Abstract
  • Access to and completion of a primary COVID-19 vaccine series in all countries is an essential prerequisite to control the global SARS-CoV-2 pandemic. Until worldwide control is achieved, all countries remain at risk.
  • Ensuring that adults and adolescents are optimally vaccinated will help to protect younger unvaccinated children from SARS-CoV-2 infection.
  • The observation of all recommended public health and social measures i.e., use of masks, physical distancing, hand hygiene and ventilation of indoor spaces are key to reducing SARS-CoV-2 transmission.
  • SARS-CoV-2 infection in those aged 5 to 11 years is usually asymptomatic or mild. Rates of hospitalisation and ICU admission are very low, and COVID-19 related death is extremely rare.
  • Although the risk of hospitalisation is higher in children with underlying conditions, previously healthy children can develop severe COVID-19.
  • In Ireland, COVID-19 vaccine uptake is high and is 70% in those aged 12 to 15 years.
  • Prior to the introduction of vaccination for those aged 12 to 15 years, this age group had similar rates of infection to children aged 5 to 11 years. Children aged 5 to 11 years now have the highest rate of infection of all age groups, three times that of adolescents.
  • From 18 November to 2 December, there were 12,304 COVID-19 cases in children aged 5 to 12 years. Of these, only 18 children (0.15%) were hospitalised.
  • In Ireland, between March 2020 to November 2021, 212 hospitalised children aged 5 to 11 years were SARS-CoV-2 PCR positive. Of these 12% had an underlying condition, 70% had no underlying conditions and for 18% this was not reported.
  • As infections surge, rates in children also rise, with a proportionate increase in hospital and ICU admissions.
  • From 27 June to 27 November 2021 there were 322 outbreaks associated with primary schools with 2,089 cases and 7 hospitalisations. The number of outbreaks and cases associated with post primary schools is substantially less.
  • The high transmissibility of the Delta variant has contributed to the surge in new infections. The effects of the recently identified Omicron variant have yet to be characterised.
  • Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare complication after symptomatic or asymptomatic SARS-CoV-2 infection, including in those without an underlying condition.
  • The risk of long COVID-19 is lower in children compared to adults although as case numbers increase there is likely to be a considerable health impact. • Comirnaty vaccine is effective in preventing COVID-19 in this age group. It is hoped that the reduction in infection and prevention of symptomatic disease will reduce rare complications.
  • Vaccination of those aged 5 to 11 years is associated with short term, self-limited side effects. No new safety concerns were observed in the clinical trials. The number of subjects in the trials does not allow detection of rare or very rare adverse events such as myocarditis and follow-up is ongoing.
  • Children have suffered significantly from both the direct and indirect effects of the COVID-19 pandemic.
  • The decision to offer COVID-19 vaccines to those aged 5 to 11 years is a balance of benefits and risks, informed by ethical considerations.
  • Recommendation
  • Europe
  • Ireland
  • children
  • COVID-19