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UK CMOs back single dose of COVID-19 vaccine for 12- to 15-year-olds

By 13/09/2021No Comments

Ministers sought advice from the CMOs earlier this month after the Joint Committee on Vaccination and Immunisation (JCVI) said the benefits of vaccination against COVID-19 ‘marginally outweigh’ potential risks in children aged 12 to 15 years old – but stopped short of recommending adding this group to the national vaccination campaign.

In new advice published on 13 September, the CMOs said the benefits of ‘reducing educational disruption and the consequent reduction in public health harm’ from extending jabs to this group – added to the marginal benefit identified by the JCVI – justified rollout to 12- to 15-year-olds.

The CMOs said they ‘recommend on public health grounds that ministers extend the offer of universal vaccination with a first dose of Pfizer-BioNTech COVID-19 vaccine to all children and young people aged 12 to 15 not already covered by existing JCVI advice’.

COVID-19 vaccination

A DHSC spokesperson said the government had received the advice and would set out its final decision shortly.

The update on jabs for children in younger age groups comes as GPs await final advice on a COVID-19 booster campaign.

Health and social care secretary Sajid Javid said last week he was confident that a booster campaign would begin in September, but admitted it remained unclear which patients would be included.

JCVI advice on a booster campaign is expected imminently – and could deviate significantly from interim advice published in June.

Booster campaign

The interim advice suggested booster jabs could be rolled out to people aged over 70, those who are clinically vulnerable and health and care staff alongside a flu jab from 1 September and then widen to cover all people aged over 50, 16- to 59-year-olds in flu or COVID-19 at-risk groups and household contacts of some at-risk patients.

However, later comments from a JCVI member suggested booster jabs may only be necessary for a much smaller group of people.

Advice on jabs for 12- to 15-year-olds from the CMOs highlighted the risk balance between ‘very rare’ cases of myocarditis in younger people receiving a COVID-19 vaccine, and also rare cases of serious illness from the virus in this age group.

The CMOs said: ‘The absolute advantage to being vaccinated in this age group is therefore small (‘marginal’) in the view of the JCVI. On its own the view of the JCVI is that this advantage, whilst present, is insufficient to justify a universal offer in this age group.

Public health

‘Accepting this advice, UK CMOs looked at wider public health benefits and risks of universal vaccination in this age group to determine if this shifts the risk-benefit either way.

‘Of these, the most important in this age group was impact on education. UK CMOs also considered impact on mental health and operational issues such as any possible negative impact on other vaccine programmes, noting that influenza vaccination and other immunisations of children and young people are well-established, important, and that the annual flu vaccine deployment programme commences imminently.

‘The UK CMOs, in common with the clinical and wider public health community, consider education one of the most important drivers of improved public health and mental health, and have laid this out in their advice to parents and teachers in a previous joint statement.

‘Evidence from clinical and public health colleagues, general practice, child health and mental health consistently makes clear the massive impact that absent, or disrupted, face-to-face education has had on the welfare and mental health of many children and young people. This is despite remarkable efforts by parents and teachers to maintain education in the face of disruption.’

The CMOs warned that the negative impact of lost education had been ‘especially great in areas of relative deprivation, which have been particularly badly affected by COVID-19’.

They added: ‘Overall…the view of the UK CMOs is that the additional likely benefits of reducing educational disruption, and the consequent reduction in public health harm from educational disruption, on balance provide sufficient extra advantage in addition to the marginal advantage at an individual level identified by the JCVI to recommend in favour of vaccinating this group.

‘They therefore recommend on public health grounds that ministers extend the offer of universal vaccination with a first dose of Pfizer-BioNTech COVID-19 vaccine to all children and young people aged 12 to 15 not already covered by existing JCVI advice.

‘If ministers accept this advice, UK CMOs would want the JCVI to give a view on whether, and what, second doses to give to children and young people aged 12 to 15 once more data on second doses in this age group has accrued internationally. This will not be before the spring term.’

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