Vaccinating younger children

What to do about vaccinating young children is among the stack of issues the Government faces as New Zealand transitions from Covid elimination.

This is particularly pertinent as Auckland primary school pupils go back to school next week. While the matter has slipped to the background in the face of more urgent problems, there is a danger it could prove yet another example of Government tardiness.

The case for vaccinating 5- to 11-year-olds for protecting the wider population and minimising Covid spread and Covid deaths is compelling. Even as vaccination rates for those 12-plus head towards 90%, that figure is only for the eligible population. The under 12s lower the overall proportion considerably.

Among the unvaccinated, the most likely to spread the virus, are those 460,000 young New Zealanders. They are a large infection pool. They will bring Covid back into families, which could be devastating in unvaccinated households or where there are vulnerable people.

Pfizer has tested a one-third dose for this age range. The absence of any serious side effects prompted the United States Food and Drug Administration to approve its emergency use.

The roll-out has begun. San Francisco has gone as far as planning to extend its indoor proof of vaccination to 5- to 11-year-olds. The continuing monitoring of side effects will be especially important because the size of the trial was relatively small.

The case for vaccinating children when the direct benefit to them is weaker is less clear cut. While all ages catch Covid and everyone can become ill, the likely seriousness is closely related to how old someone is. However, the matter becomes a numbers game. Even if bad outcomes are unlikely, Covid will move steadily through the unvaccinated including the children.

In the United States, 300 Covid hospitalisations with 100 in intensive care and 146 deaths have been reported for that age group. A growing concern is “long Covid”. Again, this might be much less likely in younger children, but it does occur. Fundamentally, catching Covid will be much riskier than receiving the vaccine.

As well, Covid positive cases in children will close schools for periods. This happens now in the US. All this reinforces the Government’s teacher vaccination mandate, despite looming staffing difficulties from next week.

New Zealand has one advantage in being a little behind the rest of the world. By the time, they are approved, the paediatric doses will have been injected into many millions of arms. Several nations are already vaccinating the young. China has been inoculating 3-year-olds.

The Government has talked about beginning early next year, perhaps in time for the start of school. But we might find again that action has been too slow. The story of the past 20 Covid months is littered with such delays.

We were too slow to test all MIQ staff, slow to procure vaccines, slow to adopt mask protection, inordinately slow to introduce saliva PCR testing and rapid saliva antigen testing and slow to change MIQ. It is understandable the concentration now is on increasing rates for those at present eligible. The Government is also faced by Auckland, Waikato Northland level issues, overwhelmed contact tracing, its MIQ nightmares, the implementation of vaccine certificates, vaccination job mandates, Auckland’s border, its burgeoning debts, anti-vax protests, increasing non-compliance, booster shot questions, ICU and health worker shortages, approval for and sources of the new anti-viral Covid pills and so on.

But how ready is Medsafe to approve the junior doses? Has the Government satisfactory Pfizer orders in place and will such vaccines be delivered promptly? What will be the distribution plan?

Covid will spread everywhere once Auckland opens by Christmas, even with the opening being just for the double vaccinated. It would save lives if New Zealand vaccination coverage included younger children when that occurs. But there is still much to do. That looks extremely unlikely.

 

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