On November 9, 2021, a study was published, with a sample of more than a thousand children between 5 and 11 years of age, vaccinated against COVID-19. This study indicates that the same immunogenicity and effectiveness found in the results of the vaccination of adolescents were verified, that is: The vaccine is safe and all side effects are perfectly tolerated by those who are vaccinated, so there are no problems with its use. The study small sample raised the same doubts for specialists: cases of rare serious adverse effects are usually only detected in phase 4 of clinical trials, that is, in the phase of commercialization of vaccines, when their useis widespread in the population. However, it is known that, so far, nearly 3 million children in the United States have been vaccinated, so that it will soon be possible to access even more reliable information on the safety of this vaccination in children. Several countries have already started vaccinating children from 5 to 11 years old: In Europe, Austria was the first country to do so – this without waiting, at the time, for the decision of the European Medicines Agency (EMA), the responsible European authority, by vaccines aproval. Both France and Germany are also preparing to take the same step. In the rest of the world, the USA, Canada, Argentina, China, some countries of the Arabian Peninsula, among many others, are already doing this. On November 23, 2021, the Portuguese Society of Pediatrics issued a statement stating that: In children, COVID-19 is usually an asymptomatic or mild disease and, fortunately, serious cases that require hospitalization or admission to intensive care units are still rare, occurring mainly in children with risk factors. However, children have been heavily harmed by the the pandemic due to successive confinements that seriously affect their learning and mental health and increase the risk of poverty and maltreatment; COVID-19 vaccines are safe and effective, protect against serious illness and reduce transmission of the infection, although not completely prevent it; Vaccination against SARS-CoV-2 was evaluated in a clinical trial in children aged 5 to 11 years, in which 1517 children were vaccinated. The results showed that it is safe and effective against COVID-19, as in other age groups, so its use has already been approved by the US Food and Drug Administration (FDA) and is awaiting approval by the EMA. The fact that many adults are now protected by vaccination, explains the proportion of new positive tests found in children is higher than before, mainly with the intensive testing of children attending schools. Thus, once the safety and efficacy of the vaccine has been proven, its application in this age group may be considered, if this allows for the normalization of children lives. On November 24, 2021, the World Health Organization (WHO) issued a statement also saying that the vaccine is safe, but leaving it to each country to decide whether or not to vaccinate its child population. WHO did not make a recommendation for vaccination, but states that the vaccine is safe and effective. In Portugal, on December 7, 2021, the Direção Gera da Saúde (DGS) recommended the vaccination of all children between 5 and 11 years old, with priority being given to children with diseases considered to be at risk for severe Covid-19. The vaccine used in this age group in Portugal is that of Pfizer/BioNTech, the only one that already has the green light from the European Medicines Agency. Many experts have defended the need to 'look at the child as a whole', when considering whether or not to vaccinate children against COVID-19. In this analysis and in the public debate that has taken place around these vaccines, we have been focused on the issue of preventing serious illness, hospitalization, admission to intensive care and death. But when considering children vaccinations, the issue of serious illness is only a small part of the impact COVID-19 has on their lives, many experts have said. To that extent, it can be considered that vaccines are not justified just because they have a direct interest in the health of those who are vaccinated. In the case of children, the weight of indirect interests is greater, as vaccination keeps children in school, contributes to their mental health, affected in times of pandemic, and allows to keep their families free from serious illness. COVID-19, that is also important for children. What to expect from the generalization of vaccination? With more than 85% of the population over 12 years of age vaccinated, some countries reveal that: Since January 2021, only 0.8% of people vaccinated with the two doses have become sick, that is, less than 1% of those vaccinated have become sick; About 80% of hospitalization cases are unvaccinated and 67% of deaths also occur among the unvaccinated. The Technical Commission on Vaccination against Covid-19, in whose opinion the DGS supported the decision to recommend the vaccination of children between 5 and 11 years of age, indicates that vaccination can avoide in the next four months and in this age group: More than 13,500 cases of Covid-19; 50 ward hospitalizations; And five hospitalizations in intensive care units. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
