Thread by @ID_ethics

🧵Let me make this uncomfortable truth loud and clear:

Healthy children and adolescents likely face higher risks from some (perhaps all) #covid19 vaccines than from natural infection

I.e., the risks of vaccination likely outweigh the direct individual benefits

https://twitter.com/COVID_questions/status/1402189106105389074

To take the most obvious example, multiple high-income country regulators have restricted the use of the AstraZeneca vaccine in children and young adults

This is because the risks outweigh the direct individual benefits

https://twitter.com/ID_ethics/status/1380291174137667584?s=20

Some people look at the figure above and say it doesn't include other things like longcovid, but there is precious little evidence that longcovid is common/severe in healthy children or young healthy adults (despite a lot of unverified claims about this)

https://twitter.com/ID_ethics/status/1376642478531473409?s=20

What the figure above does not reflect is that average risk in a given age group includes those with risk factors for severe #covid19 like diabetes, heart & lung conditions, and obesity - risks in healthy people in that age group are significantly lower

If we are just talking about healthy children and adolescents, their risk of #covid19 is even lower than the average risk in their age group (where this average includes people with risk factors)

medium.com/wintoncentre/h…

This is not just the AstraZeneca vaccine, as Pfizer is now associated with myocarditis in young healthy adults & teenagers

Given the extremely low risks of #covid19 in children & young healthy people, the risks of vaccination may well outweigh benefits

sciencemag.org/news/2021/06/i…

Some propose that we could just give children one dose of Pfizer (as the second dose has a stronger signal for myocarditis), or a lower dose of the vaccine

This is also because of reasonable concerns that risks of standard regimens may outweigh benefits

https://twitter.com/apoorva_nyc/status/1402283227314798598?s=20

In recent history, regulators have restricted the use of other vaccines in children where there are concerns that risks outweigh benefits

For example, Australia stopped the use of an influenza vaccine associated with febrile seizures:

https://twitter.com/ID_ethics/status/1374131421728534530?s=20

Likewise, European regulators restricted the use of another influenza vaccine associated with narcolepsy in children, which peaked at 6+ months after receiving the vaccine

https://twitter.com/ID_ethics/status/1374191049971671045?s=20

It should be obvious that:

Harming healthy children with vaccines for a disease that is associated with extremely low risks in children is a bad idea, even if those harms are rare

Harming healthy children will undermine vaccine confidence

https://twitter.com/ID_ethics/status/1401643429591846912?s=20

If we want to promote public health, and confidence in #covid19 vaccines as well as other vaccines, we should be extremely careful to determine that the benefits of childhood vaccination outweigh the individual risks before we make vaccines routine for healthy children

Note: I think it is fine to give current #covid19 vaccines to children and adolescents with health conditions that put them at high risk of severe #covid19, or for young healthy adults who make a free choice to be vaccinated

The more difficult case is young healthy children

Also note: it is fine to do more research to try to find safer vaccines / regimens of exisiting vaccines in younger age groups, but there is a big difference between research and (“emergency”) public health roll out where risks might outweigh benefits

Update: here is the German regulator making a sensible decision on Pfizer:

Only approved for adolescents with medical conditions / at increased risk of severe #covid19

Or those who consent to current risk & uncertainty in discussion with a doctor

https://twitter.com/rfsquared/status/1403043733021593608?s=20