The main issues of children and adolescents vaccination against COVID-19
DOI:
https://doi.org/10.15574/SP.2022.123.55Keywords:
vaccination, COVID-19, childrenAbstract
The main principles of specific immunoprophylaxis of COVID-19 in children and adolescents were determined based on the accumulated scientific data. It was established that only two vaccines, Pfizer-BioNTech (BNT162b2) «Comirnaty» and Moderna mRNA-1273 «Spikevax» were approved by the WHO for emergency use in children and only the first of them was approved for use in Ukraine.
Both vaccines have a proven safety and efficacy profile according to the results of clinical trials. The current analysis of side effects associated with Pfizer-BioNTech (BNT162b2) "Comirnaty" and Moderna mRNA-1273 "Spikevax" vaccination indicates a favorable clinical course of local, systemic reactions and myocarditis following a vaccination with regression of symptoms in all patients. The risk of the multisystem inflammatory syndrome in children following acute infection, the potential for other sequelae of SARS-CoV-2 infection, the risk of severe disease in children with underlying medical conditions, remain compelling reasons for vaccination of children and outweigh possible risks of side effects associated with vaccination.
In the context of the global shortage of vaccines in the world, immunization programs should focus on groups of highest risk of hospitalizations and deaths, according to the Prioritization Roadmap. Children vaccination against COVID-19 with risk factors, comorbidities, immunodeficiency is a priority. Before vaccinating children and adolescents at low risk of serious disease, children from high-risk groups should be actively identified and vaccinated, justifying the importance of their vaccination.
Despite the widespread introduction of vaccination, appropriate preventive measures for fighting COVID-19 should be taken, including physical distancing, frequent handwashing, wearing masks.
It is extremely important to maintain a high level of vaccination coverage against other infectious diseases and not to delay the planned vaccination of children.
No conflict of interests was declared by the authors.
References
Ali K, Berman G, Zhou H, Deng W, Faughnan V, Coronado-Voges M et al. (2021). Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents. N Engl J Med. 385: 2241-2251. https://doi.org/10.1056/NEJMoa2109522; PMid:34379915 PMCid:PMC8385554
American Academy of Pediatrics. (2021). American Academy of Pediatrics Applauds CDC Advisory Committee's Approval of Safe, Effective COVID-19 Vaccine for Children Ages 5-11. URL: https://www.aap.org/en/news-room/news-releases/aap/2021/american-academy-of-pediatrics-applauds-cdc-approval-of-safe-effective-covid-19-vaccine-for-children-ages-511/.
American Academy of Pediatrics. (2021). Committee on infectious diseases. Recommendations for Prevention and Control of Influenza in Children, 2021-2022. Pediatrics. 148 (4): e2021053744. https://doi.org/10.1542/peds.2021-053744; PMid:34493537
American Academy of Pediatrics. (2022). Children and COVID-19 Vaccination Trends. URL: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and_covid-19-vaccination-trends/.
Araos R, Jara A, Undurraga E, Zubizarreta J, Gonzalez C, Acevedo J et al. (2022). Effectiveness of CoronaVac in children 3 to 5 years during the omicron SARS-CoV-2 outbreak. Nature Portfolio Journal. https://doi.org/10.21203/rs.3.rs-1440357/v1
ATAGI. (2021). COVID-19 vaccination - Guidance on Myocarditis and Pericarditis after mRNA COVID-19 vaccines. Guideline. Australian Technical Advisory Group on Immunisation. URL: https://www.health.gov.au/resources/publications/covid-19-vaccination-guidance-on-myocarditis-and-pericarditis-after-mrna-covid-19-vaccines.
ATAGI. (2022). Clinical recommendations for COVID-19 vaccines. The Australian Technical Advisory Group on Immunisation (ATAGI) has made recommendations on the use of COVID-19 vaccines in Australia. Australian Technical Advisory Group on Immunisation. URL: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/advice-for-providers/clinical-guidance/clinical-recommendations#Booster-dose-recommendations%C2%A0.
