Thread by @SGriffin_Lab

I despair at the messaging around #vax4kids that I'm seeing.
All medicines are licensed based upon a balance of clinical benefit vs risk. All medicines will have risk, but as a population reducing the harms from disease outweighs it.
This does not diminish the problems faced by

those that comprise the rare group that experience moderate to severe or even deadly side effects.

Issues can arise when, on a population scale, risks are over-stated, or the perceived benefits are underplayed. Of course, the opposite is also true, but there's some pretty good

and unambiguous safety and efficacy RCT data out on COVID vax, despite the 💩some Quacks are spreading.

There is also the sensible mitigation of future risk that combines with the evidence base from trials, aka precautionary principle, to consider...for example, when dealing

with a virus that's only been circulating in humans for 2.5 years and has generated multiple and successive waves of infections, and reinfections across the globe...and which is well documented to cause complex and long-lasting pathology in addition to acute disease.

It is of

note that one similarity between many who underplay benefits and those who overstate risks is the focus upon individual, rather than population risk.
Saying "kids don't get sick from COVID" is rather like saying roads are safe because I crossed one this morning...we're all aware

aware that this happens, just that it happens to "someone else". It's also important to make sure the yardstick you're using is sensible - paediatric infectious diseases are comparable to each other, not to the same disease in adults. Kids have VERY differently wired immune

responses, as well as different immune experience/memory to adults. For example, there are numerous studies showing that they are less likely to mount effective antibody responses following infection with SARS2, leaving them wide open to repeat infection...how many times do you

want your kids to roll the dice?
Reassuringly, the response to vaccines is more consistent and durable, but yes antibodies wane and new variants can evade them...BUT, trial data shows this protects from more severe disease.
Of course kids get infected, transmit, and a small no.

can be hospitalised, develop MIS-C, and yes, some do perish. These are NOT all kids that have underlying conditions by any means (ISARIC), despite what some out-of-date 2020 based stuff might show...you know, when kids weren't mixing...
It's also important to consider the long

term consequences of infection with a newly emerged virus, which is clearly NOT the same as other CoVs, which could involve occult disease later in life as we see with adults (diabetes, cardiovascular, neurological, pulmonary problems), but definitely DOES include #LongCovidKids

...every case of which is just the most dreadful consequence of what some ignoramuses call a sniffle...
Now, unless you're prepared to spend time scrutinising these numbers and consider the population risk as we geeks do, it's entirely understandable that many parents simply do

not perceive the risk on the population scale, after all, the individual risk is small and it's lovely not to worry about a pandemic that we've all been "told" is over...
So, what I can't understand is the inability of government and the UK vax approval process to act in a timely

fashion in the same way that the FDA does. Now, this does NOT involve throwing caution to the wind...remember the UK being the first to approve the Pfizer jab? I don't doubt that analysis, so why do other appraisals languish SO far behind the ROTW?
No, kids don't contribute a

major proportion of severe disease, hospitalisations and deaths that we (used to) see on the dashboard/news etc., but there's a reason that paediatric ICUs are small relative to adult provision...kids don't get seriously ill ANYWHERE near as often as adults. Thus, whether or not

approvals are supported by positive messaging likely comes down to other factors affecting policy in addition to the risk/benefit assessment. Choosing not to add the precautionary principle to considerations, as well as the longevity of population immunity is a choice. The Govt

saying something is "non-urgent" sends a powerful message...I imagine this is particularly upsetting for families with vulnerable children, or relatives, or who have/are experiencing long COVID.
We still see less than 10% of under 12s having a 1st jab, way less for the second...

the numbers speak for themselves.
I for one have had my 9 and 5 yo vaccinated, thankfully without any reactions. My opinion is that the very low risks for the paediatric vax vs COVID is a no-brainer.
However, I do NOT mean in this thread to belittle or minimise those for whom

a vax reaction has caused harm. This can be serious and we shouldn't shy away from this. These are potent immune adjuvants, and our diverse genetics means that sadly some will not respond well. The scale of the issues generally only become apparent during phase 4, such as with

the AZ clotting risk, but thankfully, aside from the myocarditis in adolescent males, these risks have been very rare. Even so, there has not been a single death attributed to juvenile vaccines AFAIK, whereas this is clearly not the case for COVID.
So, again, it comes down to

population-based risk. This is why I am vehemently pro-vaccination, I believe it is the route to ultimately ending the pandemic in the future, and when we say due to brevity that vaccines are "safe", what we mean is of course than benefit is great, risk is small.
So, next time

you see a tweet highlighting potential complications from a vaccine reaction, remember these DO exist, but despite what VAERS/yellow card based studies conclude, these are very rare, albeit horrible events. Some groups will say the opposite to what I've said here, and that these

side effects constitute a crime against children, that COVID is benign in kids, or long COVID is "in the mind"...this feeds upon lackadaisical messaging from government, of course. I urge parents to make a balanced decision based upon population risks, to be aware when one-offs

are being artificially applied to the population, but also to realise that when you are "other people that things happen to" that this is terrible...yet the latter occurs much more commonly for COVID compared to vaccines...including in kids. Anyone who's had a child in hospital

for something serious will tell you that in this case there is no such thing as "mild hospitalisation" as well, despite gaslighting from certain quarters...be risk averse, but also risk aware. This really does affect all of us, one at a time...
#VaccinesWork