Of the three vaccines approved in Europe, none are suitable for children under 16: not for some elusive side effect, but because the trials carried out so far have not included children and adolescents. Moderna and Oxford-AstraZeneca’s anti-covid vaccines are authorized for ages 18 and up, Pfizer-BioNTech’s can be done from 16 years. However, things are destined to change. Because if it is true that pediatric drug trials take longer, in the long run, vaccinating even the youngest has a protective effect for everyone.
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A matter of priority. With few doses of vaccines available and an unbalanced mortality among the elderly, it is understandable that we start vaccinating from the older ones: proceeding like this pressure on hospitals is reduced and more lives are saved. But thinking about a future in which the covid will be present as an endemic disease, capable of raging only on the most fragile, the idea of vaccinating children and adolescents is also filled with meaning. Not surprisingly, both Pfizer and Moderna have already recruited, or are recruiting, teenage volunteers over the age of 12 for trials of their vaccines, while Johnson & Johnson has already included 12- to 17-year-olds in the trial of its anti-covid product. still approved.
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benefits for children. Although deaths and hospitalizations are extremely rare in younger people, they have nevertheless been documented cases of multisystem inflammatory diseases among children and adolescents, and the long-term effects of a possible covid infection are still unknown. Children with previous illnesses may contract the disease in worse form, just as observed in adults, not to mention that attending school requires maintaining social contacts. Furthermore, it has been seen that children belonging to minorities or living in conditions of hardship are more often victims of severe or lethal forms of covid.
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Benefits for the community. But by immunizing the youngest, benefits can be obtained that can be extended to every segment of the population. As explained in an article on the US version of Wired, the under 18s make up an important slice of the population that cannot be left behind, especially considering that the protective effect of vaccines does not last forever and that the virus could mutate to become more resistant. With this in mind, it is useful to vaccinate those who – such as children and teenagers – regularly come to the pediatrician several times a year for the usual vaccinations. Including the anti-covid vaccines in the routine vaccination schedule would create a generational barrier to the virus, much more effective than it would be without involving the kids. As we age, keeping patients on regular vaccination schedules becomes more difficult.
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Indirect protection. To stimulate maximum coverage, it is best to intervene on a young and responsive immune system. The approach is already being exploited against other infections: by systematically vaccinating children against influenza and pneumococcus the elderly are also protected, who are vaccinated less regularly and effectively. And giving young people the rubella vaccine reduces the spread of the virus among pregnant women, who could develop serious complications for the unborn child if infected.
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As per practice. The recruitment of children and young people in the trials takes place in a gradual and “downward” process. It starts with adolescents, who have almost mature defenses comparable to adult ones, for an even more careful and precise study on possible side effects and safety.
We then move on to under 12, but starting from lower dosages, and only at the end we include younger children. Typically, in the latter phase of the trial, tests slow down, partly due to the difficulty of finding parents who agree to participate and because we are part of an already tight vaccination schedule. For this reason, no results are expected for under 12s before 2022.
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