In the clinical trial there were no cases of COVID-19 in the 1,131 children who received the Pfizer vaccine and 16 cases among the 1,129 children in the placebo group. The trial also found that vaccinated adolescents had high levels of antibodies in their blood — a signal they had developed strong protective immunity.The EMA (European Medicines Agency) is also currently reviewing the approval of the Corona vaccine for this age group in Europe. A decision is expected in June. As these trials got underway, Moderna began a similar study for its vaccine last month. Scientists are seeking answers to important questions regarding the safety and effectiveness of these vaccines for kids, and we wanted to know how the situation is evaluated in Luxembourg.
For that, I talked to Dr Serge Allard, paediatrician and president of the Paediatrics Association of Luxembourg.
What is the situation here regarding Covid vaccinations for children and adolescents?
“It will still take some time before we potentially can start vaccinating children under the age of 16. Currently, we wait for the EMA, who need to give their approval first. As soon as we have that, the CSMI (Council of Infectious Diseases Luxembourg) will also need to approve the vaccination. Our Paediatrics Association and the CSMI will draw up a joint recommendation for the government and the Direction de la Santé, who also have their own experts. Dr. de la Fuente, who is the Vice President of CSMI in charge of the topic of children, has already let me know that they will probably be in favour of the vaccination and I expect that they will try to provide a recommendation as soon as possible.
For the CSMI it is also important to determine how to prioritise. Vulnerable children would potentially get offered a vaccination even before some adults.”
How is the feedback regarding the willingness to getting vaccinated, from either parents and/or children?
“One has to know that generally, around 15% of people are against any type of vaccination. I don’t think that with the Covid vaccine we will have the same willingness to get children vaccinated as we have seen in adults, since children here weren’t that sick in general. So far, only a few children in Luxembourg have been in intensive care.”
Long-lasting symptoms, the potential of transmission, and the chance of children providing an environment for the virus to mutate into a more dangerous or resistant variant are some of the arguments speaking for vaccinating as many young people as possible. Regarding transmission, evidence is building that indeed vaccines might block transmission of Covid, so vaccinating children could have beneficial knock-on effects on the wider community.
What are advantages of the vaccination for younger people?
“Finally, we can protect vulnerable children and the advantage for the others would be that they could get back to a normal life, at school and elsewhere. It could mean a life without masks, without home-schooling or social distancing. We have noticed that quite a lot of young people suffer from psychological problems because of the situation we are in. They have suicidal thoughts and so on. I work with a paediatric psychiatrist and she has never had as much work as during the last year. This would definitely speak for having as many teenagers vaccinated as possible.
If we told young people: ‘If you get vaccinated, you can go to parties again, get together with friends’, that alone could be an argument for them to get vaccinated. The psychological health is a very important factor in this.”
What about the risks of the Pfizer/BioNTech vaccination?
“I have seen the Pfizer/BioNTech study. All of the vaccinated children were protected against Covid. The initial fear, that the vaccination could trigger PIMS syndrome ]editor’s note: PIMS is a rare systemic illness involving persistent fever and extreme inflammation following exposure to SARS COV-2], hasn’t materialised so far, but one has to know that a potential PIMS syndrome would only occur around 1 month after the injection. In general, I expect children’s tolerance of the mRNA vaccination to be good, as it is usually the case with children and vaccinations.”
Until now, all of the Covid vaccine approvals were emergency approvals, what is the difference to a regular approval?
“I am not an expert in the regulatory field but regular studies take much longer in order to exclude potential long-term risks. Here they provided a high-speed study and 2000 children are not that many to detect all potential rare side effects, for example.”
The children that are now being vaccinated in the US and elsewhere are being monitored afterwards for potential issues. Aren’t those children guinea pigs for the others who get vaccinated later?
“In a way, yes. I believe that this could lead to parents deciding to get their children vaccinated at a later stage.”
Usually, the law demands that a vaccination offers an individual benefit that is higher than the risks stemming from the disease itself. How would you see the individual benefits for younger children from the vaccination at this time?
“Normally, with the other known vaccinations like the ones against tetanus, diphtheria, etc, we really urge parents to get their children vaccinated. I don’t believe that at the moment there are enough advantages of vaccinating children against Covid to convince their parents, since usually they are not that sick.
I believe that it is very useful for very sick children and children with preconditions but I assume that parents of otherwise healthy children would rather like to wait at this point.
Of course, vaccinating generally make sense in order to stop the virus from circulating in the population and to stop transmission.”
On the point of herd immunity, figures from Israel, who are leading in terms of vaccination/population ratio, are compelling. There, more than 60 % of the adult population had received the Pfizer vaccine and Covid had been virtually eradicated, without any child under age 16 having been vaccinated. From an ethical point of view, it is also being discussed, if – as long as the doses are rare – those vaccines cannot be put to better use elsewhere in fighting the pandemic by increasing vaccination rates in adults globally.
In the US, it will become obligatory at some schools and universities for children to be vaccinated against Covid in order to attend again. Do you think that something like this would be possible here as well?
“I don’t think so. Of course, if everyone were vaccinated it would be possible to return to a normal school life for example but I don´t think that it would become mandatory.”
Where do you believe will the vaccinations for younger people in Luxembourg take place, if they are approved?
“I believe that this is going to happen in the known vaccination centres. This makes sense because of the logistical conditions that have to be considered, like cooling, especially for the BioNTech vaccine.”
How could an exit strategy look like?
“Honestly, I don’t know which point we need to reach in order to stop wearing masks for example. It all depends on several factors, for example the amount of people who have received a vaccination, the amount of hospitalized people, how many people are still in intensive care. There are a lot of questions left.”
What is the experience here so far with the Covid vaccinations?
“Apart from the usual side effects, we have had 3 thrombosis cases in Luxembourg, two with the BioNTech/Pfizer vaccine and one with AstraZeneca. All of those cases occurred in elderly people.
The new Pfizer vaccination is fantastic also with regards to other potential fields of applications, for example against malaria or cancer. In my opinion, the person who found this mRNA vaccine deserves a Nobel Prize.
We have never been in a comparable situation, where so many people get vaccinated at the same time against one specific virus type. I think that because of the systematic monitoring of these vaccinations under such strict conditions we were able to detect also rare side effects that we simply never detected for other vaccines.
In general, we as paediatricians are pro- vaccination. We are convinced that this is the future and we will try our best to convince people to get vaccinated.”
