Explainer | Covid-19: what parents want to know about vaccinating children

Increasing numbers of children around the world are becoming infected with Covid-19 as the Omicron variant fuels a surge in cases. In many places this reflects the fact that children are less likely to be vaccinated, prompting many governments to redouble their efforts to boost vaccination rates. In Hong Kong, for example, the Sinovac and BioNTech vaccines will be made available to 400,000 children aged between five and 11. Some parents have questioned whether the vaccines will affect their children’s growth and development, or whether there are pros and cons to different types of vaccine. Here are some of the most common issues raised. Why vaccinate children? Child infections and hospitalisations are surging in many regions. “In most countries, immunisation of children is at a lower level than that of adults,” said Professor Terence Stephenson from University College London. “After two years of a pandemic, with children’s education and development being so disrupted, one of the big arguments for vaccination is that it stops them having to isolate and be absent from school. I think that’s a perfectly good reason.” In the United States, over 1.1 million children tested positive last week, doubling the case counts from two weeks prior, and bringing the total number of child Covid-19 cases to 10.6 million. Omicron: BioNTech booster shot offers enough protection, Hong Kong team finds In Hong Kong, over 500 children under nine have contracted the virus. What are the arrangements in Hong Kong? Full-day and in-person school classes in Hong Kong are suspended until February 21 and the Education Bureau sees increasing inoculation rates as a path to resuming normal classes. Children between the ages of five and 11 are able to receive the Sinovac vaccine starting on January 21 and the BioNTech vaccine starting from February 16. The BioNTech vaccine will be administered to children in a third of the adult dose – an “off-label” practice also adopted in Britain, implying that the drug is used in a manner not included in the product registration. As of Friday, over 6,000 children had received the first dose, accounting for 1.5 per cent of the group. BioNTech ‘committed’ as wait goes on for China to approve its Covid-19 vaccine Are Covid-19 vaccines effective for children? The efficacy of Covid-19 vaccines in children is similar to, if not higher than, that for adults, according to Wilson Lam, an infectious diseases specialist at Hong Kong’s Gleneagles Hospital. “Children’s immune systems are stronger, especially when compared to older people, hence their response to the vaccine will also be better – this is backed up by the data we have now,” he said. Sinovac or BioNTech? When deciding what vaccine to give their children, adults should consider the same factors that they did for themselves – except for one thing. “The only factor that is rare among adults and more particular to children is the risk of myocarditis, but that’s the only difference,” Dr Lam said. Experts at the University of Hong Kong found that teens receiving two doses of BioNTech were six times more at risk of inflammation of the heart muscle than those receiving one. However, such cases are rare, with three in every 100,000 over-12s showing symptoms, which rises to 22 in every 100,000 after two doses. “BioNTech may be more effective [than Sinovac] in terms of preventing severe conditions and protecting the individual against the virus, but the side effects will also be greater,” Lam added. Trials in adults found that BioNTech had an efficacy rate of 95 per cent compared with Sinovac’s of just over 50 per cent. Inhaled Covid-19 booster ‘more effective than third dose of Sinovac’ BioNTech’s own data also suggests it is more than 90 per cent effective for children aged between five and 11. Last month the first report into Sinovac’s efficacy for children – released by the Argentine health ministry – found it was 76 per cent effective against Covid-19 and 87.6 per cent against hospitalisation. Do children experience more severe side effects from the vaccine than adults? Mild side effects are a normal sign that the body’s immune system is building protections and are common in children as well as adults. The Mayo Clinic in the US found that the side effects experienced by children who received the BioNTech vaccine were similar to those felt by adults. Vaccine T-cells may hold robust defensive line against Omicron: study They include a sore arm, fatigue, headache and chills, but they usually disappear within one to three days. Some people experience no side effects at all. Will the vaccine affect a child’s development? While current data cannot show if the vaccines will have long-term effects, the Mayo Clinic noted that vaccines “rarely” do. The US Centres for Disease Control and Prevention have warned that it is a “myth” that children will build a stronger immunity by getting infected with the disease instead of getting vaccinated. In fact, unvaccinated children are at greater risk of becoming seriously ill or even dying. How does Hong Kong’s vaccination rate compare with mainland China? At present, more than 70 per cent of Hong Kong’s population aged 12 and older have received two doses and more than 83 per cent of those aged 12 to 19 are fully vaccinated. Covid-19 experts agree: 2021 was a failure for vaccine distribution According to the National Health Commission, mainland China has administered nearly 3 billion doses of Covid vaccines so far. Over 1.2 billion people, or 85 per cent of the population, have completed their course of vaccination. Seven vaccines are available in mainland China, including the World Health Organization-approved Sinovac, which is also available in Hong Kong. Are children in other countries getting vaccinated? Mainland China has been vaccinating children between the ages of three and 11 since October last year. Singapore, Saudi Arabia, the US, Britain and the European Union are vaccinating children as young as five, while Russia, Sweden, South Korea and the Philippines are among those vaccinating those aged 12 and over.