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COVID vaccines for kids are coming

October 25, 2021

Kids under 12 years generally can't get a COVID vaccine. US authorities will rule on emergency approval for the BioNTech-Pfizer jab for 5- to 11-year-olds.

A young person gets a jab in Germany
The pros and cons of vaccinating children under 12 years old are still being debatedImage: Ying Tang/NurPhoto/imago images

For 10-year-old Maja, there's no question: Kids should get vaccinated against coronavirus. Maja says she was happy to be among the very first kids in the world to get a BioNTech-Pfizer vaccine.

"The first thing I'm going to do is have a huge sleepover with all my friends, like a party or something," she said.

Maja was part of a United States-based study that could ease the way for authorities there to approve the BioNTech-Pfizer mRNA vaccine for kids under the age of 12 years.

On Tuesday, a US Food and Drug Administration (FDA) advisory panel discussed the study's findings and voted unanimously that the vaccine's benefits outweigh any potential risks in that age group. 

After the expert panel's green light, the FDA is expected to make its decision on formal authorization within days. 

The FDA isn't legally bound to follow the panel's recommendation, but it usually does. 

Study shows good efficacy

Researchers tested the vaccine on 2,268 kids between the ages of 5 and 11. About the same number of children got a placebo.

After the study, developers said they were confident their vaccine was safe and effective for kids in that age group when the dose was reduced.

Children under 11 years of age would get about a third of the dose that adults get. At the time of writing, the vaccine has only been approved for kids of 12 years and older.

BioNTech-Pfizer is seeking approval in the US and the EU, where the European Medicines Agency (EMA) makes those decisions. The EMA has indicated it will decide in the coming months. Further submissions for approval have been made worldwide.

Other vaccine developers and manufacturers, such as AstraZeneca, Novavax and Johnson & Johnson, are also working on jabs for kids.

Get it early or wait?

"I am absolutely in favor of vaccinating children under the age of 12," said Kawsar Talaat in an interview with DW. Talaat is an associate professor of International Health at the Johns Hopkins Bloomberg School of Public Health in the US.

"The only way to get us out of this pandemic is to vaccinate as many people as possible and [that goes for] all ages," Talaat said.

Jakob Armann, a pediatrician in Germany, meanwhile, is more reserved. Speaking to DW, Armann said that children with comorbidities should get vaccinated, "for example, if the kid has trisomy 21."

But Armann said he would wait "if it's a healthy kid."

"I would wait until we have more data and have had a chance to see rare side effects like myocarditis. And then make a call on who benefits from the vaccine and who does not," he said.

COVID-19 and Down syndrome

Armann says that the BioNTech-Pfizer study involved too few people for communities to start mass vaccination programs with confidence.

For instance, says Armann, there are signs that some young men and boys get myocarditis, an inflammation of the heart muscle. The cases have tended to be mild and rare — but specifically for that reason, says Armann, a study of just over 2,200 kids is too small.

Kids' immune systems activate rapidly

There is another reason why some experts are advising to proceed slowly: Only few kids who get infected with COVID-19 experience a severe case. Often, the infection feels like a mild cold, they say.

The human immune system uses receptors that recognize patterns — like the shape of a virus — to defend the body against a viral attack, said Roland Eils in an interview with DW. But those receptors need to be activated.

"Once they are activated, they trigger the production of interferon, which is the primary line of defense against any viral infection," said Eils, who heads the department of digital health at the Charité University Hospital in Berlin.

"And we found that children's immune systems were [very good at activating] those receptors in comparison to adults," he said.

Schools as super-spreaders

Eils is not against vaccinating kids, because, he says, even if their infections tend to be mild, they can still pass on the virus to other people.

In Germany, the past year has shown some evidence of that. Even when and where the general incidence rate has risen relatively slowly, schools have, at times, become super-spreader locations.

India fears 'lost' COVID generation

If you have scores of unvaccinated kids sitting close to one another, it is possible higher incidence rates will follow. Some German communities have seen weekly incidence rates of 500 per 100,000 population, which is quite a high rate.

Vaccines don't only protect you

Talaat says vaccinating kids will contribute to herd immunity. That is a global goal — and the primary way in which we may eventually overcome the pandemic.

Beyond that, says Talaat: "COVID effects [childrens'] lives in terms of shutdowns, quarantines, inability to go to school, inability to do their normal activities and so on. The best way to get their lives back to normal is to vaccinate them."

That would be one way for 10-year-old Maja's dream to come true and have all her friends over for a huge sleepover.

Deutsche Welle Fabian Schmidt App NEU
Fabian Schmidt Science editor focusing on technologies and inventions