On the 5th January 2022, the US equivalent of ATAGI, the Advisory Committee on Immunization Practices (ACIP) met to review the safety data following the roll-out of the Pfizer vaccine to 5-11 year old’s. You probably don’t need to be reminded that the Pfizer childhood vaccine is a third of the adult dose at ten micrograms which has been shown to elicit a strong antibody response with very few side effects in the clinical trial. The dose separation in Australia and some other countries is eight weeks to allow for an optimal immune response and further minimise side effects. In the US, the gap is three weeks.
The trouble with clinical trials is that the number of participants is limited, and you don’t necessarily detect rare side effects. That’s why carefully monitoring what happens in the real world after the vaccine has been released is very important. In fact, never in medical history have any medications been scrutinised as closely as the four major COVID vaccines (Pfizer, Moderna, Astra Zeneca and Johnson & Johnson).
At the January meeting, ACIP looked at the safety data on nearly 8.7 million doses of the childhood Pfizer vaccine. Apart from the usual sore arms and flu like symptoms, there were very few side effects. What they were really interested in though was myocarditis, the heart muscle inflammation noticed in young adults (more common in males). In males over the age of 17, the incidence is already rare at one in 50,000 and when they looked at the 12-15 age group, they had already noticed that myocarditis was even rarer. In the 5-11-year old’s the findings were really reassuring. There were 12 cases of myocarditis in 8.7 million doses and only occurred after the second dose. All 12 did well and were discharged home. The rate was one in 250,000 in boys and one in 500,000 in girls.
So, the bottom line is that this rare complication of the Pfizer vaccine is five to 10 times rarer in children than in 17-year old’s and older. Great news if parents are asking.
“On the other hand, one in 3,000 children who contract COVID-19 develop multi-system inflammatory syndrome, which is quite serious and lasts many months,” according to the head of the TGA, John Skerritt.
Of course, vaccinating children can help reduce community transmission and help prevent children passing the virus on to younger siblings, grandparents and the wider community.
Data from overseas suggests that the Omicron strain is affecting children more often than the Delta strain, which is another reason for children to get vaccinated.
Tools to help with vaccine hesitancy
If the adults haven’t been vaccinated, prominent public health experts have collaborated to develop an online tool backed by the National Centre for Immunisation Research and Surveillance: Decision aid launched for those with COVID-19 vaccine concerns
Some jurisdictions such as Victoria are producing resources that will help assist parents decide on getting their child vaccinated. Visit https://www.coronavirus.vic.gov.au/vaccination-information-children-and-teenagers