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Should children be vaccinated against COVID-19 now?
  1. Brian Li Han Wong,
  2. Mary Elizabeth Ramsay,
  3. Shamez N Ladhani
  1. Immunisation and Countermeasures Division, Public Health England, Colindale, London, UK
  1. Correspondence to Dr Shamez N Ladhani, Immunisation and Countermeasures Department, Public Health England Colindale, London, UK; shamez.ladhani{at}phe.gov.uk

https://doi.org/10.1136/archdischild-2020-321225

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    The recent authorisation of vaccines against the novel coronavirus, SARS-CoV-2, raises important questions about prioritising the vaccine to those who are most likely to benefit from protection. Unlike influenza vaccines, it is currently not known whether any of the SARS-CoV-2 vaccines can interrupt onward transmission to others. The decision to vaccinate must, therefore, be made on the direct protection offered by the vaccine to those who are vaccinated. The highest burden of severe disease, hospitalisation and death lies among older adults, raising the question as to whether children and young people should be vaccinated during early deployment of any national immunisation programme.

    COVID-19 in children

    COVID-19 has affected millions of people since SARS-CoV-2 was identified in December 2019. Children account for 1%–3% of diagnosed COVID-19 cases and have less severe disease and better prognosis than adults, with deaths being extremely rare and mainly affecting adolescents and those with significant underlying comorbidities.1 Early epidemiological studies suggest that children do not contribute much to the spread of SARS-CoV-2 and that younger children may be less likely to get infected or transmit the virus compared with older children or adults.2 Most children with SARS-CoV-2 infection are either asymptomatic or develop mild and non-specific respiratory symptoms. Some children have, however, developed paediatric inflammatory multisystem syndrome (PIMS-TS; also known as multisystem inflammatory syndrome in children), which shares features with Kawasaki disease and toxic shock syndrome and typically occurs 2 to 4 weeks after SARS-CoV-2 infection.

    Vaccinating children

    The low rates of severe disease and death associated with SARS-CoV-2 infection in children and young people would suggest that they should not be prioritised for vaccination …

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    Footnotes

    • Twitter @brianwong_

    • Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.

    • Contributors All authors contributed equally to the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.