If a new variant emerges that causes moderate to severe disease in children, we may have to vaccinate healthy children
The Drugs Controller General of India (DCGI) has recommended for Emergency Use Authorization (EUA) for Covaxin among children aged 2-18. In order to ensure safety of children in schools, the DCGI is having high level discussions so that the vaccine could be introduced after thorough introspection as part of the National Vaccination Programme. The statement of Dr NK Arora, Chairman of National Immunization Technical Advisory Group (NTAGI), that children with comorbidities will be prioritized to receive the vaccine "immediately and healthy children can be immunized subsequently" generates confidence amongst all the stakeholders. Earlier, in August,2021, the DGCI had granted an emergency use approval for Zydus Cadilas's DNA vaccine for use in adults and children aged 12 years and above.
The impact of the pandemic on the education of children can be gauged from the fact that almost 24 million children are at the risk of not returning to school next year due to the economic fallout of Covid-19, according to the policy brief released by the United Nations. More than 1.6 billion learners across the world have been affected by the disruption of the education system, but the pandemic has also served to exacerbate existing disparities, with vulnerable populations in low-income countries including India taking a harder and longer hit. For example, during the second quarter of 2020,86 per cent of children at the primary level have been effectively out of school in poor countries, compared to just 20 per cent in highly developed countries.
However, opinions of experts are divided on various issues related to vaccination of children,"Whether there is a need of Covid-19 vaccination for children?". Speaking at a seminar, Dr Soumya Swaminathan,Chief Scientist, WHO,said "Children have the same percentage of antibody exposure that adults have. We had shut schools saying children should not be exposed to the virus, but there has been community exposure since they have been doing other activities. Children have been going to malls, playing outside, and are around their families. Making a case for reopening schools is vastly different from children getting a Covid-19 vaccine, while one discusses the continuation of life as it is lived, the other is a deeply ethical question".
Commenting on the value of Covid-19 vaccines for children, Gavi, the Vaccine Alliance, says that considering that children under the age of 18 form a large proportion of the population, i.e., 32 per cent globally, ensuring protection for them is a move towards pandemic control. Protection is urgently needed when the disease risk is high. However, for children, there is relatively low risk of disease, it added.
Another relevant question is, "Are vaccines needed for healthy children and adolescent, especially since Covaxin supply is still limited and millions of adults are yet to be vaccinated?" According to Dr Chandrakant Lahariya, Physician-epidemiologist and vaccine expert, "At present, the healthy children in India do not need vaccination. India has reached a stage where there is more Covid-19 vaccine supply then demand. However, just because a country has more availability, it should not start vaccinating children. At the same time,that does not mean healthy children would never need Covid-19 vaccines. They may,in future. For example, if a new variant emerges that causes moderate to severe disease in children at a rate higher than at present,then we may have to vaccinate healthy children. Considering the available evidence, I don't think India should consider vaccinating any child younger than 12 years before early next year", he added.
Dr Satyajit Rath, formerly with the National Institute of Immunology,New Delhi, however, have a different point of view: "Vaccines are certainly needed for everyone. I do not think that guesses about the proportions of people in various groups already infected/vaccinated, which depend on sero-surveys, are well founded. Many if not most of the sero-surveys have been modest in size,yet we are assuming that they correctly reflect reality."
In India,the parents are anxious and worried about the well-being of their children. They do not want to take any chances and most of them would welcome vaccination of their wards to be on the safe side. However, they need to understand that no country in the world had rolled out vaccines for any subgroup of children without data being thoroughly examined and reviewed by the experts. We should also go by the advice of the experts.
(The writer is a senior journalist and Chairman, Panwar Group of Institutions, Solan, Himachal Pradesh. The views expressed are personal.)
