While governments across the world race to inoculate against COVID-19 in a bid to bring about the end of the pandemic, one significant portion of the population remain excluded – children.
Scientists are still undecided on the efficacy and ethical considerations of using only-recently-approved vaccines on children – none of which have yet to undergo full clinical trials on those under the age of 16.
“Children were not a high priority for early studies,” said Dr Paul Offit, member of CDC Advisory Committee on Immunization Practices and director of the Vaccine Education Center at Children’s Hospital in Philadelphia told Al Arabiya English. “Because people less than 21 years of age make up about 26 percent of the US population but account for about 0.08 percent of the deaths.”
Recommendations by health authorities have yet to include children, with the American Academy of Pediatrics (AAP) recommending that all those aged 16 above to be inoculated with an approved COVID-19 vaccine, while the US Center for Disease Control and Prevention (CDC) has yet to approve a vaccine for children.
According to the Nature Journal, emergency approval of COVID-19 vaccines might complicate efforts to study long-term effects of the vaccines. This is one of the reasons why children have not been included in earlier studies.
Should children get the COVID-19 vaccine before returning to school?
Experts are yet to agree on whether COVID-19 vaccinations should be a prerequisite for those below the age of 18 returning to schools in the fall, after lengthy shutdowns by authorities to prevent infection spread.
The White House’s Corona Taskforce has issued a statement on February 17 that high school students might be vaccinated in the fall, while primary school-aged children might have to wait until 2022.
Enrolling children in clinical trials has proven to be complex, as it requires parental approval and more nuanced ethical considerations.
A study published in the Human Vaccines and Immunotherapeutics Journal in November last year, found that only one-in-five (18.4 percent) of the 2,768 parents surveyed would enroll their child in COVID-19 clinical trials.
“It is pretty unusual to start going down into children at an early stage [of vaccine trials],” said Dr Emily Erbelding, an infectious diseases physician at the National Institutes of Health in the US, to NYT in mid-February. “But I think we have to include children if we’re going to get to herd immunity.”
While the debates on whether it is safe to vaccinate children against COVID-19 are ongoing, experts have yet to agree as to whether a vaccine is necessary for kids to return to school.
“Once teachers are immunized, I think we do not need to wait for kids to get immunized to get them back to school,” said Alan Schroeder, medical doctor at Stanford Children’s Health, to ABC News.
Children in COVID-19 vaccine trials
As of February 11, more than three million pediatric COVID-19 cases have been reported in the US alone, representing 13 percent of all cases, with the overall rate of 4,030 child cases per 100,000 children in the population, according to the AAP.
In late January, Pfizer enrolled 2,259 participants aged 12-15 in its pediatric clinical trials for its COVID-19 jab.
“The results should be available by summer,” said Keanna Ghazvini, a spokeswoman for Pfizer, to NYT in mid-February. “Moving below 12 years of age will require a new study and potentially a modified formulation or dosing schedule.”
“Children might require a lesser dose to induce protective immunity,” confirmed Dr Offit.
The US-based vaccine manufacturer, Moderna, has already started clinical trials with children aged 12-18, while the AstraZeneca/Oxford COVID-19 vaccine trials were announced for children aged 6-17 on February 15.
While Moderna included 30,000 and Pfizer/BioNTech included 43,661 adult volunteers in their late-stage clinical trials, that number would have to be greater when it comes to recruiting children volunteers, given that they rarely exhibit symptoms of the COVID-19 virus.
Since a study comparable to that of adults would be unfeasible, vaccine manufacturers will look at vaccinated children for signs of a strong immune response against the virus.