Debate on opening schools should be separated from discussion on immunization of children
Due to school closures and restrictions on movement, children have suffered a lot in the past year and a half. There is a lot of debate now on administration Children’s vaccines for COVID-19 in the context of the reopening of schools in India. As practicing scientists and concerned parents, we have followed the scientific literature on these topics. Any medical intervention, especially for children, should include a careful risk-benefit analysis. What is the risk of children being affected by COVID-19? Is the risk of the vaccine guaranteed to be less than this? Are the tests designed to uncover rare risks? What about long term risks? We are trying to find out these questions.
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compare risks
Children at high risk of serious consequences due to COVID-19 Rare, and the chances of death are extremely low (about in two lakhs). The chronic condition was found even in severely affected children. These facts have not changed with the Delta version either. The numbers may not mean much because we are passionate about children. So, to understand the risk, consider the following comparisons. For a child, the chances of contracting COVID-19 are almost as high as contracting it. Lightning. For those under the age of 25, the risk of traffic accidents or even suicide is nearly 10 times higher More than death due to COVID-19. Even the threat of long-lasting COVID-19 Symptoms Very rare in children.
Now, let’s compare this with the risks of vaccines. While the risk of current COVID-19 vaccines is certainly low, it is not zero. This is relevant because the risk of severe COVID-19 in children is low. Both serious adverse effects and vaccine-related deaths have been reported in adults. World, including India. Based on the risk-benefit analysis, AustraliaThe UK and many European countries do not recommend AstraZeneca (Covishield) for children. Vaccines in use for 12+ are Pfizer/BioNTech and Moderna Vaccines, and these also put children at risk of myocarditis (inflammation of the heart muscle). A recent US study reported a one in 6,000 increased cardiovascular adverse event risk from the Pfizer vaccine for boys aged 12-15; Similar numbers have been reported from Israel and Canada. It is worrying to come to such conclusions after vaccinating millions of children.
Long term safety not assured
In addition to the short-term effects, there is also the question of long-term safety. All existing COVID-19 vaccines being rolled out have only limited short-term safety data; The clinical trial will run until 2023. Long-term effects may take a few years to appear. In addition, Pfizer and Moderna Vaccines use a new gene-based technology (mRNA) different from previous vaccine technology. The long-term safety of this new technology itself is unknown. These aspects make children at low risk from COVID-19: There is no COVID-19-related medical emergency for children.
One aspect underlining the importance of the issue of long-term safety is that zero liability has been given to all COVID-19 vaccine manufacturers. A senior AstraZeneca official explained why pharmaceutical companies have requested zero liability: “This is a unique situation where we as a company cannot take the risk if … in four years the vaccine is showing side effects. “
The importance of long-term protection is further emphasized by the fact that the past history of ’emergency vaccines’ is not entirely rosy. The swine flu vaccine, Pandemrix, was introduced in response to the 2010 pandemic. It was later withdrawn when it was found that one in every 55,000 jabs caused narcolepsy (a chronic sleep disorder) in children. Dengvaxia, a vaccine against dengue, was withdrawn in 2017 after 19 children (1 in 44,000) died from a possible antibody-dependent increase.
An important aspect to consider in terms of safety is the size of current vaccine trials. It is worth noting that some risk for adults did not show up during adult trials (for example, given the trial size of 32,449 for AstraZeneca, blood clots resulting from the AstraZeneca vaccine, which is a one in 50,000 chance), Couldn’t find it). In India, the current test size for children is only 525 covaxin and for 1,000 ZyCoV-D. These are extremely low and insufficient to capture even a one in 1,000 side-effect risk. This is extremely worrying.
Even though children and young adults are not at high risk from severe COVID-19 (unlike adults), some countries, such as France and Germany, allow vaccination for all people over the age of 12 in the hope that it will prevent community transmission. And lead can be prevented. For herd immunity through vaccination. Although recent data is showing it increasingly scientifically Wrong Because current vaccines neither prevent infection nor prevent transmission. This is evidenced by the high number of cases even in highly vaccinated countries such as Israel And Iceland. In addition, putting children at risk for the protection of adults (without ensuring long-term vaccine safety) is morally wrong, especially when those adults who have access to a COVID-19 vaccine anyway may be hospitalized. /Effective against death. Indeed, the UK decided not to “recommend the vaccine to all healthy children”, given the lack of a clear benefit for them.
Because the risk of severe COVID-19 in children is low, the medical benefit of COVID-19 vaccination for children is questionable, and a lack of studies on long-term safety as well as small trial sizes is concerning. . COVID-19 vaccines for children may be warranted in exceptional cases, such as for people with other co-morbidities who are at greater risk from COVID-19. In any event, parents have their children’s best interests in mind. Given that vaccination is an irreversible medical procedure, parents should do due diligence before vaccinating their children: examine all available evidence, ask the experts the pertinent questions, and then make an informed choice. Vaccination should also not be mandatory; The choice of parents is important.
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school opening hours
Recently there has been talk of reopening the school for children’s COVID-19 vaccines. It has no scientific basis because schools were safely opened in most other countries, often before the vaccine was tested. Furthermore, sero-survey shows that a large percentage of children have already been exposed to COVID-19: we have not looked into this yet because severe COVID-19 in children is very rare. And it’s not like vaccines are readily available in India (Covaxin and ZyCoV-D are still under testing). It will take several months for the pick-up from those who want to take it. How long can we keep schools closed? Huge majority parent Those who wish to send their children to school should have the option to do so. We have the distinction of being one of the few countries that have not yet fully opened schools, while more than 175 countries have come up with safety protocols prioritizing children’s education and safeguarding their country’s future. Schools have opened.
Kameshwari Chebrolu and Bhaskaran Raman are faculty in the Department of Computer Science and Engineering at IIT Bombay. thoughts are personal
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