ATAGI. (2022). COVID-19 booster vaccine advice. Australian Technical Advisory Group on Immunisation. URL: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/getting-your-vaccination/booster-doses#winter-dose.
ATAGI. (2022). ATAGI recommendations on the use of a third primary dose of COVID-19 vaccine in individuals who are severely immunocompromised. Australian Technical Advisory Group on Immunisation. URL: https://www.health.gov.au/resources/publications/atagi-recommendations-on-the-use-of-a-third-primary-dose-of-covid-19-vaccine-in-individuals-who-are-severely-immunocompromised.
ATAGI. (2022). ATAGI recommendations on the use of Spikevax (Moderna) COVID-19 vaccine in children aged 6 to 11 years. Australian Technical Advisory Group on Immunisation. URL: https://www.health.gov.au/news/atagi-recommendations-on-the-use-of-spikevax-moderna-covid-19-vaccine-in-children-aged-6-to-11-years.
Bellino S, Punzo O, Rota MC, Manso MD, Urdiales AM, Andrianou X et al. (2020). COVID-19 Disease Severity Risk Factors for Pediatric Patients in Italy. Pediatrics. 146 (4): e2020009399. https://doi.org/10.1542/peds.2020-009399; PMid:32665373
Bialek S, Gierke R, Hughes M,. McNamara LA, Pilishvili T, Skoff T. (2020). Coronavirus Disease 2019 in Children - United States. MMWR Morb Mortal Wkly Rep. 69 (14): 422-426. https://doi.org/10.15585/mmwr.mm6914e4; PMid:32271728 PMCid:PMC7147903
Castagnoli R, Licari A, Marseglia GL. (2020). Additional Concerns Regarding Children With Coronavirus Disease 2019-Reply. JAMA Pediatr. 174 (12): 1218-1219. https://doi.org/10.1001/jamapediatrics.2020.2940; PMid:33104184
CDC. (2020). Information for Pediatric Healthcare Providers. URL: https://www.cdc.gov/coronavirus/2019-ncov/hcp/pediatric-hcp.html.
CDC. (2022). COVID-19 Vaccine Boosters. URL: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html.
CDC. (2022). COVID-19 Vaccines for Children and Teens. URL: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html.
CDC. (2022). Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States. URL: https://www.cdc.gov/vaccines/covid-19/clinical-considerations/interim-considerations-us.html#Interchangeability.
CDC. (2022). Selected Adverse Events Reported after COVID-19 Vaccination. URL: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html.
CDC. (2022). US COVID-19 Vaccine Product Information. URL: www.cdc.gov/vaccines/covid-19/info-by-product/index.html.
CDC. (2022). Use of COVID-19 Vaccines in the United States. URL: www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#primary-series.
ClinicalTrials. (2021). A Study to Evaluate Safety and Effectiveness of mRNA-1273 COVID-19 Vaccine in Healthy Children Between 6 Months of Age and Less Than 12 Years of Age. URL: https://clinicaltrials.gov/ct2/show/NCT04796896.
ClinicalTrials. (2021). Efficacy, Immunogenicity and Safety of COVID-19 Vaccine , Inactivated in Children and Adolescents. URL: https://clinicaltrials.gov/ct2/show/NCT04992260.
ClinicalTrials. (2022). A Phase 1/2/3 Study to Evaluate the Safety, Tolerability, and Immunogenicity of an RNA Vaccine Candidate Against COVID-19 in Healthy Children and Young Adults. URL: https://clinicaltrials.gov/ct2/show/NCT04816643.
Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z et al. (2020). Epidemiology of COVID-19 Among Children in China. Pediatrics. 145 (6): e20200702. URL: https://pediatrics.aappublications.org/content/145/6/e20200702. https://doi.org/10.1542/peds.2020-0702; PMid:32179660
Dorabawila V, Hoefer D, Bauer UE, Bassett MT, Lutterloh E, Rosenberg ES. (2022). Effectiveness of the BNT162b2 vaccine among children 5-11 and 12-17 years in New York after the Emergence of the Omicron Variant. MedRxiv preprint. https://doi.org/10.1101/2022.02.25.22271454; PMCid:PMC8853477
ECDPC. (2022). Technical report COVID-19 vaccine effectiveness in adolescents aged 12-17 years and interim public health considerations for administration of a booster dose 8 February 2022. European Centre for Disease Prevention and Control. URL: https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-considerations-for-booster-doses-in-adolescents-Feb%202022.pdf.
EMA. (2021). Comirnaty COVID-19 vaccine: EMA recommends approval for children aged 5 to 11 Share. The European Medicines Agency's. URL: https://www.ema.europa.eu/en/news/comirnaty-covid-19-vaccine-ema-recommends-approval-children-aged-5-11.
EMA. (2022). EMA recommends approval of Spikevax for children aged 6 to 11. The European Medicines Agency's. URL: https://www.ema.europa.eu/en/news/ema-recommends-approval-spikevax-children-aged-6-11.
European Medicines Agency. (2021). First COVID-19 vaccine approved for children aged 12 to 15 in EU. URL: https://www.ema.europa.eu/en/news/first-covid-19-vaccine-approved-children-aged-12-15-eu.
FDA. (2021). Briefing Document EUA amendment request for Pfizer-BioNTech COVID-19 Vaccine for use in children 5 through 11 years of age. Vaccines and Related Biological Products Advisory Committee Meeting. October 26. URL: https://www.fda.gov/media/153447/download.
Fernandes EG, López-Lopes GIS, Silva VO, Yamashiro R, Madureira KCR, Gallo JF et al. (2021). Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine (CoronaVac) in inadvertently vaccinated healthy children. Rev Inst Med Trop Sao Paulo. 6 (63): e83. https://doi.org/10.1590/s1678-9946202163083; PMid:34878041 PMCid:PMC8660031
Frenck RW, Klein NP, Kitchin N, Gurtman A, Absalon J, Lockhart S et al. (2021). Safety, Immunogenicity, and Efficacy of the BNT162b2 COVID-19Vaccine in Adolescents. N Engl J Med. 385: 239-250. https://doi.org/10.1056/NEJMoa2107456; PMid:34043894 PMCid:PMC8174030
Han B, Song Y, Li C, Yang W, Ma Q, Jiang Z et al. (2021). Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine (CoronaVac) in healthy children and adolescents: a double-blind, randomised, controlled, phase 1/2 clinical trial The Lancet. 21 (12): 1645-1653. https://doi.org/10.1016/S1473-3099(21)00319-4
Hause AM, Baggs J, Marquez P, Myers TR; Gee J, Su JR et al. (2021). COVID-19 Vaccine Safety in Children Aged 5-11 Years - United States. Morb Mortal Wkly Rep. 70: 1755-1760. https://doi.org/10.15585/mmwr.mm705152a1; PMid:34968370 PMCid:PMC8736274
Hopkins TJ. (2021). COVID-19: FDA authorises Pfizer vaccine for children 12-15. BMJ: 373. https://doi.org/10.1136/bmj.n1204; PMid:33975874
JCVI. (2021). JCVI statement on COVID-19 vaccination of children and young people aged 12 to 17 years. Joint Committee on Vaccination and Immunisation. URL: https://www.gov.uk/government/publications/jcvi-statement-august-2021-covid-19-vaccination-of-children-and-young-people-aged-12-to-17-years/jcvi-statement-on-covid-19-vaccination-of-children-and-young-people-aged-12-to-17-years-4-august-2021.
JCVI. (2022). JCVI statement on vaccination of children aged 5 to 11 years old. Joint Committee on Vaccination and Immunisation. URL: https://www.gov.uk/government/publications/jcvi-update-on-advice-for-covid-19-vaccination-of-children-aged-5-to-11/jcvi-statement-on-vaccination-of-children-aged-5-to-11-years-old.
