Children aged five to 11 can be vaccinated against Covid-19 from 10 January, making about 2.3 million additional Australians eligible for the jabs.
An independent group of medical, scientific and consumer experts known as the Australian Technical Advisory Group on Immunisation recommended this age group receive the Pizer vaccine at one-third of the dosage given to those aged 12 years and over. The drug regulator, the Therapeutic Goods Administration, has also approved the jab for this age group after reviewing the available evidence.
So what do we know about vaccinating young children, and what happens next?
Vaccinating children protects others
It is true that serious symptoms and complications from Covid-19 in unvaccinated children are extremely rare, and transmission between children in schools is low. But children are highly likely to spread the virus to members of their household if they do become infected, leading to transmission beyond the school.
Data published by the National Centre for Immunisation Research and Surveillance found most children diagnosed with the Delta variant experienced mild or no symptoms, with only 2% requiring hospitalisation. Not all of that 2% were seriously unwell, the report found. Many children were admitted because their parents were seriously ill and in hospital and the children had nowhere to go, with special family wards established in some hospitals to accommodate this.
But as older age groups increasingly become vaccinated, school-age children now account for an increasing proportion of cases and hospitalisations overseas, compared with earlier in the pandemic. School outbreaks are becoming more common, and children can spread the virus to those who are vulnerable, including those with weak immune systems who aren’t as strongly protected by vaccination.
It is also highly disruptive having to close schools each time an outbreak occurs. According to Unesco, when schools close “the disadvantages are disproportionate for under-privileged learners who tend to have fewer educational opportunities beyond school”.
Finally, the higher the proportion of the overall population that is vaccinated, the more rare outbreaks and spread will become and the more vulnerable people will be protected, easing pressure on the health system. Vaccinated people can still catch and spread Covid-19 but their chances of doing so are reduced, particularly after a third booster dose, evidence is showing. Importantly, vaccinated people overwhelmingly experience no, or much less severe, symptoms, with the key goal of vaccination being to prevent hospitalisation and death.
Atagi and the TGA require strong evidence
Data reviewed by the experts included findings from Pfizer’s clinical trials of the vaccine in children aged five to 11. The trials found a 10 microgram dose (one-third of the standard dose) administered 21 days apart was safe, and led to a strong immune response which was more than 90% effective – similar to the response seen in older people.
The Australian regulators and experts also reviewed data from the real world, beyond the pharmaceutical company trials. This is because any very rare side-effects only emerge once millions of people are vaccinated. The experts reviewed data from overseas, including from the US where about 5 million children have received at least one dose.
There were concerns after it emerged that some adolescents and young adults, especially males in the 12-to-30 age group, were experiencing myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the outer lining of the heart).
But these conditions after vaccinations are rare, and most cases have been mild, with patients recovering quickly. No cases have yet been reported in the five-to-11 age group.
Atagi also reviewed clinical data from Canada, prompting the recommendation of an eight-week interval between the two doses for five- to 11-year-olds. This can be shortened to three weeks in special circumstances such as outbreaks, Atagi advised. This is because data shows increasing the interval may increase efficacy, while reducing the already rare myocarditis and pericarditis risk even further.
More common side-effects for children are similar to those experienced by adults, including a sore arm, fatigue and/or headache. Atagi and the TGA will continue to monitor data and can update recommendations if required.
Where and when can I book a jab for my child?
Parents, carers and guardians will be able to book January appointments from late December.
Vaccines will be made available through general practices, Aboriginal health services, community pharmacies, and state and territory clinics. Individual clinics will determine if they will provide vaccines for children of five to 11, and states and territories will be responsible for any school-based programs.
Healthcare providers will be able to order vaccines over the coming weeks. The needle used to administer the vaccine will be smaller than the one for those age 12 and up, and the cap on the vial the vaccine comes in is orange instead of purple and grey to avoid mix-ups.
Booster doses are not now recommended for those aged under 18 because the vaccines generate a strong immune response in this group, so the benefit from additional doses of vaccine is likely to be small. There is also only limited data on the safety of additional vaccine doses in this age group.
