Will our toddlers get a Covid jab with their MMR?
Trials on children show stunning results. So, as infections among the young tick up, experts are asking...
IN JUST over a week, millions of Britons will be dining at restaurants, returning to exercise classes and, at long last, getting a haircut. This easing of lockdown rules is a remarkable feat, given that just eight weeks ago Covid deaths stood at 1,500 a day and the population was stuck inside with no hope of an imminent escape.
The turnaround is all down to the astonishing success of the Covid vaccine rollout, with nearly two-thirds of the adult population now protected. There is ‘nothing in the data to delay’ the continued easing of lockdown, the Prime Minister said last week.
But there could be a fly in the ointment. While cases are still dropping, the rate of decline has stalled. And in pockets of the country, infections are creeping up again. In Scotland, for instance, infections in younger age groups have doubled since the end of February.
Dr Deepti Gurdasani, epidemiologist from Queen Mary University, highlighted the culprit: children.
‘We appear to have two different pandemics,’ she warned. ‘It’s declining in older age groups, but accelerating among young children.
‘Infection rates are highest – and rising – among primary-school children, followed by secondary-school children.’
BORIS JOHNSON admitted the slight uptick was ‘almost certainly’ to do with the reopening of schools. And scientists are already investigating the solution: vaccinating youngsters. Early data from Israel – where the majority of over-16s have been vaccinated – shows jabbing older teens not only limits child infections, but also drives down cases in the wider community, preventing mutant variants from developing.
Last week Pfizer reported early results from its trial on 12 to 15-year-olds – and the data is stunning. Immunity was seen in 100 per cent of the 2,000 adolescents given the jab.
Similarly positive findings are expected to be reported in June from Oxford University researchers, who are currently trialling their AstraZeneca jab on six to 17-year-olds.
Meanwhile, Pfizer and Moderna – the American firm supplying 17million doses of its vaccine to the UK – are testing their jab on babies as young as six months old.
If more data proves jabs are safe – and work – every child could be offered a jab by August, according to recent reports. Experts have even suggested the Covid jab is added to the list of routine vaccinations given to toddlers, such as the MMR and polio jabs.
‘Vaccinating infants against respiratory diseases isn’t unusual,’ says virologist Dr Julian Tang. ‘It would make sense to give them immunity in the first year or two of life. But it would need to be an annual programme, like the flu vaccine, to account for mutant variants and waning immunity.’
Despite the clear benefits, unsurprisingly, the subject of vaccinating children has sparked fierce debate on social media. Some went as far as to declare Covid jabs for kids a ‘live experiment’.
But others strongly disagreed. Among them was journalist Robert Byers, 51, who allowed his 12-yearold son Nicky to become a volunteer on the Moderna vaccine trial in the US in January.
Robert, from Kentucky, says it was his wife Tara, a freelance editor, who first suggested it. Speaking
to The Mail on Sunday’s Medical Minefield podcast, he admitted he was nervous at first: ‘My first thought was, well, if something would go wrong, we’d hate ourselves for the rest of our lives.’
But Nicky’s reaction to the suggestion convinced Robert it wasn’t such a bad idea. ‘He’s been asking from the beginning when children could get their vaccine,’ says Robert. ‘When we suggested it, he was kind of excited. And we thought, we’ve all felt so helpless over the past year, maybe this is something we could help with.’
By the time it came to the injection, Robert’s doubts had diminished. ‘We were very familiar with what was going on in the adult trials, so we felt pretty good about it.’
The Byerses’ faith in medical science continued, despite the fact that Nicky suffered side effects – developing a fever after his first dose.
‘He had a temperature of nearly
39 degrees, and was a bit miserable, but it passed within two days.’
Similarly short-lived flu-like symptoms happened after the second dose, which Robert saw as a ‘good sign’. ‘It was a clue he’d had the real vaccine, rather than the placebo. So hopefully it means he’s protected, which is great – because who knows what can happen if any of us were to contract the virus. And now he relishes the attention. All his friends think he’s a hero.’
TILDA Leighton from Oxford is another brave young person taking part in a trial – the 16-year-old volunteered to be a guinea pig for the AstraZeneca vaccine. ‘I saw the advert for participants and immediately signed up, then three hours later they called to ask me to come in the following week,’ says Tilda, who received the first dose back in February at Oxford’s Churchill Hospital.
‘I thought if I can do something to help and make getting out of the pandemic easier, I’ll do it.
‘My dad was supposed to be a part of the adult vaccine trial but couldn’t in the end because of his history of allergies, so it was almost like I was doing it for him.’
