Should we vaccinate young children against COVID-19?

Is it wise to immunize children against COVID-19? Several parents wonder about the relevance of vaccinating those under 12, who suffer less from the disease. Still others are concerned about the side effects that new messenger RNA vaccines could cause in their toddlers. Among experts, on the other hand, there is little hesitation: vaccinating children will undoubtedly be beneficial, both for the children themselves and for society as a whole.

Pfizer and Moderna, the two makers of COVID-19 mRNA vaccines, are currently conducting clinical trials on the efficacy and safety of their vaccine in children aged six months to 11 years. They have yet to make this data public.

Pfizer is expected to submit its data on the effects of its formula in school-aged children (ages 5 to 11) to the US Food and Drug Administration (FDA) in early October, followed by data on toddlers ( from six months to 4 years) the following week. On the ABC channel, the Dr Anthony Fauci, head of public health in the United States, said in recent days that “the FDA should [en principe] authorize the administration of a first dose in children of primary school age in mid-October ”.

Having said that, is it really necessary to immunize young children, who usually have little SARS-CoV-2 infection? some parents wonder. “It is true that the risk of complications in toddlers is lower than in adults and adolescents, but it is not absent,” says Dr.r Gaston De Serres, epidemiologist at the National Institute of Public Health of Quebec (INSPQ). In the United States, several pediatric hospitals are currently overwhelmed by cases of COVID-19, he also notes.

“Across Canada, we have seen children seriously ill from acute COVID-19, and some being transferred to intensive care. These cases are infrequent, but their number is not negligible, ”adds the D for his part.r Jesse Papenburg, specialist in microbiology and pediatric infectious diseases at the Montreal Children’s Hospital.

The latter also underlines the risk posed by the postinfectious multisystemic inflammatory syndrome, which can appear a few weeks after a banal infection and “affect several organs in a fulminant way”. “This is an inflammatory syndrome where children get very sick, very quickly. A third of these children are transferred to intensive care. Fortunately, they respond very well to anti-inflammatory agents, but the fact remains that a stay in intensive care is not trivial, ”he explains.

“If the vaccine proves harmless, it will be relevant to administer it to prevent these severe infections. Vaccination will not only protect children themselves, but also allow the safe return to activities that are so important to children’s development and mental health, ”says Dr.r Papenburg.

“Protecting against the disease, even if it is not very serious, it is still advantageous: the infection disturbs the child and all his family. In addition, the vaccine would reduce transmission to other family members, or even to other people. [que l’enfant côtoie] », Argues the Dr De Serres, who also mentions the risk of long-lasting COVID-19.

“We have seen since the start of the school year how COVID-19 continues to be a puzzle in schools [primaires] and day care centers. These would be much less disturbed if young children were vaccinated, ”he adds.

Lots of precautions

The Dr Papenburg notes that when the FDA and Health Canada approve vaccines for young children, it will be almost a year since those same vaccines have been given to adults. “This year-long experiment adds an extra layer of data on their safety,” he says, before explaining why these vaccines are slow to be used in young children.

“First of all, we had to do studies to determine what would be the smallest dose that would induce an immune response as good in young children as in adults. It has been shown that about half of the adult dose of Pfizer’s vaccine is sufficient to elicit the same types of antibodies and the same cellular immunity as obtained in adults. This is explained by the smaller body mass of young children, but above all by their generally more vigorous immune response, ”he explains, while noting that“ by minimizing the dose, we thus reduce the risk of Side effects “.

“Second, the FDA has asked manufacturers to recruit twice as many participants for their clinical studies in young children as for those in adolescents, to add another layer of data,” he adds.

“Third, since this was a new vaccine technology, we extended the duration of follow-up. It is six months, instead of two months for adults and adolescents […], despite the fact that in vaccinology, side effects always appear during the first two months following administration, ”he points out.

The Dr De Serres recalls that, although some adolescents and young adults have developed myocarditis after receiving a messenger RNA vaccine, young children are normally very little affected by this pathology – which can also be easily cured with the help of ‘an anti-inflammatory drug.

Once the vaccine is authorized and distributed in Canada, “a surveillance program led by the Canadian Pediatric Society and the Public Health Agency of Canada will be deployed in emergency rooms and pediatric hospitals to allow to screen for possible rarer side effects that would not have been detected in the initial studies, ”adds Dr.r Papenburg to reassure parents.

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