The Scottish Mail on Sunday
Is it safer for kids to catch Covid than get the jab?
As a swathe of other countries have been jabbing under-18s for weeks, the question more and more parents are asking...
BEFORE they turn one, babies in Britain are immunised against a raft of diseases that once could have killed them – measles, diphtheria, polio and meningitis B, to name just a few. More jabs, throughout childhood, protect them – and those around them – from bugs that cause severe illness and life-long problems. Could Covid-19 soon be added to these lists?
It’s a question dividing scientists and doctors. While some argue that the only way out of the pandemic is vaccinating the entire population, including children, others, among them highly respected doctors and researchers, have a different view: that it might be safer to let most youngsters catch Covid and develop natural immunity than have the jab.
Could they be right?
Last Monday health chiefs announced that hundreds of thousands of children aged 12 and older, who are at higher risk from coronavirus infection, will be offered a Covid shot.
This includes those with immune disorders, some cancers, severe autism and profound learning difficulties, cerebral palsy and epilepsy, and Down’s syndrome – a move that was instantly welcomed by disability campaigners.
The Joint Committee for Vaccination and Immunisation (JCVI) watchdog has recommended the Covid vaccine for healthy 12-to-17year-olds who live with people who have a suppressed immune system – roughly half a million Britons fall into this category.
This they say will provide ‘indirect protection’, preventing these children contracting the virus and possibly unknowingly passing it on to their vulnerable family member.
ONE mother of a child in this group welcomed the move: Christina Owusu, The Mail on Sunday’s News Desk Manager. Christina, 41, has sickle cell anaemia, a genetic blood condition that causes painful episodes called sickle cell crises, tiredness and shortness of breath as well as an increased risk of serious infections and strokes. It means she is highly vulnerable to the virus.
Despite having shielded since the start of the pandemic – she barely left home – Christina caught Covid in December last year and spent three weeks in intensive care.
She pulled through and has since been vaccinated. But with infections on the rise again, she feels understandably cautious.
Her 13-year-old son, Isaiah, is eligible for the jab.
Christina said: ‘I’ve no idea how I got the virus.
‘Isaiah was going to school and using public transport every day, but the school were taking all the necessary precautions and isolating pupils if children came into contact and to get a test. This happened on one occasion to Isaiah and the result came back negative.
‘When he got home, he’d take off his uniform and leave it at the front door and go upstairs to shower.
‘When the second wave hit, I was worried but I thought we were doing everything we could to prevent me getting sick.
‘Being in hospital was hard – not having visitors was the worst bit.
‘Even when I got home, it took me weeks before I was strong enough to get upstairs or shower without help. I started working again, on a phased return basis, in April but I still don’t feel 100 per cent. I’m fortunate to be able to work from home, which is aiding my recovery.
‘I’ve encouraged all my friends to be vaccinated and now I’ve discussed it with Isaiah too.
‘He knows it’s to protect me, first and foremost. But he’ll also be helping to protect other vulnerable people in society, and himself.’
Britons aged 17 who are within three months of their 18th birthday will be urged to get a vaccine in the coming weeks.
But crucially the JCVI hesitated on a full rollout for under-18s. It said: ‘At this time, our view is that the health benefits of universal vaccination in children and young people below the age of 18 years do not outweigh the potential risks.’
A key reason for the JCVI’s caution is the emergence of a rare side effect: a risk of heart inflammation in about one in 20,000 after a dose of Pfizer’s vaccine. Young men are said to be at a slight increased risk of this. And only the Pfizer jab is approved at present for use in children aged 12 to 17.
Meanwhile, the risk of a healthy child dying from the virus is so small it’s hard to put a figure on it.
Scientists recently looked at death records in England and concluded that 25 people under 18 died as a direct result of the Covid virus up to the end of February. Of these, 19 had some kind of chronic health condition, and most were aged ten or older.
So far Public Health England data shows that 469,982 children had Covid, meaning it led to about five deaths per 100,000 child infections. Experts have pointed out even this could be an overestimate, as routine testing of children was only introduced relatively recently.
This has led some scientists – including those on the JCVI panels – to conclude the risk of the jab, however small, is greater than the risk of Covid to most children.
Professor Robert Dingwall, a JCVI member, caused a stir when he wrote last month: ‘Given the low risk of Covid for most teenagers, it is not immoral to think that they may be better protected by natural immunity generated through infection, than by asking them to take the possible risk of a vaccine.’
The sociologist at Nottingham Trent University, who sits on the Government’s Sage advisory board, added: ‘A last wave of mild infections in unvaccinated younger people may well be what we are now seeing.’
Other child health experts seem to agree.
Newcastle paediatrician Dr Sunil Bhopal said he felt the JCVI’s ‘cautious approach’ was the right one. He added: ‘Children get ten to 13 viruses a year on average. It’s not that we want them to get flu, or RSV [an infection than can cause severe respiratory symptoms], but we accept the risk that they might, as part of going out and getting an education, and having fun with their friends.’
