Child immunization: the 39 countries that have approved immunization of children under 12 against Covid

At least 39 countries have authorized or have started the use of Covid-19 vaccines in children (under 12 years old), and the vast majority apply or will apply Pfizer/BioNTech’s immunizing agent for young people aged 5 to 11 years.

But, in addition to this, there are several vaccines adopted for this age group around the world: Sinopharm, Sinovac (Coronavac) and Soberana 02.

Doctors, health officials and scientists have argued that given the persistence of the delta variant, the accelerating advance of omicron and the return to face-to-face teaching, vaccinating children is the crucial next step in combating the pandemic.

“Parents need to understand the urgency of vaccination because the pandemic is not over,” James Versalovic, chief pathologist at Texas Children’s Hospital (USA) told the BBC.

The endorsement by US authorities, for example, was given after a group of experts from the Centers for Disease Control and Prevention (CDC) and the local food and drug control and regulation agency (FDA) assessed the risks and benefits of vaccinating children. against Covid-19.

In the US, more than 5 million children have already received the Covid vaccine. In justifying the need to vaccinate children, the US CDC says they can develop severe cases of Covid-19 and that they can also have short-term and long-term health complications developed from Covid.

Official data from the US point to nearly 1.8 million cases of Covid in children aged 5 to 11 years in the country. Nearly 200 died, and most of them already had chronic health problems.

The vaccine is effective and safe for children, according to researchers, regulatory agencies in several countries (including Anvisa) and the World Health Organization (WHO).

According to analyzes by US regulator researchers, the Pfizer/BioNTech vaccine is nearly 91% effective in preventing Covid in young children, an immune response comparable to that seen in people aged 16 to 25 years. No serious side effects were identified by the researchers.

The vaccine for the age group from 5 to 11 years has a different dosage (one third of that applied in adults) and requires smaller needles.

The second dose is estimated to be given three weeks later. As a result of these changes, countries need to place new orders with Pfizer/BioNTech, rather than splitting doses already purchased.

In Europe, at least 23 countries have already approved or have started vaccination of this age group against Covid-19.

They are: Germany, Austria, Belgium, Croatia, Cyprus, Denmark, Slovakia, Spain, Estonia, Finland, France, Greece, Netherlands, Hungary, Ireland, Italy, Latvia, Lithuania, Malta, Portugal, United Kingdom, Czech Republic and Sweden .

There are several differences in the programs adopted on the European continent. Many decided to immunize all children in this age group, like Portugal.

But other countries will start immunizing only those at high risk of contracting the severe form of Covid-19, such as the UK, France, Finland and Sweden. Immunization is expected to be expanded in the coming weeks in these countries.

At least 16 other countries have also authorized or started vaccinating children, according to data gathered by the Reuters news agency and BBC News Brasil report.

They are: Australia, Bahrain, Brazil, Chile, China, Cuba, El Salvador, UAE, Ecuador, USA, Israel, Indonesia, Philippines, New Zealand, Singapore and Thailand.

In Brazil, the National Health Surveillance Agency (Anvisa) authorized on December 16 the application of the Pfizer vaccine to children aged 5 to 11 years.

Now, the immunization of this public, in practice, depends on the Ministry of Health. But minister Marcelo Queiroga said that the matter will only have a definition on January 5th (understand further below in this text).

The first country to apply vaccines to young children was China, in June, when authorities approved the emergency use of the vaccine from the manufacturer Sinovac (a partner of the Butantan Institute in Brazil in the production of Coronavac) for young people aged 3 to 17 years.

The country has set an approximate target of vaccinating 80% of its 1.4 billion population by the end of the year, a number impossible to reach without also including a large number of children under 18 years of age.

In theory, the Covid-19 vaccine is voluntary in China, although some local governments have said that students will not be allowed to return to school this semester unless their entire family has been vaccinated with two doses.

This same Coronavac vaccine has been approved for emergency use in children over 6 years of age in other countries, such as Chile (September), Ecuador (October) and Indonesia (November).

