Thread by @dgurdasani1

Ok, given the anti-vaxx sentiment for childhood vaccination of 5-11 year olds is in full flow, thought some helpful facts might help debunk myths and provide factual information around this. Here goes...

'We don't need it because children aren't seriously affected by COVID-19'

Yes we do. Stop comparing kids to adults. Compare COVID-19 to other illnesses in kids! Kids generally die less than adults, and we should be aiming to keep it that way!!

Let's look at most severe outcomes first - deaths.

We've had 21 deaths with COVID-19 *on the death certificate* as per ONS data in 2021 in 5-14 yrs in England & Wales. These are deaths *involving COVID-19* not *with COVID-19*

Of these, 18 had COVID-19 as primary cause, with the remaining being contributing (also on the causal pathway).

'But we're talking about 5-11 yr olds. Why are you looking at 5-14 yr olds?'

Because I want to make comparisons with other childhood illnesses & this is how death data are provided. Take it up with NOMIS/ONS!

Let's compare these deaths to deaths from other childhood illnesses- let's look at 2020 - deaths in 5-14 yr olds
Flu: 8
flu and all pneumonias: 14

Measles: 0
Mumps: 0
Varicella: 1
Rubella: 0

'Not fair- mitigations were in place in 2020, which is why all this was low'
Yes, but that's the same for COVID-19 - we're yet to see completely unmitigated spread. But I'll indulge you.
Here's the data from 2019
Flu: 11
Flu & *all* pneumonia: 34
Measles:1
Mumps:0
Varicella:1

'Oh, but we vaccinate for these- not comparable with impact of illnesses unvaccinated'

Ok, fine. Let's look at the data from the ONS on flu.
*21* deaths from flu *and* all pneumonias in *0-14 yr* olds in 2003 *before* routine flu vaccination in kids.

So COVID-19 under current mitigations comparable to deaths from flu and all-cause pneumonia pre-vax and *much* higher than all vaccinatable childhood illnesses in recent years

Let's look at other outcomes now. Long COVID tripled in children between July-Nov '21 increasing to 117,000 from 38,000. For 2-11 yr olds this number is 44,000. And 20,000 children with persistent symptoms for *more than a year* - of which 11,000 are 2-11 yr old.

That isn't trivial. This was pre-omicron - since when many more have been infected in this age group. And we have no idea what the prognosis is for many of these children, and what the long term effects of this illness are.

The UKHSA review of multiple studies showed that vaccines were effective in reducing the rate of long COVID, and potentially the severity and duration as well. And this is on top of the small but relevant impact vaccines have on reducing infection.

And vaccines do reduce transmission. Even if the impact isn't huge. Infection rates in primary school children have exceeded those in secondary school children since vaccine rollout in - however inefficient it's been - in the older age group.

320,000 children were absent from school for COVID-19 related reasons in the 6th Feb DfE attendance report. 165,000 of these were primary school kids. Any reduction in this would be worth it. Even if vaccines have a small effect on transmission, this will make a diff.

Impacts on families: Almost 12,000 children in the UK have been orphaned by SARS-CoV-2 as per Imperial estimation. Any reduction in transmission to children and from children matters - if it makes their families and carers safer.

8 million children have been vaccinated in the US alone. Most countries that have resource are able to vaccinate kids in this age group are doing so. We know these vaccines are safe and effective. Risk of myocarditis is extremely low- *far far far* lower than risk from COVID-19.

And vaccine associated myocarditis apart from being extremely rare (2/million) is also typically mild. This is not the case for COVID-19 associated myocarditis which has been associated with arrhythmias and fatalities in children.

'But what about global vaccine equity?'
Global vaccine equity is vital but we're not going to achieve it by donating 10 million paediatric doses of Pfizer to Covax. If we're serious about this, we need patent waivers and tech transfer agreements to scale up domestic manufacturing

And the only way donating those dosing would be ethical would be if we then made every effort to reduce exposure in kids to the minimum - because letting tens of thousands of kids get long COVID cannot be the moral alternative. But we aren't doing that.

So we owe our children to do this - at the very least- given we've done so little to protect them.

Adding a bit more myth busting here at request - on natural infection of children.
'But loads of kids have been infected now- why do they need to be vaccinated?'

There's a lot of evidence that infection in children leads to lower levels of antibodies than adults, & that many children serorevert (become antibody negative) not very long after infection - vaccines provide safe & reliable immunity. Infection doesn't.

https://twitter.com/dgurdasani1/status/1439905644409245696?s=20&t=uZVtNCCA0Oes73TH2WCj7A

This may also explain the high levels of re-infection we saw in 10-14 yr olds during the omicron wave. As new variants emerged we will likely see more re-infection, so getting vaccinated is important, even if you've been infected to give you greater & more reliable protection.

All refs here:

https://twitter.com/dgurdasani1/status/1494263093421133826?s=20&t=o2cqe4TMNpHbB0l2Ptdyxg