The World Health Organization (WHO), with the support of the Strategic Advisory Group of Experts (SAGE), has released an interim statement on the role of COVID-19 vaccines in children and adolescents in the context of the continuing global disparities in vaccination.
In the statement, it is concluded that before considering implementing primary vaccination series in children and adolescents, attaining high coverage of primary series – and booster doses as needed – in highest and high-priority-use groups must be pursued.
WHO refers to the global inequity in vaccine rollout, with only 25% of older populations having received a complete primary series of COVID-19 vaccines in lower income countries – the very places where healthcare access is more limited.
To tackle this, WHO published an update of its COVID-19 vaccination strategy last month to increase vaccination target to 100% of healthcare workers and the highest risk populations with both primary and booster doses, including older populations and those who are immunocompromised or have underlying conditions.
In its latest statement, WHO recognises the benefits of vaccinating children and adolescents in terms of reducing the number of infections, hospitalisations, deaths and long-COVID cases, as well as minimising disruption to education for children and maintaining overall wellbeing, health and safety.
Additionally, it is noted that vaccination that decreases SARS-CoV-2 transmission in this age group may reduce transmission from children and adolescents to older adults, and may help reduce the need for mitigation measures in schools.
However, WHO states that ‘the direct health benefit of vaccinating healthy children and adolescents is lower compared with vaccinating older adults due to the lower incidence of severe COVID-19 and deaths in younger persons’.
Although the majority of COVID-19 vaccines are only approved for use in adults aged 18 years and above, an increasing number of vaccines are now also being authorised for use in children. Some countries, including the US, have given emergency use authorisation for Pfizer/BioNTech and Moderna’s mRNA vaccines for use in the age groups of six months and above.
Additionally, Covaxin, an adjuvanted inactivated vaccine developed by Bharat, was approved in India for the age indication of 12-17 years, though this age indication has not yet received a WHO Emergency Use Listing.