Kelso JM. (2022). COVID-19: Allergic reactions to SARS-CoV-2 vaccines. UpToDate. URL: https://www.uptodate.com/contents/covid-19-allergic-reactions-to-sars-cov-2-vaccines?sectionName=mRNA%20vaccines&topicRef=129849&anchor=H783000999&source=see_link#H783000999.
Koch R. (2022). Epidemiologisches Bulletin 1. STIKO: 15. Aktualisierung der COVID-19-Impfempfehlung. SARS-CoV-2-Infektionsgeschehen an Hamburgs Schulen. URL: https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2022/Ausgaben/01_22.pdf?__blob=publicationFile.
Koch R. (2022). Epidemiologisches Bulletin 1. Weltlepratag. STIKO: 17. Aktualisierung der COVID-19-Impfempfehlung. SARS-CoV-2-Ausbrüche in Kitas. URL: https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2022/Ausgaben/03_22.pdf?__blob=publicationFile.
Koch R. (2022). Epidemiologisches Bulletin 7. STIKO: 18. Aktualisierung der COVID-19- Impfempfehlung. Pseudoausbruch mit Acinetobacter baumannii. URL: https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2022/Ausgaben/07_22.pdf?__blob=publicationFile.
Laws RL, Chancey RJ, Rabold EM, Chu VT, Lewis NM, Fajans M et al. (2021). Symptoms and Transmission of SARS-CoV-2 Among Children - Utah and Wisconsin. Pediatrics. 147 (1): e2020027268. https://doi.org/10.1542/peds.2020-027268; PMid:33033178
Lee B, Raszka WV. (2021). COVID-19 in Children: Looking Forward, Not Back.Pediatrics. 147 (1): e2020029736. https://doi.org/10.1542/peds.2020-029736; PMid:33033179
Liguoro I, Pilotto C, Bonanni M, Ferrari ME, Pusiol A, Nocerino A. (2020). SARS-COV-2 infection in children and newborns: a systematic review Eur J Pediatr. 179 (7): 1029-1046. https://doi.org/10.1007/s00431-020-03684-7; PMid:32424745 PMCid:PMC7234446
MOZ Ukrainy. (2021). Pro vvedennia v diiu Rishennia operatyvnoho shtabu Ministerstva okhorony zdorovia Ukrainy z reahuvannia na sytuatsii z poshyrennia infektsiinykh khvorob, yakym mozhna zapobihty shliakhom vaktsynatsii vid 01 zhovtnia 2021 roku. Nakaz MOZ Ukrainy vid 13.10.2021 No.2234. URL: https://moz.gov.ua/article/ministry-mandates/nakaz-moz-ukraini-vid-13102021--2234-pro-vvedennja-v-diju-rishennja-operativnogo-shtabu-ministerstva-ohoroni-zdorov%e2%80%99ja-ukraini-z-reaguvannja-na-situacii-z-poshirennja-infekcijnih-hvorob-jakim-mozhna-zapobigti-shljahom-vakcinacii-vid-01-zhovtnja-2021-roku.
NACI. (2022). COVID-19: Making vaccination decisions for children 5 to 11 years of age. National Advisory Committee on Immunization. URL: https://www.canada.ca/en/public-health/services/vaccination-children/making-decisions-5-11-years-age.html.
NACI. (2022). Moderna Spikevax COVID-19 vaccine. National Advisory Committee on Immunization. URL: https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines/moderna.html#a2.
NACI. (2022). Vaccines for COVID-19. National Advisory Committee on Immunization. URL: https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/vaccines.html.
NTHEI. (2021). POZYTsIIa No. 27-09/2021-1 (ofitsiina zaiava) Shchodo rekomendatsii MOZ Ukrainy stosovno okremykh pytan vaktsynatsii proty COVID-19 v Ukraini. Natsionalna tekhnichna hrupa ekspertiv z pytan imunoprofilaktyky. URL: https://phc.org.ua/sites/default/files/users/user90/2021.10.04_Pozytsia_NTGEI_27.09.2021.pdf.
