Is vaccination safe for children

Difficult consideration: The corona vaccination for children and adolescents

The pediatrician always finds out on Thursday lunchtime whether Alexandra Lützenkirchen can bring many patients good news. Then the woman from Leverkusen receives the announcements for the vaccine deliveries for the coming week. "For this week we received 24 vaccine doses with two doctors in the practice. That is four longed-for bottles of the Biontech Pfizer vaccine. We had ordered twelve. We are currently very busy re-closing the vaccination appointments that we have agreed move."

Will the vaccine for 12-15 year olds soon be approved in Europe?

Lützenkirchen and her colleague have had a good 100 corona vaccinations in their practice so far: Trisomy 21 patients who are 16 years of age or older and other seriously ill adolescents have received them, but also parents of children with a high risk of severe corona -Course. So far, however, the doctor has not noticed a run on the vaccinations: "We actively call our eligible patients over the age of 16 and offer them the vaccination. That works well, but I am amazed that we have received very few inquiries from healthy adolescents after the prospect of vaccination. That only starts after the patients hear about the approval in the US. "

The US drug agency approved BioNTech-Pfizer's corona vaccine for children and adolescents between the ages of twelve and 15 earlier this week - following the Canadian authorities. This Wednesday, an advisory committee at the federal level could make a recommendation and thus give the go-ahead for the vaccinations.

The EU could give the green light at the end of May

In the USA, vaccinations for the offspring are supposed to give new impetus to the currently crippling vaccination campaign. And in Europe too, politicians are hoping for progress on the way to herd immunity with the extended approval of the vaccine, which could be available for the EU by the end of the month. In any case, the European Medicines Agency (EMA) is setting the pace. "We are trying to see if we can accelerate this by the end of May," said EMA boss Emer Cooke in a newspaper interview. Studies by the manufacturer BioNTech have shown maximum effectiveness and few side effects in this age group.

Mask requirement in schools: The corona vaccination could normalize lessons

After approval, according to Federal Health Minister Jens Spahn, series vaccinations in schools could help to offer all 12 to 18 year olds a vaccination offer by the end of the summer vacation and thus normalize school operations. Prerequisite: the parents must also have their offspring immunized.

No emergency approval

Since corona infections in children are generally associated with fewer symptoms, parents of healthy children are faced with a difficult decision. The German Society for Child and Adolescent Medicine (DGKJ) is correspondingly cautious. DGKJ President Jörg Dötsch points out clear legal restrictions: "It is always very important that a vaccination or drug therapy is only used in children if it is of direct benefit to the child or adolescent themselves. The hurdles are there So high because we have a group that is subject to protection, some of which of course cannot decide or speak for themselves, "said the director of the Clinic for Pediatric Medicine at the Cologne University Clinic in an interview with Deutschlandfunk. That is why it is absolutely essential that the focus is on self-interest, personal benefit for the children and adolescents. For these reasons, Dötsch speaks out against an emergency approval of the vaccination for adolescents.

For children vaccinations (here vaccination against measles) there is a stricter risk-benefit assessment

So far, the pandemic has been comparatively quiet on the children's wards in German hospitals. According to the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Hospital Hygiene (DGKH), around 1200 of around 14 million children and adolescents in Germany with a Sars-CoV-2 infection had been admitted to hospital by mid-April - five percent of them went to the intensive care unit.

Throughout Germany, the Robert Koch Institute has so far recorded a dozen COVID-19 deaths in the group of 0-9 year olds during the pandemic. For 10-19 year olds there are seven.

So far no case of long COVID

In her practice in Leverkusen, the pediatrician Alexandra Lützenkirchen has registered numerous Sars-CoV-2 infections. But: "Fortunately, we did not have a single child seriously ill with COVID-19. We did have patients among the adolescents who did not feel fit for a few months. But even then, after heart and lung examinations, I have not been able to confirm a case. which indicates long COVID. "

Sars-CoV-2 test in children: Healthy adolescents usually have mild symptoms

However, parents are not only concerned about possible long-term consequences, which are not uncommon with virus infections, the so-called PIMS syndrome is also mentioned again and again in the media. Four to six weeks after infection, this rare immune reaction can occur in children and adolescents and put the young organism in a kind of state of emergency.

Skepticism in Israel

The fear of long COVID and PIMS has so far been the central medical argument in favor of vaccinating children and adolescents. In addition to the medical component, there is above all a social dimension to the corona vaccination for adolescents. Can the corona pandemic be brought under control without vaccinating the under 16s? If the children are not vaccinated, epidemiologists calculate, the proportion of vaccinated adults would have to increase in order to stop the pandemic.

Greatly reduced corona restrictions: In Israel, more than 60 percent of the population are vaccinated

Israel is one of the countries that have vaccinated their populations particularly quickly and are now pushing for children to be vaccinated. There, the number of people vaccinated has stagnated for a good two months at around 60 percent of the population. The vaccination of children and adolescents in the very young society would increase this level. But in a survey in February, only 41 percent of the parents questioned were sure that they would have their children between the ages of 6 and 15 vaccinated - 29 percent refused.

Can the pandemic be stopped without vaccinating the children?

The pediatrician camp is also divided. While the Israeli professional association recommends vaccination, almost 100 doctors have spoken out in an open letter against vaccination for children. The previous experience and studies were not sufficient for such an application. In view of the very low incidence in Israel and extensive freedoms, the question of child vaccination in the country has now receded somewhat into the background.

It is quite possible that Europe, too, with vaccination rates of more than 60 percent of the population, will be able to normalize life like in Israel even without child vaccination. Beate Kampmann from the London School of Hygiene & Tropical Medicine also advocates a look beyond national borders: "If the virus is no longer spreading widely in a society and the vulnerable groups are vaccinated, you avoid more suffering by passing on the Vaccine at Corona hotspots such as India at the moment, than by vaccinating adolescents here, "said the professor.

How does the Stiko decide?

The Leverkusen pediatrician Alexandra Lützenkirchen is now waiting for the decision of the EMA and the subsequent recommendation of the Standing Vaccination Commission (Stiko). Stiko chairman Thomas Mertens recently expressed skepticism as to whether the commission would even make a recommendation for a nationwide vaccination for healthy adolescents. The commission must weigh whether the benefits of vaccination actually outweigh the risks for the individual.

Should there be the green light for the vaccination, Lützenkirchen would have one wish above all: "Please no new prioritization rules! Then I would like to use the summer vacation to vaccinate interested patients until school starts. They should then just be able to come."