As with any other vaccine or medical product, the decision of whether or not to vaccinate rests on whether the benefits outweigh the potential risks for the individual and at population level.
In general, children are at low risk of severe COVID-19 disease, although serious conditions, such as multiple inflammatory syndrome in children (MIS-C), as well as post-COVID condition and myocarditis do occasionally occur. Recent surveillance data from the US has reported 91% effectiveness of the Pfizer-BioNTech COVID-19 vaccine (2-dose series) in reduction of MIS-C in adolescents 12 to 18 years of age[^1]. Moreover, vaccinating children has additional benefits of minimizing disruption to their education, therefore improving their overall well-being.
The potential risks of COVID-19 vaccination in children are also very low.
The benefits of vaccination outweighs the very rare risk of peri/myocarditis following mRNA vaccines, especially after the second dose, in males 12-19 years of age. The probability of such events remains very low (<1/10,000 administered doses) and the vast majority of cases have evolved favorably in a few days and with hardly any treatment. Furthermore, it is important to remember that risk of developing myocarditis is much higher following COVID-19 disease[^2] [^3].
WHO recommends that children aged 5 – 17 years with comorbidities that put them at a higher risk of serious COVID-19 disease should be offered vaccination.
A paediatric formulation of Pfizer-BioNTech (Comirnaty) vaccine is available for children aged 5 -11 and has been approved by the US Food and Drug Administration, European Medicines Agency and other regulatory authorities.
WHO further recommends that vaccination of healthy children should only be considered when high vaccination coverage of higher priority groups, including the administration of boosters, has been achieved.
- Zambrano LD, Newhams MM, Olson SM, Halasa NB, Price AM, Boom JA, et al. Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination Against Multisystem Inflammatory Syndrome in Children Among Persons Aged 12–18 Years — United States, July–December 2021. MMWR Morb Mortal Wkly Rep. 2022 Jan 14;71(2):52,58. DOI: https://doi.org/10.15585/mmwr.mm7102e1.
- Oster ME, Shay DK, Su JR, et al. Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021. JAMA. 2022;327(4):331–340. DOI: https://doi.org/10.1001/jama.2021.24110
- Boehmer TK, Kompaniyets L, Lavery AM, Hsu J, Ko JY, Yusuf H, et al. Association between COVID-19 and myocarditis using hospital-based administrative data - United States, March 2020-January 2021. MMWR Morb Mortal Wkly Rep. 2021 Sep 3;70(35):1228,1232. DOI: https://doi.org/10.15585/mmwr.mm7035e5