Following Israel and North America, European Union countries are now the latest to allow parents to get children under the age of 12 vaccinated.
Even amid renewed infection surges in many places and the threat of the new, faster spreading omicron variant, parents may be wondering if their child's natural resistance to the coronavirus is enough.
Here are some answers to questions parents may be asking in countries which have approved coronavirus vaccinations for children.
Yes: Smaller children get only one third of the dose compared to the age group 12 and older (10 instead of 30 micrograms). Otherwise, the procedure is the same as for older children: Two injections are given into the upper arm, three weeks apart.
An evaluation published in the New England Journal of Medicine concluded, based on Biontech/Pfizer vaccine trials, that this vaccine was safe and effective.
The vaccine effectiveness was estimated to be 90.7%: Three of the children vaccinated for the study contracted COVID-19 during the observation period. In total, around 1,300 children received the vaccine.
The study authors saw "a favourable safety profile" and "no vaccine-related serious adverse events." Only "mild and moderate" reactions such as fever, pain at the injection site, fatigue and headaches were documented. As such, common reactions appear to be largely similar to adults after receiving the vaccine.
According to the authors, three more serious injuries taking place during the observation period, such as a broken arm, were not related to the vaccination. Heart muscle inflammations, which have occasionally occurred after vaccination for a large number of children aged 12 and older, were not found in this – quite small – group of test persons.
The European Medicines Agency (EMA) concludes from the data that the benefits of vaccination outweigh the risks, especially in children with pre-existing conditions which could increase the risk of a severe course of COVID-19.
The United States Centers for Disease Control and Prevention (CDC) meanwhile say that "vaccinating children can help protect family members, including siblings who are not eligible for vaccination and family members who may be at increased risk of getting very sick if they are infected."
However in Europe, the EMA's approval decision does not mean a blanket recommendation for all children to be vaccinated. This is a matter for national governments or health authorities, the EMA says.
In Germany, many pediatricians are guided by the vote of the Standing Committee on Vaccination (Stiko), which hopes to decide on its guidance for the vaccination of children by the end of 2021.
"Approving a vaccine is something completely different to recommending one," Fred Zepp from Germany's Stiko committee says.
For approval, he said, it must be proven that the vaccination triggers a protective antibody response and that it did not have any acute adverse side effects in the test persons.
"What you don't see in the approval study are risks that occur less frequently than would be statistically expected in such a small group."
If only a few children are vaccinated, very rare side effects are not seen, for example those which only occur in 10 out of 100,000 cases. Experts are keen to get data on rare vaccination complications from other countries. This may soon come from the U.S., Canada and Israel, where the campaigns have already started.
For healthy children, it is comparatively low. They do get infected, but getting seriously ill is the absolute exception, says Jakob Maske, spokesperson for Germany's Professional Association of Paediatricians and Adolescent Doctors.
The risk-benefit ratio for vaccines must therefore be different for children than for adults. "Because the risk is very small, the benefit must be very great. Therefore, much stricter criteria would have to apply to possible side effects," Maske says.
According to the CDC, children aged between 5 and 11 have experienced more than 8,300 COVID-19 related hospitalizations and nearly 100 deaths from COVID-19 in the U.S. "In fact, COVID-19 ranks as one of the top 10 causes of death for children aged 5 through 11 years."
There are a number of parents who urgently want to have their children vaccinated. There are several reasons for this: for example, their own or their child's previous illnesses, concern about the possible consequences of a coronavirus infection or the desire to allow their children to have a largely normal school and social life.
There are also parents who fundamentally reject vaccination for their children, for example because they are afraid of the possible risks of vaccination or think a coronavirus infection would be harmless to their children. In either case, consulting a pediatrician is advised before making a final decision (and before further expert guidance is issued).
That is questionable and we should not forget that a large part of the problem is unvaccinated adults, says vaccine specialist Zepp.
"The most important measure to overcome the pandemic remains unchanged, to protect as many adults as possible, preferably all adults, through vaccination." This is because older unvaccinated people have a higher risk of needing intensive care in the event of an infection.
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