Can Herd Immunity Be Reached Excluding Children?

"Certainly, I think if it is a very low cost, very safe, very effective way to prevent the spread of COVID-19, then I don't see why we wouldn't vaccinate children purely for that reason."

"If it came to pass that we weren't able to achieve herd immunity without some kind of mandate, and in particular a mandate for children, it's something we should definitely consider."

"It's not forcing people to be vaccinated; it's not forcibly injecting them or anything like that, of course."

Anthony Skelton, associate professor of philosophy, Western University 

 

"There are two ethical questions when it comes to vaccination. Do the benefits outweigh the risks for this individual -- is it in their interest to have a vaccine? And, secondly, is there somebody else who needs it more?"

"For children, at this point in time, I think the answer to the first question is uncertain; for younger children it's more uncertain, simply as a function of the fact that there has been very little experience in them."

"Even if the vaccine is highly effective in children, it can only eliminate an already tiny risk." 

Dominic Wilkinson, professor of medical ethics, University of Oxford

 

"Realistically, if we want to reach herd immunity in the short term it's likely that we're going to have to vaccinate kids."

"Because the vaccines aren't perfect at preventing transmission, you're talking about vaccinating all of the eligible population age 12 and older, which we know we're not going to hit."

Ashleigh Tuite, University of Toronto infectious disease epidemiologist

A dilemma has arisen over whether it’s right to vaccinate young children — not so much for their own good, but to help achieve herd immunity. Photo by Getty Images

There are several reasons why children should be vaccinated, posits philosopher Anthony Skelton. If vaccines prove to be safe and effective in younger children the option is less risky than trusting that if they become infected everything will turn out well. Science still has not established many things about COVID-19 outcomes following infection, and researchers have much yet to learn about long COVID in children. Although Pfizer's vaccine used to inoculate older children see some reactions that are "pretty small and manageable", concerns are raised over unnecessarily vaccinating them.

 

 According to Dr.Skelton, children are part of the 'herd' in a population and there are concerns that Canada will be unable to reach effective herd immunity with the boost that vaccinating only over-12-year-old children will give, and bypassing all younger children in the drive for herd immunity. The 0-to-11-age group account for 12.5 percent of the country's population, at a 4,783,562 total, according to Statistics Canada. 

 

In Canada some 271,000 COVID infections were reported in children under age 19 and of those roughly 1,400 children were hospitalized, and thirteen of the total perished due to COVID. Most children infected with COVID experience mild or no symptoms whatever. Rare, occasionally life-threatening conditions, such as multisystem inflammatory syndrome can occur, a hyper immune reaction to being infected with COVID causing coronary aneurysms. But overall, children seem spared from COVID's serious conditions.

 

Pfizer-BioNtech is preparing to approach U.S. regulators for an expansion of emergency authorization of its vaccine to be used with children aged five to 11, with younger children to follow, according to a senior Pfizer executive. Awaiting data to unequivocally demonstrate safety and immunogenicity (immune response in children), expectations are that Pfizer will pursue similar timelines to Health Canada in a similar submission. Canada, in May, became the first country globally to authorize Pfizer's vaccine for use with 12- to 15-year-olds.

 

Both Pfizer and Moderna have been undergoing tests with children to ensure efficacy and safety, and both tested a series of doses to discover safe minimum doses to ensure a immune response. "Kids do have a stronger immune response, so it's super important that we have the right dosing and we figure out the right schedule before to go ahead and do it", explained Dr. Fatima Kakkar, infectious disease pediatrician at Sainte-Justine hospital in Montreal.

 

A safe dose-to-age formula appears to have been settled by Pfizer, with a three-microgram dose each shot for children ages six months to five years, and 10 microgram doses for five to eleven-year-olds. Adult doses in comparison, have 30 micrograms.

 

“Even if the vaccine is highly effective in children, it can only eliminate an already tiny risk,” says Oxford professor of medical ethics Dominic Wilkinson. Photo by Getty Images

"[It's reasonable to ask children] to do something to help us all, including them, get back the world that we want them to live in and grow up in. I think we need to give children credit: They know what's going on. They worry. They're anxious. They're thinking about what they're seeing."

"This is not about, 'dig a moat around your house, make that safe and stay inside'. We've been through that stage."

"This is about, how can we make our family, our community, our town, our country, our world safe, so that it can be the place that we want children to have the chance to grow up in."

Perri Klass, professor of pediatrics and journalism, New York University