Editorial: Vaccinating children against Covid - what to consider

A child arrives to receive the Pfizer vaccine at London Middle School in Wheeling, Illinois. More than 17 per cent of US children are fully vaccinated. Photo / Nam Y. Huh, File

EDITORIAL

For most of us, the decision to roll up our sleeves and take a dose of Pfizer vaccine has been as easy as one, two, three.

One, it's necessary to safeguard ourselves; two, our family; and three, our wider communities.

From Monday however, another consideration is in play. Whether to vaccinate our young children is not such a simple matter. Typically, we'll take the potential consequences for ourselves, but taking any chances with our tamariki and mokopuna is a harder one.

From this week, parents and caregivers have to consider protecting their children aged 5 to 11 against Covid-19, by being vaccinated with a paediatric formulation of the Pfizer vaccine.

The Ministry of Health reports the vaccine used for tamariki is a children's version of the Pfizer vaccine, with a lower dose and smaller volume. The lower dose was chosen based on a trial that showed the lower dose was safe and had few side effects in this age group.

Children need two doses of the vaccine to be fully protected. The ministry recommends these are at least eight weeks apart. The interval can be shortened to a minimum of 21 days if needed; for example, if the child is starting significant immunosuppression treatment.

If a child has their second vaccination after they turn 12, the official advice is to complete their vaccination course with the paediatric formulation of the Pfizer vaccine.

The Ministry of Health recommends immunising your child to keep them safe and to help protect your whānau and community from Covid-19.

Tamariki aged 5 to 11 are not eligible for AstraZeneca or booster vaccinations.

The rigour applied to reporting of adverse events means all changes in health occurring after a vaccination are reported, whether they are thought to be connected to the dose or not. Medsafe has taken the stance of "actively encouraging healthcare professionals and consumers to report suspected adverse events, even without a causal relationship with the administration of the vaccine".

After reviewing all of these reports, it is still Medsafe's view that the protective benefits of vaccination against Covid-19 far outweigh the potential risks of vaccination.

Most medical procedures have potentially adverse effects. In approved practice, such cases are rare but they can lead to real harms. So should we shy from all medical advances because there is a slim chance of a less than optimum outcome?

The Covid-19 virus can be unpredictable. The ministry says Covid-19 generally has milder effects in children, with symptoms being similar to a cold, but some children become severely ill and require hospitalisation.

Children can also have rare complications such as multisystem inflammatory syndrome (MIS-C) that may require intensive care. Children can also suffer ongoing effects (known as long Covid), even after initially mild symptoms.

As for likely outcomes of receiving the vaccine, John Hopkins University paediatricians advise children might notice pain at the injection site (upper arm), and may feel more tired than usual. Headache, achy muscles or joints, and even fever and chills are also possible. These side effects, generally the same as for adults, are usually temporary and clear up within 48 hours.

But what of the risk of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining outside the heart)? John Hopkins University advises that, considering the hundreds of millions of Covid-19 vaccine doses that have been administered, these reports are very rare. The problem occurs more often in adolescents (teens) and young adults, and in males. The myocarditis or pericarditis in almost all cases is mild and resolves quickly.

Dr Allison Messina from John Hopkins notes that myocarditis is a much more common complication of having Covid-19 than from getting vaccinated.

The question then is this: Should I go ahead and protect my child against the higher likelihood of illness from Covid; or should I not protect my child at all?