Tilda likened the injection to her HPV jab – given to teenage girls to protect against the cancer-causing strain of the sexually transmitted human papillomavirus.
‘It wasn’t painful but my arm ached a little bit for the rest of the day,’ she says. ‘Later in the evening I felt a bit tired and had a temperature, but it disappeared within an hour and a half.
‘The next day I felt a bit like I had mild flu, with some muscle pain, but it only lasted 24 hours. I woke up the following day feeling absolutely fine.’
And after her second dose a fortnight ago, she suffered no problems whatsoever.
Tilda hopes the mild side effects she felt with the first dose mean she received the real Covid-19 vaccine rather than the meningitis B jab given to teens in the control group.
‘My parents have had their first doses too – so hopefully it means our family are pretty protected,’ she says. ‘We often do shopping for my great-aunt, who is 84, so it would be nice to know I can talk to her outside without worrying too much about the virus.’
Convincing parents the jab is safe is one thing. But experts say the biggest challenge will be persuading them that it is necessary.
‘Vaccination has been a very easy decision for the elderly, who were very concerned about the risk of Covid to them personally ,’ says Professor Adam Finn, paediatrician and public health expert from the University of Bristol. ‘But as you work your way down the population towards childhood, that personal risk is reduced.’
It’s true that children rarely get ill with the virus. Roughly three per cent suffer critical symptoms, according to Imperial College London research.
‘The aim of vaccinating children wouldn’t necessarily be to protect them, but to stop them from spreading it to older, vulnerable people around them,’ says Prof Tang.
Part of the problem in persuading parents may come from the fact that public health messages on Covid in children have been confusing. Last autumn, shortly before schools reopened, Education
Secretary Gavin Williamson claimed there was ‘little evidence’ that the virus was transmitted in classrooms. Meanwhile, the Royal College of Paediatrics and Child Health said children played a ‘minor role’ in transmission.
But experts now say this isn’t the case.
Early Chinese studies found children were just as vulnerable to Covid as adults, with the disease spreading widely between children in Hubei province.
More recently, research from Israel, South Korea and the US shows children and teenagers may, in fact, be more likely to transmit Covid than adults. Dr Tang says: ‘The only reason we didn’t have evidence in the UK that children were spreading it was because we weren’t testing enough of them.’
Vaccinating children would, he says, help to ‘plug gaps’ in the adult programme, assuring that as many as possible in the population have some immunity. ‘A significant number of people who end up in intensive care with Covid are in their 30s and 40s with no underlying health issues,’ says Prof Tang.
‘And the fewer outbreaks we have, the less likely vaccineresistant variants will develop.’
But vaccinating children to protect older, vulnerable adults is a notoriously hard sell.
It is, says Prof Finn, a dilemma familiar to doctors who work to improve the uptake of the flu jab in children every year.
Since 2013, all schoolchildren aged between five and 11 have been offered a flu vaccine each year – despite only 12 in every 10,000 children who catch it becoming severely ill. The programme was launched after pilot studies showed an 85 per cent reduction in flu-related hospital admissions in older, vulnerable people, in areas that vaccinated children.
But the national scheme hasn’t quite managed the same striking effect, due to a problem with take-up.
The vaccination rate in children has hovered just under 60 per cent for much of the past decade – short of the target of 65 per cent. In some areas, coverage is as low as 30 per cent.
Studies suggest it’s not just parents’ reluctance to give kids a jab for the good of others that causes low uptake, but also practical and cultural reasons.
Prof Finn says that health officials must hammer home the direct benefits of vaccination on children’s lives.
He adds: ‘If people are choosing not to have effective vaccines, it’s a failure on our part to give them the information that they need in order to make what is an obvious and clear decision.
‘We should say: in order for schools to stay open and children to benefit from normal social interactions, it proves necessary to immunise them.’
DESPITE recent reports, Prof Finn says we’re still ‘a way off’ rolling out a national Covid jab plan for children. ‘At this point, I don’t think immunising children is a certainty, but it’s something we need to be able to do if it proves necessary,’ he says. ‘We’re still in the relatively early stages of knowing about the safety profile, the correct dose and effectiveness of these vaccines in children.’
And thanks to youngsters such as Nicky and Tilda, we will, hopefully, soon have that data.
Tilda says it feels ‘amazing’ to know she’s been part of a groundbreaking medical trial.
‘I’m the only one in my school who has potentially been vaccinated. Hopefully it means that I am less of a risk to younger people I know with underlying health conditions.
‘All my friends think it’s great. In fact, they all wanted to do it but the trial got filled up quickly.
‘I have no doubt there will be plenty of people my age who will be more than willing to take the jab too.’