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
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)
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)
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
Likewise, European regulators restricted the use of another influenza vaccine associated with narcolepsy in children, which peaked at 6+ months after receiving the vaccine
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
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
One response, as below, is that we should mix vaccinated and unvaccinated in order to reduce the probability of infection in the latter (i.e., indirect protection or herd immunity)
This might be a good strategy insofar as unvaccinated people want to be vaccinated but just haven't had access yet - it protects them until they get vaccinated
3/
@COVID_questions@bergerbell@pgodfreysmith@NahasNewman@WesPegden Regarding India, I first noted in July 2020 that we would eventually see bad news due to comorbidites (in the context of poverty and inequality), but that overall deaths per capita would be limited by the low population age - similar to current events
The above is an example of how scientists and journal editors could better communicate findings and risks
The widespread and baseless fears that there would not be immunity to #covid19 could have been reduced, rather than increased, by more careful reporting of the same data
From the same study:
~50% of people infected with endemic coronaviruses still have higher levels of antibodies after 4 years
No reason to think that #covid19 would be wildly different
(antibodies don't necessarily = clinical protection, but still good data)