Many experts have pointed out that the vaccine programme was modified after it emerged that the AstraZeneca vaccine could trigger blood clots in rare instances. Although the risk was tiny – vastly smaller than for many other commonly taken medicines – the risk of severe Covid illness for those aged 18 to 30 was even lower, and so this age group is no longer offered that particular jab.
Dr Bhopal, along with many experts, is concerned about the prospect of another controversy. ‘All medicines have side effects. And all it would take would be one or two cases of complication arising from a Covid jab to seriously dent trust in it, and our other childhood vaccination programmes.’
Many have suggested it’s vital to look beyond the personal health risk the virus poses to children and consider the wider impacts that a continuing pandemic causes, in terms of disruption of education, and wider mental health.
Schools often require entire year groups to go into ten-day isolation if one pupil tests positive. Earlier this month more than 250,000 children were reported to be quarantining in such circumstances. This is despite data showing that just one in 50 goes on to develop Covid.
Dr Bhopal agreed it was a big problem, but said: ‘This needs to stop. It doesn’t require vaccination, it requires a change in policy.’
However, not all experts are convinced. Last week data expert Professor Christina Pagel, director of the Clinical Operational Research Unit at University College London,
wrote: ‘Ten to 15 per cent of twoto-16-year-olds report [Covid] symptoms for more than five weeks. We vaccinate school-age children against flu every year and Covid is more fatal than flu, even for young children. I just cannot understand how it’s OK to get to immunity in under-18s by infecting millions of children, whereas over-18s get to do it by a safe and effective vaccine.’
DR JULIAN Tang, Professor of Respiratory Sciences at Leicester University, called the JCVI decision not to vaccinate all children ‘odd’ when so many other countries were doing so.
He said: ‘There is enough data from around the world to show the risks-versus-benefits ratio is in favour of universal child vaccination. I’m curious as to what British scientists think they know, that their esteemed colleagues in so many other countries don’t.’
Programmes to vaccinate children aged 12 and up have been under way in the United States and Canada, New Zealand and Japan, among others, since June. This came after the drug company published trial data showing it was effective and safe.
In Europe, Italy, France and Denmark are already giving healthy children vaccines. In Spain there are plans for 12-to-17year-olds to be jabbed before the new school year in September.
Prof Tang argues that the pandemic will only truly end once all children – including babies – are jabbed. Until then the virus will continue to circulate, hitting us with wave after wave like the one we are now seeing. He added: ‘There are many people who are still vulnerable to Covid. This delay in vaccinating children will have consequences.’
The JCVI has said it’s not clear how effective it would be to jab children, in an effort to stop the virus spreading to older, less resilient members of the community.
Not so, according to Dr Peter English, a communicable disease expert. He says: ‘There is enough evidence now that schools reopening has been linked to outbreaks. It is clear that vaccinating children aged 12 to 17 would dramatically decrease the number of overall Covid cases. We are now moving to a phase where it will be important to vaccinate based on who will transmit rather than jabbing people most at risk.’
But paediatrician and JCVI member Professor Adam Finn wrote: ‘There’s a lot of discussion about the merits of immunising children to protect adults but surprisingly little about the importance of immunising adults to protect children and their education.
‘Getting first and second doses into adults right now is the best thing to do.’
While all British adults have been offered a vaccine, far from 100 per cent have taken it up.
A quarter of 30-to-34-year-olds are still unvaccinated, and that figure rises to roughly a third of 18-to-29-year-olds.
Prof Pagel commented: ‘With [Indian variant] Delta we probably need 85 per cent plus of population immune. Children are 21 per cent of the English population. You cannot get to 85 per cent without a high proportion of children being immune.’
If this were to be done via infection, at least six million children would need to catch the virus, she said, adding: ‘Each one also potentially infecting someone else. Each one providing a chance for Covid to mutate further.’
Just last week, official data showed that 90 per cent of the population could carry coronavirus antibodies – showing they have been either vaccinated or infected with the virus, or both. Despite this Covid hospitalisations in some areas are rising rapidly.
Government models suggest the peak of our current wave could hit roughly 2,000 hospitalisations and 200 deaths a day by August – however Sage was quick to point out that these figures were highly uncertain, partly because they weren’t totally sure how many people there were in the UK.
‘Although the number of [vaccine] doses administered is known, the overall population size and hence the number of unvaccinated people is not,’ it said.
For instance, NHS England data shows 1.98 million first doses have been given to 75-to-79-yearolds. But according to the Office for National Statistics, which keeps the official records, there are only 1.94 million 75-to-79-yearolds in England. And even single percentage differences in population figures can have a huge impact, resulting in thousands more hospital cases.
Chief Medical Officer Professor Chris Whitty last week refused to rule out reintroduction of restrictions should that happen.
It would seem that allowing the virus to spread unchecked in children may be a gamble.