WHO also calls for sharing of vaccines by countries that are more advanced in vaccination

The World Health Organization (WHO) is “reviewing the information” on vaccination of children and adolescents against Covid-19, but insists on the priority immunization of groups at greatest risk.

“Countries should consider the individual and population benefits of immunizing children and adolescents, within the framework of their specific social and epidemiological context”, advises the WHO, declaring that “it is less urgent to vaccinate” younger people than to immunize older people, the chronically ill and health professionals.

On the eve of the European Medicines Agency’s pronouncement on the vaccination of children under 12 against Covid-19, the WHO admits – in an “interim position” released this Wednesday – that this option could be relevant to reduce transmission disease to adults and reduce the need for mitigation measures in schools.

However, he stresses, “before considering implementing the first dose in adolescents and children, any country should consider prioritizing the vaccination of risk groups, either with a first dose or with boosted doses.”

In addition, it is necessary to take into account the current “global inequality in access to vaccines”, recalls the WHO, in the statement on “the need and time to vaccinate children and adolescents with currently available vaccines against Covid-19”.

Countries with high vaccination rates “should prioritize the global sharing of Covid-19 vaccines, through the COVAX alliance, before moving forward with vaccination of children and adolescents at low risk of severe disease”, calls the WHO.

Given the context of “constraints in the supply” of vaccines, “the focus of immunization programs must continue to be the protection of populations most at risk of hospitalization and death”, he advises.

“The benefits of vaccinating children to reduce the risk of serious illness and death are much smaller than those associated with vaccinating adults,” he adds.

In this context, countries with little or no vaccine supply constraints “should consider global equity when making policy decisions about vaccinating children and adolescents.”

Stressing that “the greatest pressure, in severe illness and death, continues to be placed on the elderly and those with comorbidities”, the WHO indicates that, according to data collected up to October, children under the age of five represented only 2% of reported cases globally and 0.1% (1,797) of identified deaths.

Children and young people between 5 and 14 years old represented, in the same period, 7% of the reported cases and the same 0.1% (1,328) of deaths.

Adolescents and young adults between 15 and 24 years old represented, in the same period, 15% of reported cases and 0.4% (7,023) of deaths.

WHO concludes that deaths in people under the age of 25 account for less than 0.5% of reported deaths worldwide.

In addition, children and adolescents generally show “fewer symptoms and less severe symptoms” of SARS-CoV-2 infection compared to adults, and are less likely to develop severe forms of the disease. This leads to these groups being “less tested” and cases may “go unreported”, he acknowledges.

WHO stresses the importance of children continuing to receive recommended vaccines for other diseases. “Routine vaccination services were also negatively impacted as a result of the response to the pandemic, exacerbating the potential resurgence of vaccine-preventable diseases, such as measles, tetanus, yellow fever,” he warns.

WHO recognizes “advantages in vaccinating all age groups”, but stresses that “the direct health benefit of vaccinating children and adolescents is smaller compared to vaccinating older people”.

But there are other factors to take into account, he acknowledges, estimating that “24 million children are at risk of not going back to school due to the pandemic” and that vaccinating children and adolescents can ensure the preservation of education.

Despite the “low risk” of contracting the severe form of the disease, children and adolescents “have been disproportionately affected by Covid-19 control measures”, stresses the WHO, specifying that school closings are the biggest example, having increased the “emotional distress and mental health problems” in this population.

In addition, out of school and in social isolation, “children are more susceptible to abuse and sexual violence, teenage pregnancy and child marriage”, he warns, also adding the impact on food (guaranteed by school meals).

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