Universal versus risk-based strategies for vaccinating children against COVID-19: Japan and Korea

Area of Science:

• Pediatric infectious diseases
• Public health policy
• Vaccinology

Background:

• The global impact of COVID-19 highlights the critical need for effective pediatric vaccination strategies.
• While most pediatric COVID-19 cases are mild, children with underlying health conditions face severe risks, necessitating targeted public health interventions.
• Different national approaches to pediatric COVID-19 vaccination exist, with varying levels of success in achieving broad coverage.

Discussion:

• Comparing Japan's universal recommendation with Korea's high-risk prioritization reveals significant differences in vaccination coverage rates (Japan: 19%-72%; Korea: 2%-55%).
• Despite similar healthcare infrastructures, Japan's approach yielded substantially higher vaccination uptake among children.
• Korea's higher child mortality rates associated with COVID-19 suggest that its risk-prioritization strategy may be less effective in mitigating severe outcomes.

Key Insights:

• Universal pediatric vaccination policies are associated with higher coverage rates and potentially lower child mortality.
• Current vaccination strategies in both nations lack robust methods for assessing and addressing individual-level risk factors.
• A systematic, universal approach to pediatric vaccination may offer superior protection against the broader impacts of infectious disease outbreaks.

Outlook:

• Further research is needed to understand the specific factors driving the differential vaccine uptake between Japan and Korea.
• Developing personalized risk-assessment tools could enhance the effectiveness of future pediatric vaccination campaigns.
• Implementing universal vaccination strategies is recommended to systematically reduce the impact of future pandemics on child populations.