Cuba, in turn, began vaccinating children aged two to 18 years old with vaccines produced in the country at the beginning of the month, making it the first country in the world to immunize such young children. The campaign will be carried out in stages to enable the return to school.

In November, the UAE and Bahrain also authorized the emergency use of the Pfizer/BioNTech vaccine for children ages 5-11. Both countries had already approved the use of another immunizing agent, Sinopharm, weeks before for young people aged 3 to 17 and 3 to 11 years old, respectively.

Vaccination of minors in Brazil

For now, the only vaccine being applied in Brazil to minors is Comirnaty, developed by pharmaceutical companies Pfizer and BioNTech, for young people aged 12 to 17 years. The Butantan Institute has already made a request for the use of Coronavac in minors, but Anvisa requested more data from the studies that support this type of request for use.

On December 16, Anvisa authorized the application of the Pfizer vaccine to children aged 5 to 11 years. Now, the immunization of this public, in practice, depends on the Ministry of Health. But Minister Marcelo Queiroga announced an unusual and problematic public consultation (initially carried out on a website that only accepts 50,000 contributions and which remained inoperative for hours), in addition to a public hearing , to make your decision. Queiroga also said that the matter will only have a definition on January 5th.

The Bolsonaro government has also said that it will require a medical prescription for each child to be immunized, but several Brazilian states have reacted against the “unreasonable” measure and said they will not require any medical approval, as the vaccine was approved by Anvisa and the technicians from Ministry of Health itself.

Pfizer’s vaccine approved in Brazil for children has a different dosage and composition than what is already being used for those over 12 years of age.

Queiroga said that “haste is the enemy of perfection”, when commenting on the vaccination of children. “Parents will have the answer at the right time, without haste.”

More than 300 children aged 5 to 11 years died from Covid in Brazil during the pandemic, one of the highest rates in the world.

For infectologist Raquel Stucchi (Unicamp), “not to be in a hurry at this time is putting our children at risk, it’s letting them live in an unsafe environment”.

Stucchi says that putting Anvisa’s decision in public consultation is “an aberration”.

“We have never put the decision to introduce vaccines on our calendar into public consultation. We have committees of experts who advise the immunization program to decide whether or not to include a new vaccine – whether for children, adults, elderly or pregnant women. This decision reflects the will to government’s explicit intention to block, hinder the vaccination of children against Covid in Brazil”, says the infectologist.

In addition to immunizing children, childhood vaccination is important to help protect those around them – including other children who have not yet reached the eligible age for vaccination and young people and adults who for very specific health reasons have weakened immunity even when vaccinated , for example.

The Pfizer/BioNTech approval for 12 to 17 year olds, for example, was based on a study that included 1,972 adolescents, in which a 100% effectiveness rate was detected.

The main side effect of the Pfizer vaccine in younger people has been myocarditis, a type of inflammation in the heart muscle. But cases are considered very rare and mild.

According to the calculations (the same used by the Ministry of Health), 16 individuals were affected for every 1 million vaccinated, and most cardiac inflammation was mild. Those affected recovered after a short period of treatment and rest. Also, no infarction resulting from this complication was observed.

Authorities are still studying whether this heart problem is really caused by immunization agents or whether there is no relationship at all, says Dr. Denise Garrett, vice president of the Sabin Institute of Vaccines, an organization that works with public policy on immunization in several countries around the world.

According to the US Centers for Disease Control and Prevention (CDC) website, the most common symptoms that appear in teenagers after the vaccine are pain and redness in the arm, tiredness, headache, chills, fever and nausea. Not all people feel the discomfort – and even those who have these side effects, the condition is usually mild and lasts a few days, according to the American entity.

And although teenagers are not among the most affected by coronavirus infection, experts interviewed by BBC News Brazil understand that bringing this protection to them is a natural step, even though it is more urgent and priority to guarantee the second dose to adults and give a third in vulnerable groups.