Vaccinating children in Australia would help protect against Covid but high-risk groups first, experts say
Public health experts say vaccinating children against Covid-19 will be important for protecting Australians against the Delta variant, but that high-risk populations must take priority.
On Monday, the New South Wales government indicated the state would consider vaccinating young people as part of its efforts to control the current Delta outbreak.
“I think there will be a key role for vaccinating children,” the NSW chief health officer, Dr Kerry Chant, said at the daily press conference. “It is pleasing to see in some countries overseas that we have vaccines that are licensed for use in children.”
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In Australia, the Therapeutic Goods Administration has approved the Pfizer vaccine for use in 16-year-olds and older, and both the AstraZeneca and Johnson & Johnson vaccines for those aged 18 and older, although the latter is not yet included in the national vaccination program.
Pfizer has applied to the TGA for approval to administer the vaccine to children aged between 12 and 15.
A Department of Health spokesperson said: “The Australian government continues to follow advice from the Advisory Group on Immunisation (Atagi) on the priority groups for the first doses of a Covid-19 vaccine.
“If regulatory approval is granted by the TGA for the younger age group, Atagi would then provide advice on the prioritisation as the program rollout continues.”
Dr Andrew Miller, former president of the Australian Medical Association in Western Australia, said vaccinating younger age groups would help achieve herd immunity, as well as protecting children.
“What we’re seeing in the countries that are well ahead of us in vaccination status is that it’s actually very hard to get up to the around 90% of people over the age of 16 [vaccinated] that we would need to get herd immunity with the current variants,” he said.
People aged 12 and older are now widely vaccinated with Pfizer in the US and Canada, and the UK is beginning to vaccinate vulnerable teenagers aged 12 to 15. Clinical trials are under way for Pfizer, AstraZeneca and Moderna vaccines for even younger age groups.
In many countries, children comprise an increasing proportion of new Covid cases. Prof Alexandra Martiniuk, an epidemiologist at the University of Sydney, said that was likely to be a result of the Delta variant’s increased transmissibility, the relaxing of restrictions in certain countries, and more adults being vaccinated.
“We need to vaccinate children because they can get and transmit Covid – to protect the health of the child but also those who are not able to be vaccinated, or for whom vaccination isn’t as effective,” she said.
But Prof Fiona Russell, the director of child and adolescent health at the University of Melbourne, said the decision to vaccinate teenagers was complex.
“Many paediatricians are concerned about vaccinating teenagers right now when there is not enough information on safety,” she said.
Though trials have shown the Pfizer vaccine to be safe and effective in adolescents, mRNA vaccines have been linked to extremely rare incidents of heart inflammation, particularly for males under 25.
“It is very uncommon for children to die or end up in hospital with Covid. Those that do usually have underlying conditions,” Russell said. One large UK study found that children accounted for less than 1% of hospitalised cases.
But evidence also suggests that children may be at risk of long Covid – between 7% to 9% of children experience symptoms of the condition, according to one estimate.
“We are amassing huge amounts of information from the vast numbers of children who are being infected with Covid [internationally], showing that it is by no means a benign disease,” Miller said.
The spread of the Delta variant in young people has also complicated the question of whether schools should remain open.
“Previously, it seemed possible to control Covid while avoiding vaccination of teenagers and children, as control was achieved prior to Delta’s arrival in the UK and Israel by vaccinating adults alone,” Russell said.
“However, Delta has changed this and there is increased viral transmission among young adults and older teenagers in particular.”
As a result, arguments have been made for vaccinating teenagers in Australia sooner, Martiniuk said. “However, if we take the stance of aiming to prevent as much hospitalisation and death as possible, then vaccinating high-risk and older age groups continues to be the priority.”
Miller said: “What we certainly should not be doing is ignoring the issue of children altogether and talking about [opening up] once we’ve got a certain proportion of adults vaccinated … because then we’ll turn this into a paediatric epidemic.”
The question of vaccinating children also affects the figures used to measure the progress of the rollout. By Tuesday about 11% of Australia’s total population had received both doses of the vaccine, one of the lowest rates in the OECD according to figures compiled by Our World in Data. But the government prefers to use the percentage of adults vaccinated, currently around 14%.
On Tuesday evening the ABC’s 7.30 ran a correction at the end of the program, after the government objected to the lower figure it had used earlier in the show.