1/ On 19 July 2021, JCVI published their statement on #Covid19 vaccination for 12-17 yr-olds

If you only heard that JVCI did not recommend vaccine for teens then you missed out on a wealth of information & recommendations in the report

Here’s why 🧵

👉 gov.uk/government/pub…
2/ First, the MHRA & JCVI have very different functions. The MHRA authorises medicines, including vaccines, & monitors their safety but does not make vaccine recommendations. The JCVI makes recommendations on vaccines for the national immunisation programme & for risk groups
3/ JCVI took rather long to release their statement on vaccinating 12-17 yr-olds because risk-benefits of vaccinating this age-gp
were finely balanced between risk of severe #Covid19 & risk of rare but severe side-effects for the only vaccine licensed for 12-15 yr-olds (Pfizer)
4/ The JCVI reviewed all the available evidence on #COVID19 vaccines in teenagers & young adults including data that are not yet in the public domain. They also heard representations from professional bodies & members of the public on vaccination of children against #COVID19
5/ The JCVI also considered #Covid19 deaths, hospitalization, PIMS-TS, long covid, indirect health implications, wider heath implications, operational issues & educational impact of vaccination. Cost-effectiveness & vaccine supply were *not* part of the scientific decision-making
6/ The main concern raised by JCVI was emerging reports from UK & other countries of rare but serious adverse events, including myocarditis (inflammation of heart muscle) & pericarditis (inflammation of membrane around the heart) after Pfizer & Moderna vaccines in younger adults
7/ JCVI stated that data on the incidence of adverse events are limited 👉 this is because new cases continue to be reported & risk estimates continue to evolve: Israel estimates myocarditis rates to be between 1 in 3,000 & 1 in 6,000 vaccinated men 👉 sciencemag.org/news/2021/06/i…
8/ JCVI then clarified that “longer-term health effects from the myocarditis events reported are not yet well understood” 👉 even though the young men recovered & went home, we need more data to reassure us that there are no lasting effects to the ❤️, which take time to collate
9/ Myocarditis is no joke. It involves immune cells & cytokines in heart muscle & the inflammation can take days to weeks to settle. Importantly, the consequences of this inflammation are not known. Hopefully it’s nothing but any damage or scarring to tissues would be lifelong
10/ Given these unknown risks (ie. after myocarditis), the JCVI stated that: “Until more safety data have accrued and their significance for children and young people has been more thoroughly evaluated, a precautionary approach is preferred”
11/ The JCVIs position is not against vaccinating teens but: “JCVI favours deferral of a universal offer of vaccination until more data have accrued” 👉 JCVI will continue to monitor the situation & if more data emerge to favour vaccination, then the decision will be reassessed
12/ The JCVI did recommend that 12+ years-olds with specific underlying health conditions that put them at risk of serious #Covid19 should be offered COVID-19 vaccination. These include (*but are not restricted to*) severe neurodisabilities, Down syndrome & immunocompromised
13/ Severe neurodisabilities: the JCVI actually recommended vaccinating 12+ year-olds with severe neurodisabilities back in Jan 2020 when the vaccines weren’t even licensed for 12-15 year olds because benefits outweighed potential risks after vaccination 👉adc.bmj.com/content/early/…
14/ Immunosuppressed teens are also recommended the vaccine because they have a higher risk of severe #COVID19, whilst acknowledging that vaccine responses may be lower in this group - this is true not just for COVID vaccines but all vaccines in for the immunocompromised
15/ JCVI also advised that 12+ year-olds who are household contacts of adults/kids who are immunosuppressed should be offered COVID-19 vaccination - this is to help indirectly protect the immunosuppressed household member
16/ Teens with Down syndrome (Trisomy 21) get a specific mention because this condition has one of the highest risk of severe #COVID19 among all underlying conditions 👉 bmj.com/content/371/bm…
17/ For 16-17 years-olds who have a higher risk of #Covid19, including those with specified underlying medical condition as currently set out in the Green Book, they will continue to be offered COVID-19 vaccination as per the Green Book 👉 gov.uk/government/pub…
18/ The JCVI also stated that it is currently reviewing the list of underlying medical conditions among 12-15 year-olds who will also be recommended #Covid19 vaccine. The full list of conditions will be published in the Green Book in the next few weeks 👉 gov.uk/government/pub…
19/ In conclusion:

- JCVI is waiting for more safety data on outcomes of myocarditis before recommending vaccine for all teens
- JCVI listed the major risk groups among 12-15 yr-olds for vaccination & confirmed that the full list of medical conditions will be published soon


• • •

Missing some Tweet in this thread? You can try to force a refresh

Keep Current with Shamez Ladhani

Shamez Ladhani Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!


Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @ShamezLadhani

21 Jul
1. Most of us do not really appreciate how resilient children and their immune systems are when they encounter #sarscov2. Most kids don’t even realize they have been exposed, which leads to ⬆️⬆️⬆️ over-estimation of the long-term effects of #COVID19 in children

Here’s why … 🧵
2/ when asked, most parents don’t even realize when they child was exposed to #SARS_CoV_2 because most kids either remain asymptomatic or have such a mild and transient illness that parents don’t even associate the illness with #COVID19
3/ In our primary schools study, although small numbers, parents reported no symptoms in 85% of kids who didn’t have #SARS_CoV_2 antibodies at start of the study & then developed antibodies during the study (ie. got infected) compared to 47% of staff
👉 thelancet.com/journals/lanch…
Read 7 tweets
16 Jul
1/ We studied the quality,
quantity and persistence of #SARSCoV2 antibodies in primary school students (6-11 year-olds) compared to staff (adults) over 6 months (until ~7-8 months after their #SARSCoV2 infection)

Here’s what we found (pre-print) 🧵

👉 medrxiv.org/content/10.110…
2/ The proportion of students & staff who had #SARSCoV2 antibodies in back June 2020 was similar:

👉 11.5% (95%CI, 9.4-13.9) & 11.3% (95%CI, 9.2-13.6; p=0.88) students had nucleoprotein & RBD antibodies vs 15.6% (95%CI, 13.7-17.6) & 15.3% (95%CI, 13.4-17.3; p=0.83) staff
3/ Live virus neutralising activity (ability of antibody to kill #SARSCoV2) was detected in 79.8% (71/89) of N antibody & 85.5% (71/83) of RBD antibody positive kids. RBD correlated more strongly with neutralising activity (rs=0.75; p<0.0001) than N antibodies (rs=0.37; p<0.0001)
Read 7 tweets
16 Jul
1/ We developed & validated an oral fluid assay to measure #SARSCoV2 antibodies. Basically it’s a lollipop stick with a sponge that collects oral fluid (saliva) from around cheeks/gums. Kids can do the test themselves & sample can be posted to the lab 🧵👉 medrxiv.org/content/10.110…
2/ Here’s the technical stuff: We used contemporaneous blood & oral fluid samples from ~2,000 kids & adults taking part in our school studies and developed 3 different oral fluid assays for testing & validating: N-antibody, Spike-antibody & RBD-antibody 👉 medrxiv.org/content/10.110…
3/ The N-protein capture assay was the best candidate, sensitivity 75% (95%CI, 71–79%) specificity 99% (95% CI: 78–99%) when compared with paired serum antibodies, but higher sensitivity in kids (80%, 95% CI: 71–88%) than adults (67%, CI: 60%-74%) 👉 medrxiv.org/content/10.110…
Read 5 tweets
11 Jul
1/9. In England, #SARSCoV2 infection rates in school-aged kids & #COVID19 outbreaks have both ⬆️ in recent weeks (latest data 4 July) but that does not change the narrative on kids & their role in infection/transmission in school

Here’s why … 🧵

👉 assets.publishing.service.gov.uk/government/upl…
2/9. No one has claimed that kids don’t get infected or don’t transmit #SARSCoV2 to others. But the data suggest that lower risk with kids than adults. Eg. We don’t see two-thirds of staff/students infected in a single outbreak as we do in care homes 👉 thelancet.com/journals/eclin…
3/9. We & others have shown that #SARSCoV2 cases & outbreaks reflect community infection rates. Cases in kids generally follow adults *unless* adults are in lockdown & kids continue to go to school. This happened in Nov/Dec 2020 & Mar/Apr 2021. See👇👇

👉 journalofinfection.com/article/S0163-…
Read 9 tweets
10 Jul
1/5. Mental health of Adolescents in the Pandemic: Long-COVID19 or Long-Pandemic Syndrome? (pre-print, thanks @MaryKRe)

Here’s another case-control study on long covid that measured #SARSCoV2 antibodies in teenagers

Here’s what they found … 🧵

👉 medrxiv.org/content/10.110…
2/5. 1560 kids (median age 15y):
- 188 (12%) seropositive (exposed to #SARSCoV2)
- 1365 (88%) seronegative (never exposed)

If you think this sample size is small, try bleeding 1500 teens!

They were asked the same questions ➡️ responses were near-identical in cases & controls
3/5. The authors did a subgroup analysis & found near-identical responses in teenagers who knew their #SARSCoV2 infection status vs those who didn’t

Yes, small samples size, but not even a signal of any difference in mental health status (see table👇)

👉 medrxiv.org/content/10.110…
Read 5 tweets
9 Jul
1/4 Childhood #COVID19 deaths. This preprint by @RCPCHtweets & @PHE_uk provides critical new information about #SARSCoV2 and kids which we didn’t have until now. Here’s why the small numbers in this paper matter 🧵

👉 researchsquare.com/article/rs-689…
2/4 Death is the most objective outcome & can be accurately measured in countries like England. The results show ~3,000 of 12 million kids died in 1 year & only 61 with #SARSCoV2. Detailed medical record analysis showed only 25 (42%) died *of* #COVID19

👉 researchsquare.com/article/rs-689…
3/4. Of the 25 kids who died of #COVID19, 19/25 (76%) had underlying conditions & of these 15/19 (60%) had a life-limiting condition & mostly with 2 or more medical conditions, esp. severe neurological conditions

👉 25 fatalities = 2 per million kids

Read 4 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!