As Covid Puts Question Mark On Exams in India, What Is Happening With Vaccines For Children?

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The exam season in India has, in the time of the pandemic, given way to a season of uncertainty over whether, and how, exams can be held when the country is still grappling with the second wave of cases. One solution mooted in several quarters is for children to be vaccinated so that they can safely show up at examination centres. Although India itself is not giving vaccines to those below 18 years of age, many countries around the world are rolling out shots for kids and adolescents.

Which Countries Are Vaccinating Children?

The US is an early mover on Covid-19 vaccinations for adolescents. According to the US diseases watchdog, about 6 lakh children between the ages of 12 and 15 have already received the Pfizer-BioNTech vaccine following its approval in the country for use among children and teens.

On May 5, Canada became the first country to approve the Pfizer vaccine for children aged 12. Reports say the Canadian authorities are looking to ensure that children and teenagers get at least one shot of the two-dose vaccines before schools reopen later this year.

The latest to give the nod to Pfizer’s vaccine for kids between 12 and 15 years of age is the European Medicines Agency (EMA), making it the first such shot for the European Union. The drug will have to be cleared for children by the individual national regulators and also get a clearance from the European Commission. Once the relevant permissions are received, it is understood that Germany could start vaccinating children from as early as June 7. The UK, too, is reportedly planning to launch a vaccination campaign for adolescents.

Are Vaccines For Children Different From Those For Adults?

So far, no specific Covid-19 vaccine has been created for children and all the trials and permissions are for existing jabs that were first tested on and then rolled out for adults.

For example, the Pfizer vaccine was approved for the 12-15 age group in Canada and the US following the completion of a study on 2,260 people in that age group. The company reported 100% efficacy of the shot in the said trial, the highest for any demographic that is at present being given the Pfizer vaccine.

Some experts say that one has to also remember that people aged 16 and above were part of the larger trials that were earlier held and there is, hence, a body of data that scientists can study as part of efforts to see how they may work for younger people.

But, as experts point out, at least when it comes to vaccines, kids are not smaller versions of adults. Which is to say that a child’s immune system and that of an adult work differently. Experts cited by Deutsche Welle, the German public broadcaster, said that “vaccines developed for adults are not automatically suitable for children”. Pointing to the tetanus vaccine, they said that infants are given a modified vaccine that is different from the one for children and teenagers. Also, the dosage may differ for different age groups. Thus, while those under 14 years may get two HPV vaccine doses, people aged 15 and up may need a third one.

It is further clarified that children’s immune systems do not respond in the same way to vaccines like teenagers and adults and finding “the safest and most effective vaccine dose is thus essential”.

Do children need a vaccine?

This question has been debated from multiple angles amid a resurgence of Covid-19 cases across the world.

Newer variants of the novel coronavirus are seen as more capable of infecting children, leading to calls for vaccines for them.

For example, in India, doctors say that the second wave and the dramatic rise in the number of infections have made cases among children more common. According to government data, about 12% of the 56 lakh confirmed cases in the country between January 1 and April 21 were in the age group 0-20 years.

The journal Nature said that “children rarely develop severe forms of Covid-19, and deaths from the disease are rarer still”, but pointed to a condition called multi-system inflammatory syndrome (MIS-C) of which rare instances have been reported. Vaccination is seen as being protection against such medical events.

British daily The Guardian has quoted experts as saying that vaccines for kids should be only allowed after careful thought. “Children transmit Covid to some extent, although they rarely suffer badly from the disease themselves. If you offer them vaccines, then you put them at risk of possible side-effects – so there really needs to be some significant, tangible benefit to them, not just the indirect protection of adults from Covid-19,” Professor Adam Finn of Bristol University told the publication.

Further, in its vaccine advisory, the World Health Organisation (WHO) has said that “(t)here is not yet enough evidence on the use of vaccines against Covid-19 in children to make recommendations for children to be vaccinated…”

However, the larger goal of achieving herd immunity and preventing transmission may also have played a part in calls that children should be vaccinated. Nature magazine said that “(e)vidence is building that vaccines might block transmission of SARS-CoV-2, so vaccinating children could have beneficial knock-on effects in the wider community”.

With vaccination progressing apace among adult target groups in several countries, the only groups left behind are children and others who are not yet eligible for shots or are hesitant about taking one. Experts say that in such a scenario, a virus that is fast-spreading will find a way to infect more people unless all such avenues are blocked off, including by vaccinating children.

When will India get its children’s vaccines?

With authorities looking for the best solution to the Class 12 exam conundrum in India, Delhi deputy chief minister Manish Sisodia has said that the Centre should bring the Pfizer jab for children in India unless experts say that the domestically produced Covishield or Covaxin can be administered to this group.

At present, only people above 18 years of age can be given any of the vaccines that are approved for use in India. But trials have been planned for Covid-19 vaccines for children in India.

Bharat Biotech, the maker of Covaxin, has received a nod from the Drug Controller General of India (DGCI) to begin trials of the vaccine for children. Dr VK Paul, Niti Aayog member and Chair of the National Expert Group on Vaccine Administration (NEGVAC), has said that the Serum Institute of India (SII), which manufactures Covishield, is looking to start trials of the Novavax vaccine, a second shot it is working on, for children.

“Covaxin has received permission, they will start paediatric trial, I think they’re going all the way to 2 years of age in a systematic way. I’ve been told SII wants to begin pediatric trial of Novavax,” Paul said.

It is also reported that the Ahmedabad-based Zydus Cadila is planning to test its ZyKov-D vaccine for children between 5 to 12 years of age.

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