NTHEI. (2021). POZYTsIIa No. 18-10/2021-1 (ofitsiina zaiava) Shchodo rekomendatsii MOZ Ukrainy stosovno okremykh pytan vaktsynatsii proty COVID-19 v Ukraini zghidno z protokolnym rishenniam NTHEI vid 18.10.2021 roku No.14. Natsionalna tekhnichna hrupa ekspertiv z pytan imunoprofilaktyky. URL: https://phc.org.ua/sites/default/files/users/user90/2021.10.25_Pozytsia_NTGEI_18.10.2021.pdf.
Pfizer. (2021). Pfizer and BioNTech Provide Update on Ongoing Studies of COVID-19 Vaccine. URL: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-provide-update-ongoing-studies-covid-19.
Ra SH, Lim JS, Kim G, Kim MJ, Jung J, Kim S. (2021). Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection. BMJ. Thorax. 76: e3-e3. https://doi.org/10.1136/thoraxjnl-2020-215042corr1; PMCid:PMC8728647
UNICEF. (2021). The State of the World's Children 2021. URL: https://www.unicef.org/reports/state-worlds-children-2021?utm_source=referral&utm_medium=media&utm_campaign=sowc-web.
UNICEF. (2021). Ukraine Coronavirus disease (COVID-19): What parents should know How to protect yourself and your children. URL: https://www.unicef.org/ukraine/coronavirus.
UNICEF. (2022). COVID-19 confirmed cases and deaths. URL: https://data.unicef.org/resources/covid-19-confirmed-cases-and-deaths-dashboard/.
Walter EB, Talaat KR, Sabharwal C, Gurtman A, Lockhart S, Paulsen GC et al. (2021). Evaluation of the BNT162b2 COVID-19Vaccine in Children 5 to 11 Years of Age. NEJM. https://doi.org/10.1056/NEJMoa2116298; PMid:34752019 PMCid:PMC8609605
WHO. (2021). Coadministration of seasonal inactivated influenza and COVID-19 vaccines Interim guidance. URL: https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines-SAGE_recommendation-coadministration-influenza-vaccines.
WHO. (2021). COVID-19 disease in children and adolescents: Scientific brief. URL: https://www.who.int/publications/i/item/WHO-2019-nCoV-Sci_Brief Children_and_adolescents-2021.1.
WHO. (2021). Interim statement on COVID-19 vaccination for children and adolescents. URL: https://www.who.int/news/item/24-11-2021-interim-statement-on-covid-19-vaccination-for-children-and-adolescents.
WHO. (2022). Interim recommendations for use of the Moderna mRNA-1273 vaccine against COVID-19. URL: https://www.who.int/publications/i/item/interim-recommendations-for-use-of-the-moderna-mrna-1273-vaccine-against-covid-19.
WHO. (2022). Interim recommendations for use of the Pfizer-BioNTech COVID-19 vaccine, BNT162b2, under Emergency Use Listing Interim guidance Updated 21 January 2022. URL: https://www.who.int/publications/i/item/WHO-2019-nCoV-vaccines_SAGE_recommendation-BNT162b2-2021.1.
WHO. (2022). Interim Statement on COVID-19 vaccines in the context of the circulation of the Omicron SARS-CoV-2 Variant from the WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC). URL: https://www.who.int/ru/news/item/11-01-2022-interim-statement-on-covid-19-vaccines-in-the-context-of-the-circulation-of-the-omicron-sars-cov-2-variant-from-the-who-technical-advisory-group-on-covid-19-vaccine-composition.
WHO. (2022). WHO SAGE Roadmap for prioritizing uses of COVID-19 vaccines. URL: https://www.who.int/publications/i/item/who-sage-roadmap-for-prioritizing-uses-of-covid-19-vaccines.
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