The decision to vaccinate our children must be based on the benefit to their health
Vaccinating children must only go ahead if it’s in the best interests of their health - when the risk from the disease is clearly greater than any possible risk from the vaccine.
The two sides of this equation will vary on a wide range of factors, such the nature of the disease, any medical conditions present and the age of the person whose treatment is being considered. These factors must all be considered before determining whether a vaccination (or any medical procedure for that matter) is in an individual’s best interests.
There are several examples where the answer to this equation is clear.
COVID-19 has been shown to pose a significant risk of severe illness or death to the over-60’s, and so it’s extremely important for them to be vaccinated against it. We also know that the risk from COVID-19 is directly related to age, so that the balance of risk is much reduced for healthy young people. Coronavirus poses almost no serious risk to children - not a single previously healthy under 15-year-old has died from COVID-19 in the UK.
Similarly, diseases such as measles, smallpox, and meningitis were some of the biggest contributors to child mortality in history, and countless lives have been saved by vaccinating children against them. We also know that people of any age can have underlying health conditions that put them at greater risk from COVID-19, and so it is also clearly in their best interest to have the vaccine.
When the disease itself poses virtually no risk to a patient cohort there is clearly a reduced case for vaccinating against it.
As the vaccines have not been used on children in any great number, or for long enough, there is of course a lack of data on the potential adverse reactions these vaccines may have in our young people. I further understand that this data may not be available for some months to come.
As adults we have all made our own choice about the balance of risk, but as a society we have a duty to protect the best interests of our children, and not take unnecessary risks that could potentially have damaging consequences to their health.
The Joint Committee on Vaccination and Immunisation have expressed this clearly in their recommendation against the mass vaccination of children aged 12-15:
“Overall, the committee is of the opinion that the benefits from vaccination are marginally greater than the potential known harms but... there is considerable uncertainty regarding the magnitude of the potential harms.
“The margin of benefit, based primarily on a health perspective, is considered too small to support advice on a universal programme of vaccination.”
If we were following the science, we would accept the JCVI assessment. We did for all other cohorts, and have repeatedly defended the independence of the JCVI. It made its decisions based on the benefits of vaccination to the individuals in question in relation to the risk the virus posed to their health. That is why we prioritised the elderly and vulnerable in our initial vaccination programme, and why children with underlying health conditions are already offered the vaccine.
A decision to go against the JCVI’s recommendations on this occasion would be a political one, and for that to happen when it is the health of our children in question would be unprecedented.
Return to school
There has been some talk of the need to vaccinate children before they return to school after the summer holidays in order to avoid further disruption to their learning. However, the decision to allow disruption to children’s education because of the coronavirus, though well meant, is again a political one.
Closing schools or sending groups of children home in response to COVID-19 is not an inevitable consequence of not vaccinating children. Instead, it is a decision taken by politicians – and one that need not be made. We did not close schools during the second national lockdown, and that was a political choice.
The effect of vaccinations on possible school closures is not a medical decision and should not be a factor in deciding what is in the best medical interests of a child.
I have therefore written to the Chief Medical Officer along with colleagues to urge him to focus solely on the question from a medical perspective, and not what it may mean for various political choices that might result from it.