Covid-19 vaccines are effective against severe cases of the disease in children and adolescents – but may still not be necessary, a study has found.

The authors stressed the gains from other childhood vaccines, such as for measles and polio, were much higher, with most children already having built up a natural immunity to the virus.

Since Covid first swept the globe in 2020, it has been well-documented that children, while able to catch and transmit the virus, were less likely to develop severe cases of the disease. Worldwide, Covid has claimed almost seven million lives – of these, 16,100 were under the age of 19.

Recent research found that two-thirds of children with Covid-19 who attended hospital in the first two years of the pandemic did not require medical intervention.

The latest review, led by the Murdoch Children’s Research Institute, highlights that as natural immunity is now widespread in younger populations, the additional benefit of vaccination in healthy children is minimal.

However, lead author Dr John Hart said while there was not enough evidence to support blanket vaccination of healthy children, it was different for high-risk children, especially those with disabilities and certain underlying conditions.

‘Given the very high prevalence of risk factors for severe Covid-19 in low- and middle-income countries, vaccination against Covid-19 is an important consideration in all age groups, including children,’ he said, adding that a decision to vaccinate should be based on the benefits to the individual child, not the household or community.

The study, published in the journal BMJ Paediatrics Open, focused particularly on low- and middle-income countries, and noted that many nations have still not introduced proven life saving vaccines into their immunisation schedules.

‘If Covid-19 vaccines are made available to children, the opportunity should be taken to increase coverage of standard childhood vaccines such as for measles, pneumonia, rotavirus, polio and human papillomavirus,’ said Dr Hart. 

‘Preventative healthcare and treatment should also be provided at each encounter with the health system. This will help to address the indirect adverse effects of the pandemic on children.’

Vaccine hesitancy and vaccine misinformation spread considerably during the pandemic, while lockdowns also prevented many children keeping up to date with their immunisations.

In the UK, twice as many measles cases have already been recorded as during the entire year in 2022. 

Co-author Professor Fiona Russell said there was also a lack of public health data in low- and middle- income countries, which underscored the importance of ensuring equitable access to safe and effective vaccines for future epidemics before exposure to infection.

‘In low- and middle-income countries, most people were infected by the time vaccines became available, highlighting the profound inequity in global vaccine distribution,’ she said. ‘More needs to be done to prevent this from happening again.

‘By the time vaccines became available for low-risk populations of otherwise healthy children, infection-derived immunity provided similar protection to vaccine-derived immunity and vaccine hesitancy was also increasing.’

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