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What do we know about vaccinating children?

by Gunnar_Zarncke1 min read4th Aug 20218 comments

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In Germany, the BioNTech vaccine has been approved for children:

At the end of May, the Comirnaty mRNA vaccine developed by BioNTech / Pfizer was approved by the European Medicines Agency (EMA) as the first COVID-19 vaccine in this age group for children and adolescents aged 12 and over. -- Robert Koch Institute 

But it is still not generally recommended for this age group:

There is currently no general vaccination recommendation of the STIKO for children and adolescents from 12 to 17
Years, but only for children and teens with a specific risk. -- STIKO informational material Robert Koch Institute   

I have four generally healthy boys aged 10 to 17. Only the oldest is already vaccinated, being basically an adult. I am inclined to get them all vaccinated with BioNTech because the risk-benefit tradeoff with such a safe vaccine seems obvious. 

For a cautious view of the risks, see e.g. this LessWong post: 

conditional on a kid catching COVID, ... a ~2% chance of a miserable months-long ordeal until they recover, plus (overlapping) ~1% chance of a big-deal long-term latent problem ... -- Young kids catching COVID: how much to worry? 

Nature has an article about the general topic: 

Thus far, the vaccines seem to be safe in adolescents1... A potential link between the Pfizer vaccine and heart inflammation ... the risk of these conditions is ... about 67 cases per million second doses in adolescent males aged 12–17, and 9 per million in adolescent females in the same age group. -- Should children get COVID vaccines? What the science says

So my question is: What else do we know about the risk-benefit trade-off of vaccines for children? When and based on what criteria should children get vaccinated? What other considerations should be taken into account (the nature article mentioned fairness, for example)? 

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From the CDC: Myocarditis and pericarditis after COVID-19 vaccination are rare. As of July 30, 2021, VAERS has received 1,249 reports of myocarditis or pericarditis among people ages 30 and younger who received COVID-19 vaccine. Most cases have been reported after mRNA COVID-19 vaccination (Pfizer-BioNTech or Moderna), particularly in male adolescents and young adults. Through follow-up, including medical record reviews, CDC and FDA have confirmed 716 reports of myocarditis or pericarditis. CDC and its partners are investigating these reports to assess whether there is a relationship to COVID-19 vaccination

There were 716 confirmed reports. Most clustered in a population of 18-25 year old males. There are about 9 million fully vaccinated 18-25 year old males. For that demographic the chance of getting this side effect is about 1 in 15,000 which is greater than 1 in 20000, the chance of an equally serious side effect that got Rotashield pulled from the market in 1999.

Thank you, that puts the risks into perspective. Esp. the comparison to Rotashield.

Does risk of myocarditis caused by  vaccine run in the family? So  if the parent gets  myocarditis from vaccine or natural covid; do the children  have an increased risk ? Other health risk factors are sometimes inherited, so it would be nice to know if vaccine side effect risks are too.

That way you could vaccinate  yourself and spouse first, and only then vaccinate the kids.

I guess, for the purpose of this post, we can assume that the parents are vaccinated.

Relevant recent tweet by Divia Eden, see also the comments by David Manheim in thread:

Just a totally normal @TheLancet study that came out yesterday showing that 4.4% of kids experience Long COVID symptoms and this data was collected pre-Delta variant: https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00198-X/fulltext 

3 comments, sorted by Highlighting new comments since Today at 9:40 AM

How about letting them decide? Eventually they'll have to make decicsions about their body throughout their lives. Each decision is an occasion to learn responsibility, so might as well start early. If that's too scary for them, you can still advise them.

Yes, and to do so they need information from us what is known about the vaccination.

I think we know too little. The Nature article is completely unhelpful. The LessWrong post is not particularly useful. 

From everything I have seen, the risks to kids of Covid are on the order of the risks of a home with a swimming pool. And no one freaks out about sending their kids to friends homes with swimming pools. At this level, even if the vaccines are very safe it likely doesn’t make sense. The logic is that a kid has a diminishing chance of exposure to the disease with a very small chance of serious consequences from getting that disease, compared to a 100% chance of being exposed to the very small risks of the vaccine. I’m interested in having this intuition proven wrong, though.