Covid vaccination for young children: why the Stiko only advises a few – health

The Standing Committee on Vaccination (Stiko) has decided against recommending vaccination against Covid-19 for healthy young children. The Stiko only thinks the vaccination is advisable for a very specific group of boys and girls between the ages of six months and four years, it announced on Thursday. These are children who are at particularly high risk of Covid-19 complications because they are overweight, have an immune deficiency, or have chronic kidney or severe lung disease, for example. According to the pediatrician and committee member Martin Terhardt, this group includes around ten percent of all small children.

The recommendation for five to eleven year olds was also changed. Although they are still advised to have a single vaccination, children who have close contact with adults at risk have been advised to receive a double dose. Stiko no longer considers this necessary: ​​”We now know that Omikron’s protection against transmission of the virus is much lower,” said Terhardt at a press conference of the German Science Media center. Therefore, one cannot rely on the fact that vaccination of children contributes to the protection of vulnerable people.

The revision of the vaccination recommendation became necessary due to the European approval of the vaccine for young children in mid-October. The Stiko had already recommended vaccination for older boys and girls in May – regardless of whether they have risk factors for a severe course.

Since the omicron variant has become dominant, long covid has also become less frequent

According to the experts, however, the situation has changed considerably since then: Omikron has significantly reduced the exposure, says Martin Terhardt. Compared to previous phases of the pandemic, for example, there are fewer children who have to go to the hospital with a corona infection. 127 since the beginning of October, the specialist society for pediatric infectiology calculated from the information provided by two thirds of all German children’s hospitals. And of these, half actually came to the hospital because of other problems, says the Stiko chairman, the virologist Thomas Mertens. Long Covid has also occurred less frequently since Omikron has been on the road, reported the infectiologist Clara Lehmann from the Cologne University Hospital at the press conference.

The number of children suffering from pediatric inflammatory multisystem syndrome, PIMS for short – another feared Covid complication in minors – has also fallen significantly. It is precisely these potential long-term problems that have been a major reason for many doctors to recommend that parents vaccinate their offspring.

The improved immune protection of the children certainly also contributed to this positive development. According to Terhardt, around 90 percent of all minors have already experienced an infection. Every fifth child between the ages of five and eleven is vaccinated.

Anyone who still wants to have their children vaccinated can continue to do so

On the other hand, there are the potential risks of vaccinating young children. The Stiko rates them as low: “We know from the approval studies that the tolerability is even a little bit better than in other age groups,” says Terhardt. But there is still too little data to estimate the probability of rarer problems.

Small children do not yet have a mature immune system, which is also one of the unknowns that the Stiko now had to work with. The committee therefore decided to limit the recommendation to children who are at particularly high risk of complications from Covid-19, explains Terhardt. for vaccination preferably the Comirnaty Children’s Vaccine be used (3 vaccine doses, each 3 μg, at least 3 and 8 weeks apart from the previous vaccination). Alternatively, the children’s vaccine Spikevax can be used (2 vaccine doses, each 25 μg, at least 4 weeks apart). However, this is currently not available in Germany in the dosage prescribed for small children.

However, Stiko does not want to put any obstacles in the way of parents who would like to have their children vaccinated voluntarily: If parents want this vaccination for their healthy children, says Martin Terhardt, “then there is no reason for the attending doctor to say no to say, also from a legal point of view”. He would then have to discuss this with the families and discuss it openly.

The syringe for children under five contains only three micrograms of the Biontech vaccine, children between the ages of five and eleven are given a ten microgram dose. Because of the lesser effectiveness of the smaller doses, infants are given a total of three shots.

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