Considerations for vaccinating children against COVID-19

Area of Science:

• Pediatrics
• Infectious Diseases
• Vaccinology

Background:

• COVID-19 vaccination is expanding to pediatric populations globally.
• Decision-making for pediatric COVID-19 vaccination in countries yet to adopt it is complex due to high community transmission and infection-derived immunity.
• Routine childhood vaccine coverage has declined during the pandemic, impacting diseases like measles and polio, which have higher morbidity/mortality in LMICs than COVID-19.

Purpose of the Study:

• To review the epidemiology of COVID-19 in children, focusing on LMICs.
• To summarize the safety, efficacy, and effectiveness of COVID-19 vaccines in children and adolescents.
• To highlight the complexities and considerations for introducing pediatric COVID-19 vaccination, particularly in LMICs.

Main Methods:

• Literature review of published studies on COVID-19 in children.
• Analysis of safety, efficacy, and effectiveness data for COVID-19 vaccines in pediatric populations.
• Focus on data relevant to low- and middle-income countries (LMICs).

Main Results:

• COVID-19 vaccines for children have a positive risk-benefit profile, though the benefit is less pronounced than for other life-saving vaccines, especially in LMICs with high infection-derived immunity.
• Resource allocation for vaccine rollout is a significant challenge for LMICs.
• There is a paucity of epidemiological data on COVID-19 in children within LMICs.

Conclusions:

• Pediatric COVID-19 vaccination decisions are complex, particularly given widespread infection-derived immunity in this low-risk group.
• Prioritization of at-risk children for COVID-19 vaccination is recommended.
• Introduction of COVID-19 vaccines in children should be an opportunity to bolster routine immunizations and preventative healthcare, ensuring equitable access to vaccines for future epidemics.