Thread by @globalhlthtwit

Why we should be vaccinating children over 5 much faster against Covid in the UK. (THREAD) (1)

UK vaccination for children was delayed much longer compared to the USA/Europe. Rates are lower inEngland:
Ages 5-11: almost 0%
Ages 12-15: 59% one dose, 23% second dose
Ages 16-17: 74% one dose, 53% second dose.
Vaccine approved by MHRA June 2021, roll-out started Sept. (2)

Some comments on radio have suggested Covid is only severe in children 'once in a blue moon' and the small risk of heart inflammation means parents should not treat vaccination as urgent. This is not correct. (3)

Look at the up-to-date data on cases, deaths and vaccination rates by age group in the USA. Nine million cases in children, and 954 deaths. That is not a death 'once in a blue moon'. And 6281 deaths in adults aged 18-29! (4)

The US CDC also report 6851 cases of multi-inflammatory syndrome in children which affects many organs in the body. Many end up in intensive care. 59 of these children died. Half the MISC cases were aged 5-13 and 59% were Hispanic or Black. 60% were male. (5)

The age distribution in the USA shows nearly half of MISC cases were in the 5-11 age group. (6)

The UK govt do not present figures for age group breakdown of deaths and MISC cases in children. But in the raw data I found 26 deaths of children aged 5-11 due to Covid since the pandemic began. (From the US data I would expect around 60.) (7)

In the 15 years before 1988 when vaccination was introduced, England and Wales averaged 16 deaths per year from measles. In the past fifteen years with measles vaccination, deaths from the infection were never above 1 per year. (8)

So UK records between April 2020 and December 21 show 26 deaths from Covid among children between the ages of 5-11, with 16 over the past year. Rare yes, but deaths are as common as from measles before we introduced vaccination. (9)

Children are also a major potential source of transmission to older age groups. Just 2 weeks ago 13% of primary and 8% of secondary children were infected. Hundreds of thousands of unvaxxed kids have been infected. How many spread infection unwittingly to the more vulnerable (10)

The JCVI model shows a two dose vaccination course in 5-11 year olds would prevent (assuming 5 million children aged 5-11) 290 cases of paediatric inflammatory multiorgan syndrome, 495 hospitalisations and 15 cases in intensive care. Not trivial. (11)

Perhaps the most important reason to vaccinate children is Long Covid, an outcome not considered by JCVI. The ONS data report (Feb 2022) 1 in 100 aged 12 to 16 and 1 in 400 aged 2-11 had symptoms lasting >12 weeks. i.e if half infected, 17,500 and 8750 cases would result. (12)

Two ambitious studies compared prolonged symptoms in children after Covid wt a control group who didn't have Covid. One major problem they faced was that relatively few questionnaires were returned. One can't be certain the two groups were therefore a representative sample. (13)

I was involved in more than a dozen large population trials. We sought to achieve at least 70% follow-up rates to avoid bias and to get through peer review. In the UK CLOCK study, only 13.5% returned questionnaires. (14) researchsquare.com/article/rs-798…

Having said that, the study is commendable for trying to control for non-specific symptoms. The results show that at 12 weeks after Covid, 30.3% of test-positives and 16.2% of test-negatives had 3+ symptoms, and 23.7 v 3.8% had 5 or more symptoms. A big big difference. (15)

A large study from Norway recently released as a pre-print followed up adults infected in the first year of the pandemic. They had a comparison group with rates of follow-up over 50%. medrxiv.org/content/10.110… (16)

The risks of cognitive symptoms lasting at least 12 MONTHS were much higher in the infected group. 4.8x higher for fatigue, 3.2x for brain fog, 5.3x for poor memory, and an incredible 51x for altered taste and smell. We need data on children, but it could easily be similar. (17)

We also know now that vaccination of children appears to substantially reduce the risks of Long Covid, perhaps by half. thelancet.com/journals/lanre… (18)

Almost all (98.6%) of US cases of myocarditis in children following COVID-19 vaccine have been mild. In the USA no children died or needed mechanical heart support. In every case, heart weakness in children post-vaccine resolved and returned to normal.(19) jamanetwork.com/journals/jama/…

In the UK in those aged under 18, the reported rate for heart inflammation after vaccination (myocarditis and pericarditis) is 10 per million doses, with slightly more in teenage boys. All recovered quickly and no deaths reported. gov.uk/government/pub… (20)

A child has a much greater chance of developing heart problems, including myocarditis, if they contract COVID-19 compared w getting a COVID-19 vaccine. CDC report that patients of all ages with COVID-19 have a 16 times greater risk of myocarditis. (21) cdc.gov/mmwr/volumes/7…

In summary the case to vaccinate children 5-17 against Covid is as strong as for other routine vaccines. We should not be half-hearted nor suggest it is non-urgent. Protecting our children should be a priority. The benefits far outweigh the risks. (22)

An independent review showed that when cases are high and the incidence is high, 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. During Omicron cases were much higher than this. research-repository.st-andrews.ac.uk/bitstream/hand… (23)

Just to add data from Dr Gurdasanis presentation to Indie SAGE. Much higher estimates of prevalence in children.