinical vaccine trials in children under the age of 12 are ongoing. As teenagers, parents and experts prepare for the introduction of COVID-19 vaccines in those aged 12 and older, they will also lay the groundwork for later campaigns to vaccinate young people of primary school age. There is a long road ahead but IMMUNION experts are determined to ensure that people of all ages and backgrounds get there together.
This article was updated on 11 October 2021