Why is the vaccine only for those over 16? Can schools require it? Questions about children and the vaccination process that begins

After the Public Health Institute of Chile approved, together with an Expert Committee, the authorization of the use of the Pfizer-BioNTech vaccine, doubts arose about how the immunization process.

It was indicated that it will be administered in two doses, separated by 21 days and that it will only be for those over 16 years of age. Why are children not considered? Could schools require them? These are some of the questions.

He Ministry of Education indicated that they asked the Ministry of Health (Minsal) “that the teachers and education assistants are a priority in the Covid vaccine ”, but that the entire vaccination process “depends strictly on the Ministry of Health.”

Asked about what policy they will promote, in the Minsal, they only explained that they are not talking about vaccines “Because there are still many issues to settle.”

Already in November, the Minister of Health Enrique Paris indicated that the coronavirus vaccine will be free, both in the public system and in the private system where there is an agreement. He also highlighted that “must be voluntary, not mandatory”. In that sense, requiring it in schools would not be relevant.

Alfredo Sagredo, researcher of Millennium Institute of Biomedical Neuroscience (BNI) of the Faculty of Medicine from the University of Chile, explains that among the mandatory vaccines are those that are given to the newborn. Thanks to that, a large part of the population can be protected against diseases such as smallpox or measles.

Since 1978 Chile has a National Immunization Program (PNI). Thanks to him, the morbidity and mortality of immunopreventable diseases, that is, those that can be prevented through the use of vaccines, have decreased. The program counts among its achievements the eradication of smallpox (1950), poliomyelitis (1975) and measles (1992).

Lorena Tapia, researcher at the Institute of Biomedical Sciences ICBM of the Faculty of Medicine University of Chile and member of the Vaccine Advisory CommitteeHe adds that requiring schools to have their students vaccinated against Covid-19 is unlikely. “Right now no one can demand or ask for that, because the vaccinations will probably be centralized in the vaccination centers, it will not be an open vaccination,” he explains.

But in addition, he says, not all doses will be available immediately, “so that mandatory vaccination may not be required, less for March.” From Minsal it has been said that vaccination will be voluntary and cannot be compulsory. “Today there is a lot of anxiety about the subject, but this is going to take a while”says Tapia.

Mario Rosemblatt, Executive Director of the Science and Life Foundation, adds an important antecedent to understand why the cut-off age for the vaccine is greater than 16 years: “The vaccine was tested and tested in people over 16 years of age upwards, therefore it would be a risk and irresponsible use in children”.

Globally, it has not been studied rigorously or extensively in this group. Rosemblatt adds that its effects in boys and girls are unknown, and that in Chile it has also been tested only in adults. However, he says, “the population at risk is at other ages, if it is possible to vaccinate a significant part of the adult population, teachers, cleaning staff and school administrators and the adults with whom they live, they are protected.”

That children are included in Covid-19 vaccine trials has been a demand of many organizations. In the US, the American Academy of Pediatrics (AAP) has asked manufacturers to include them in order to have a rigorous scientific process to review vaccines throughout the population.

In the US on December 11, the US Food and Drug Administration (FDA) issued an emergency use authorization for Pfizer’s vaccine for persons 16 years of age and older. A second vaccine, from Moderna, is expected to be approved soon for adults as well. And vaccines are already underway in the UK and Canada they have also been authorized for the same age range.

“If we don’t add children to these research trials very soon, there will be a significant delay at the time when children have access to potentially life-saving vaccines. This is inconceivable, “said in November the President of the AAP, Sara Goza in a press release signed in conjunction with the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Physicians, the American Medical Association, the American Society for Infectious Diseases, and the Pediatric Infectious Diseases Society.

More than 1 million children have been infected with the coronavirus since the beginning of the pandemic. And it is also a group that has suffered in many other ways, adds Goza. “This includes disruptions to their education, damage to their mental and emotional health, and greatly reduced access to critical medical services. Is unfair to allow them to bear these burdens, but not to give them the opportunity to benefit from a vaccine “, Held.

Vaccines are not just required to prove safe and effective in adults, he adds Yvonne Maldonado president of the AAP Infectious Diseases Committee, also so that parents feel comfortable administering these vaccines to their children, “We must have studies that show that they are also safe and effective in children.”

Clinical trials with children are just beginning. Pfizer, in collaboration with Germany’s BioNTech, expanded its testing of the Covid-19 vaccine to children 12 and older in October alone. Moderna announced on December 2 that it planned to soon begin trials of the Covid-19 vaccine in children ages 12 to 17.

Studies show that children can become infected with Covid-19 and transmit it to other people. Therefore, “to reduce the spread of this virus and control the pandemic, as well as for your own safety, it is It is essential that children are included in the national immunization program”, They highlight from the APP.

Sagredo indicates that there is no vaccine available for boys and girls, it is likely that they will serve as reservoirs for the virus, which will make it more difficult to end the pandemic. Although studies to date indicate that this group does not suffer from Covid-19 as serious, he clarifies “Children do not live alone, they live with their parents, with grandparents, with other people.” A vaccination also implies other benefits such as a safer return to face-to-face classes and other activities.

Children tend to have stronger immune systems than adults and may have stronger temporary reactions to vaccines. That is why they usually have more pain and swelling at the injection site for a few days and possibly a fever.

These side effects are evidence that the immune system is doing what it should be doing. However, they can generate fear in adults.

In the case of a vaccine against Covid-19, Sagredo indicates, there is resentment in some people, mainly because it is a new therapy. The good thing, he admits, is that “For the first time, we are talking about vaccines in Chile, which have been with us for decades and are safe and we are inoculating with different ones.”

Faced with fears regarding cases of contraindications that have been reported in some countries, such as in people who had severe allergies, these are expected situations, says Sagredo, because when general vaccination is carried out it is when they are tested in different individuals, not only in healthy people as in clinical trials. “Jumping out of the clinical trial and into the real world can generate some kind of discomfort, like those allergies that occurred in those with severe allergies.”

There are risks, admits Sagredo, “but there are also risks of taking an analgesic, all remedies have contraindications, and therefore that with vaccines so big trials, it is a procedure that is given to healthy people, because they are preventive ”.

In the same way as with the vaccine against human papilloma virus there are fathers and mothers who are afraid, the researcher says that the vaccine against covid-19 is a proven vaccine. “In the case of the human papillomavirus vaccine, the side effects will never be as terrible as avoiding uterine or penile cancer, you have to think about the greater good. It is that important, cancer is avoided and the benefit has to be thought of as going beyond prejudice. Something similar should exist with covid-19 “.

It is a subject that requires patience, calm and confidence, adds Tapia, “little by little we are going to realize how positive it will be, all hopes are in vaccines and they have always saved us from many diseases ”.