Vaccinating children – a middle road between the scare stories

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There’s a strong possibility that the Government, on the advice of the Chief Medical Officers will decide to offer the COVID-19 vaccine to 12-15 year olds. Given that the JCVI have advised not to offer the vaccine on the basis of individual health benefit v risk calculations, this means that if you are a parent, it is likely to fall to you to talk over the decision with your child.

It will be important then to be fully and accurately informed of the risks and those wider benefits that the CMO will have weighed up in his advice.  I’ve written here about what those potential wider benefits might be both in terms of the contribution to wider society health protection and specific benefits to children themselves.

In summary the benefits are:

  • An end to disruption to normal social life including schooling
  • Building up a level of herd immunity that provides further protection against serious disease for older and vulnerable adults
  • Building up  a level of herd immunity that provides protection for friends/peers who are clinically vulnerable and for whom the vaccine may not be fully effective.

You’ll notice that I’ve split out the herd immunity protection for older people from peers. This is not just about protecting unknown older adults but about protection for known friends.

It’s important to be clear that there are side effects and some of them are potentially serious including blood clotting (AZ) and myocarditis (Pfizer). However, despite some of the scare stories, we still are not seeing any evidence to suggest that these risks are anything other than extremely rare.

There are two extreme positions that have developed during the pandemic. On the one hand COVID deniers and minimalists have pushed hard at the claim that there isn’t really a pandemic and that all of the measures taken were part of an authoritarian conspiracy. At the other hand is the “Zero-COVID” position which argues that we can and must completely eliminate the virus all together. Just as the deniers/minimalists will push hard the claim that the vaccines are extremely dangerous and experimental, so too will the hardliners at the other end push the view that the vaccine is crucial for your child because of the huge risks to them of the virus continuing to circulate. 

I believe I’ve seen two examples of this over the past few days. The first was a suggestion circulating in the media that we could see another lockdown in October if hospital admissions and deaths surge.  The fear underlying this is that children returning to school will generate that surge.

I thought therefore that it might be helpful to have a look at what happened when the schools went back after the winter lockdown in the first phase of re-opening on the 8th March.  Here’s the case chart for March 2021.

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UK cases
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English cases

You’ll notice that cases were low and falling at that stage. There was a bit of levelling off during the Month before a further drop at the end and into April (presumably as the benefits of having some people double jabbed began to kick in).  The levelling off may well have partly been affected by school re-opening counter-balancing any factors leading to case reduction, however the affect seems to predate the point when we expect schools’ data to feed in. 

Similarly when we look at the data for this summer, we note that the rate of growth had already peaked prior to the summer holidays. No doubt there is some impact from schools opening and closing but the data suggests that it is not as pronounced as popular perception suggests.  Other factors affecting cases at the moment are likely to include summer festivals that took place in the last few weeks of August. 

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Furthermore, a projection of hospitalisations based on three assumptions (2.5% admission ratio, 3% admission ratio and 3.5% admission ratio) doesn’t suggest that we are about to see admissions rocket during September.

The current ratio is in the middle of the range (about 2.7-2.8%). This means that in order to get hospital admissions at the level we saw in the first and second wave, we would need around about 170,000 cases per day which is something we haven’t seen yet. I suspect there is a reason for that, namely that once you hit 60k cases the contact tracing system means that so many people are self-isolating that it provides a fire wall against further transmission.

Another scare has been reports of rocketing numbers of hospitalisations and deaths amongst children in the US suggesting that the Delta variant is more dangerous for children. One person on twitter shared the following two graphs to suggest this.

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My response was to ask a question about the breakdown of the data. There is a huge difference physiologically between 15-17 year olds and 0-5 year olds.  Another person kindly shared the CDC breakdown.

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As you can see, mortality in under 15s has remained significantly low among the under 15s. The increase has been primarily amongst over 15s and in line with the surge of Delta cases.

In summary, I think there is a good case for offering the vaccine to under 15s and they should not be put off by scare stories about the vaccines. At the same time, they should not feel compelled to take the vaccine by other scare stories.