Episode #42 - Vaccines and children

VGS   If you've been wondering about vaccination of children against Covid-19, this episode of Science in5 is for you. Hello and welcome. I'm Vismita Gupta-Smith and we are talking to WHO's Chief Scientist, Dr. Soumya Swaminathan today. Welcome, Soumya. So my first question to you is, at this time in June 2021, WHO saying that vaccinating children is not a priority. Could you please explain why?

SS   So the reason that today in June 2021, WHO is saying that vaccinating children is not a priority is because children, though they can get infected with Covid-19 and they can transmit the infection to others, they are at much lower risk of getting severe disease compared to older adults. And that is why when we started prioritizing people who should get the vaccination when there are limited supplies of vaccines available in the country, we recommend that we start with health care workers and frontline workers who are at very high risk of exposure to the infection.

Also, elderly, the people who have underlying illnesses that make them at high risk to develop severe disease and start with those groups, protect them first, because we want to reduce the death rates that we are seeing today globally and then gradually come down age-wise in the population till we get to children. And again, while there may be some children who are at higher risk of getting the severe disease because of some underlying illnesses or vulnerabilities or comorbidities, those children potentially could be prioritised for vaccines when they become available.

But children as a group form a much lower priority group. 

VGS   Soumya, in future then, would WHO be recommending or looking at recommending vaccination for children? And when do we expect that?

SS   So most vaccine companies and developers are currently doing studies in children, starting with the 12 to 18 year olds and then progressively going down to younger and younger age groups. So as that scientific data comes out of the studies, the SAGE, which is the strategic advisory group of experts on immunization that actually develops vaccination policy for WHO, which is then adopted by many countries. The SAGE will look at this data as it comes and make recommendations on how the vaccine should be used in children, at what dosage, what interval, etc. whether there are any safety precautions or contraindications, all of that will be provided in detail. But again, to go back to the point of children, except for very few children who are at a high risk, not considered to be a high priority right now because we have limited doses of vaccines, we need to use them to protect the most vulnerable. And also, we have to remember the fact that it's not necessary that children must get the vaccine before they can go back to school. We've seen in many countries that schools have been kept open very successfully.

And as long as the adults who are working in the school environment are vaccinated and adults in the community are getting the vaccine so that infection rates start  dropping, then by following the other public health measures that have been advised for school safety, schools should be able to reopen safely.

VGS   Soumya, how will we ensure safety of these vaccines?

SS   WHO places a lot of importance on the safety of vaccines, and in fact, we have a group called the Global Advisory Committee on Vaccine Safety. These are experts from all over the world who meet regularly and who advise WHO periodically, monitoring the safety signals from vaccines that are being used around the world and advising WHO if they want to make any specific recommendations. So, as you know, these vaccines are first put through clinical trials to assess the safety and efficacy.

So the same thing is happening in children now. All of these vaccines are undergoing testing in children to make sure that they are safe as well as effective and establish the dose at which they should be used. And following those studies, which usually involve a few thousand children, as these vaccines get deployed in children, we will continue to monitor the safety through the existing adverse event reporting systems and the pharmacovigilance programs. And all the data comes to WHO from regulatory agencies, from these global monitoring systems,  so that we can periodically review the safety data and make any recommendations if there are any concerns about safety.

Those will immediately lead to an alert on the usage. So we will be monitoring the safety of vaccines as they get rolled out.

VGS   Thank you Soumya. That was Science in 5 today. Until next time the. Stay safe, stay healthy and stick with science.