Children should be offered coronavirus vaccines – but with no pressure

Editorial: Disruption to education is the main factor to be taken into account when it comes to vaccinating children, but it is for parents and children to accept or not accept the offer

The benefits are known, but small, given the ‘low risk of serious disease’ from Covid-19 for children (Getty)

The decision about offering vaccines against coronavirus to healthy children aged between 12 and 15 is one of the hardest of the pandemic so far. Anyone who says it is obvious either that children should or should not be vaccinated should be invited to study the statement issued by the Joint Committee on Vaccination and Immunisation (JCVI) and to consider sincerely the arguments of those who are opposed to their position.

The JCVI statement is a model of clarity. It says that “the benefits from vaccination are marginally greater than the potential known harms” for healthy children, but that this margin is “too small to support advice on a universal programme of vaccination”.

That is because the benefits are known, but small, given the “low risk of serious disease” from Covid-19 for that age group, while the potential harms of vaccines could be greater, but we do not yet know enough about them. The harms we know about so far, such as the risk of heart problems, are “very rare”, the JCVI says, but not enough time has passed to be sure of the effects of the vaccines, and data on other potential adverse reactions “may not be available for several months”.

In such a situation, the justifications for going ahead with vaccinating under-16s have to refer to factors outside the JCVI’s remit. One could be the danger to children of “long Covid”. That the JCVI does not even mention long Covid in its statement suggests that it does not think the condition is sufficiently well defined or quantifiable. This should prompt urgent attempts to find out more, but without better information it is hard to assert that the JCVI’s cost-benefit analysis is flawed.

However, the JCVI does refer to two other factors, which it says are not within its remit, and about which it suggests the chief medical officers could advise governments. One factor concerns the indirect benefits to children of minimising any disruption to their education; the other is the wider benefit to society as a whole of reducing the spread of the virus.

This last point is not as persuasive as some advocates of child vaccination assume. With levels of immunity in the population aged 16 and over of at least 85 per cent – either from vaccination or from infection – the main group to which children can pass on the virus is each other. About half of under-16s are estimated to have been infected already, but the other half could still easily be.

That leaves disruption to education as the main factor yet to be taken into account. This depends partly on how schools manage outbreaks, but it seems likely that vaccination would reduce the number of children who might have to be kept at home.

On balance, therefore, we think that the scale should be tipped in favour of vaccination, and that is what we expect the chief medical officers to recommend in the coming week. We think it is right that they and ministers should take a clear position rather than, say, leaving it entirely to parents to decide. However, because the decision is so finely balanced, they should make it clear that there are risks and benefits on both sides, and that it is ultimately for parents and their children to accept or not accept the offer.

No one should be suggesting compulsion – that is a controversial enough subject even for adults working in caring occupations – but in the case of vaccinations for under-16s, no pressure should be exerted on parents or children until more information is available.