AFFIRMATION COMPLETE: “The WHO says children should not receive COVID-19 vaccines”
REVIEW
The development and authorization of COVID-19 vaccines initiated a large worldwide campaign of mass vaccination. As of 25 June 2021, there were 2.79 billion doses administered in the world. In the U.S., 150 million people are already fully vaccinated as of 24 June 2021.
So far, children and adolescents under 18 represent a small fraction of the fully vaccinated population in the U.S., with only 6 million vaccinated under 18, of whom only 103,652 are under 12. In June 2021, the claim circulated that children should not be vaccinated against COVID-19 according to the World Health Organization (WHO).
One example of this can be seen in this Instagram post, sharing a screenshot of an article published on 21 June 2021. However, the article’s headline and the Instagram post’s content are misleading as they left out important context from the WHO communication. The WHO’s intent in the original document was clarified in an updated version of its guidelines.
The claim as formulated in the article’s headline suggested that the WHO published a blanket ban against vaccinating children against COVID-19. Some misconstrued the WHO statement as an indication of problems with safety (see examples here, here, and here).
In a document about COVID-19 vaccines for the general public, the WHO had initially stated that children “should not be vaccinated for the moment” [emphasis added]. The fact that this position of the WHO about COVID-19 vaccination for children was temporary was actually cropped out in this Instagram post, misleading readers into believing that the WHO advised against COVID-19 for children under any circumstances.
The initial WHO document further explained this temporary recommendation by the importance of gathering more data: “There is not yet enough evidence on the use of vaccines against COVID-19 in children”.
Importantly, this version is now out-of-date as the WHO released an updated version later on. The new version made it clear that WHO isn’t recommending COVID-19 vaccination for children but rather states that “unless they are part of a group at higher risk of severe COVID-19, it is less urgent to vaccinate them”.
The WHO detailed the reason why COVID-19 vaccination for children isn’t as urgent as it is for other categories. First, clinical data on the effect of COVID-19 vaccination in children are limited so far. For instance, the initial Pfizer-BioNTech COVID-19 clinical trial that provided data for the authorization was limited to volunteers aged 18 and above. Clinical trials for the Moderna and Johnson & Johnson COVID-19 vaccines were similarly limited in the age group.
However, Pfizer subsequently conducted another clinical trial, this time in children aged 12 to 15, which yielded positive results according to a press release by Pfizer, reporting a 100% efficacy in that age group: no COVID-19 cases occurred in the group of teenagers receiving the vaccine, whereas 16 cases were reported in the control group that received a placebo. In line with the results of this clinical trial, the Food and Drug Administration (FDA) extended their emergency use authorization for the Pfizer-BioNTech vaccine to include people aged between 12 to 15 on 10 May 2021. The European Medicines Agency followed suit on 28 May 2021. Another of Pfizer’s ongoing clinical trials is assessing the vaccine efficacy and safety in children as young as six months.
Additional data on COVID-19 vaccine safety and efficacy among children are being collected by other vaccine manufacturers. According to press releases, Moderna is conducting a clinical trial of its vaccine for children aged 6 months to 12 years and Johnson & Johnson is now investigating its vaccine in the 12 to 17-year-old population.
Therefore, the WHO stance on COVID-19 vaccination of children reflects the fact that data are still limited. However, our knowledge of this subject is expected to be strengthened soon: “More evidence is needed on the use of the different COVID-19 vaccines in children to be able to make general recommendations on vaccinating children against COVID-19”, said the organization.
The WHO also stated another reason why COVID-19 vaccination of children is not the top priority: “Children and adolescents tend to have milder disease compared to adults”. Indeed, a CDC study showed that children are less susceptible to getting infected by SARS-CoV-2 and less at risk of developing symptomatic or severe forms of COVID-19. The study, focusing on COVID-19 outbreaks in schools, also reported that children aren’t the main drivers of COVID-19 spread. The U.S. counted 324 deaths involving COVID-19 among people below 17 since the beginning of the pandemic, as of 23 June 2021, 0.05% of the total. These data have led some to consider that children as a low-priority group for vaccination.
However, it is important to bear in mind that children are a very diverse population. Even though they are less vulnerable to COVID-19 in general, some children might be more severely affected, such as those with underlying health conditions like diabetes and asthma. Claims that imply or suggest that safety risks to children were the reason for the recommendation also fail to account for the fact that it excluded children with underlying health conditions that place them at greater risk for severe COVID-19 and complications.
On some rare occasions, COVID-19 in children appears to be associated with a serious multisystem inflammatory syndrome characterized by several inflammatory symptoms such as fever, rash, swelling or pain. Furthermore, a study by the CDC found that “Hispanic ethnicity, Black race, and underlying conditions were more commonly reported among children who were hospitalized or admitted to an ICU, providing additional evidence that some children might be at increased risk for severe illness associated with COVID-19”.
Therefore, even if children in general aren’t the population most at risk and therefore don’t require an urgent vaccination against COVID-19, they will still benefit from it. In addition, some subgroups of children seem more exposed or vulnerable to the consequences of COVID-19 and are in a more urgent need of vaccination.
In summary, it is true that WHO had initially recommended for children not to be vaccinated against COVID-19, but the recommendation was only temporary, contrary to what was implied or claimed in some social media posts. To clarify its position, the WHO has since updated its statement to explain that children are generally not at as much risk from COVID-19 as other age groups and therefore aren’t a priority for vaccination, unless they have conditions that place them at higher risk of illness. More data regarding the effects of COVID-19 vaccination in children are being collected. It is also important to note that some children are more vulnerable to COVID-19 than others, therefore vaccination remains a valid strategy recommended by the CDC.
