The decision to extend the offer of Covid vaccination to younger children was reached after months of intense deliberation about the benefits and risks by the Joint Committee on Vaccination and Immunisation (JCVI). Finally, on Wednesday, the group’s recommendation that vaccination should go ahead for five- to 11-year-olds was made public.
Surprisingly, given this was a long-awaited decision, there was no public briefing by the government. The short, neutral statement from Sajid Javid, the health secretary, that children in England would be eligible for vaccination from April “so that parents can, if they want, take up the offer” may have left some parents feeling confused or that the buck had simply been passed to them.
However, the JCVI makes clear that while the children are at very low risk from Covid-19, it recommends that vaccination goes ahead, and the reasoning behind its decision provides some useful guidance to parents. The main motivation is not to avoid school absences but to “future-proof” younger children against waves of infection that are predicted to occur later this year.
The benefits and risks are finely balanced. The number of cases of very severe illness avoided will be small, and vaccine safety is well established at this point and side-effects tend to be mild. To give a sense of the numbers being considered, the JCVI estimates that in a future severe wave of Covid, vaccinating 1 million children with two doses each would avoid 58 hospitalisations and three ICU admissions. When the committee considered school absences, it found the impact of vaccination was “indeterminate” because side-effects from vaccination, though mild, might cause children to miss school.
The JCVI recommends a “non-urgent” offer because the threat from Covid-19 is not the most pressing public health priority for this age group. It is crucial, for instance, that extending Covid vaccines does not disrupt childhood vaccination programmes such as MMR, which have fallen behind during the pandemic and tackle a more serious threat to the health of most young children.
However, the government announcement may have left some parents wondering if the lack of urgency should be taken as a personal instruction – don’t worry about coming forward, it isn’t that important – or even reflect some degree of uncertainty about the decision. The JCVI has said parents should not be rushed into a decision, but the recommendation is that people come forward when a vaccine is offered.
Given the fine balance, it is right that parents are free to choose whether to vaccinate their children against Covid-19, and experts have welcomed this move.
Simon Williams, a senior lecturer in people and organisation at Swansea University, said: “I think leaving the decision to parents is a good idea. The important thing is that parents of younger children in the UK, like parents in many countries internationally, now have the choice. Ultimately, what most parents seem to have wanted is the choice to have or to not have the vaccine for their children.”
In the absence of a formal recommendation from government, it is crucial that the science behind this policy is clearly communicated so that parents can, as they have been asked, come to their own informed decision.
