Experts welcome Covid-19 jab for kids

Experts have welcomed the green light from the South African Health Products Regulatory Authority (Sahpra) for the Pfizer Covid-19 vaccine for children over 12, and the health minister said they could be administered from the end of October.

"There is no immediate decision to expand the vaccination rollout programme to include people under the age of 18 years at the moment," Foster Mohale of the national health department told the Sunday Times this week.

He said this was because "the government's primary target group remains people 50 years and older".

But health minister Joe Phaahla said in Bloemfontein on Friday that the stance is likely to be reviewed at the end of October.

So should parents be nervous or excited that the country is moving closer to vaccinating teens? According to professor Wolfgang Preiser, an expert virologist at the University of Stellenbosch, parents should definitely be excited.

"Firstly, teenagers do have a risk of severe Covid as well as the Covid-linked syndrome called MIS-C [multisystem inflammatory syndrome in children], and long Covid too," he said.

"Secondly, vaccination is a ticket out of the pandemic - however imperfect the protection might be - and we have seen the serious negative consequences of not attending school in person, not meeting friends, doing sports and so on." 

Also, the pandemic "has had adverse medical consequences for children - obesity, for example - and non-medical consequences which need to be weighed in favour of vaccination".

Preiser said significant side effects are extremely rare and the benefit of SA's vaccination rollout lagging many other countries is the ability to observe real-time data from elsewhere, on top of all the clinical trials already done.

According to the South African Paediatric Association, the move towards vaccinating 12- to 17-year-olds is "in keeping with what is going on in the rest of the world", and many children over 12 have already been vaccinated in China, North America and Europe.

Phaahla said ensuring that "hospitals will not be overwhelmed" is a top priority, and this means reaching older cohorts first.

"We are not ignoring the science of the safety of vaccines for children," he said, but getting vaccine coverage to 60% in older groups by the end of October remained the priority.

Preiser said he felt torn by the argument that older and thus more vulnerable South Africans should be vaccinated first since so many sites are not operating at full capacity due to low demand.

"If [adults] have been given ample opportunity and not used it yet, how much longer should one wait? It is wasteful when unused vaccine doses remain and vaccine sites are underutilised," he said.

"Rather use these resources to vaccinate children. Perhaps being asked to consent to their children being vaccinated could even get some hesitant parents to consider it too."

Preiser said apart from using poorly frequented vaccine sites, he would suggest vaccinating children through the school system, with all the necessary channels of consent from parents and guardians in place.

Last week, when Sahpra announced the approval, it highlighted that this was one step in the process.

"The regulatory decisions of Sahpra do not translate into a procurement decision as our mandate is limited to the safety, quality and efficacy of health products," the organisation said, adding that the decision followed a review of updated safety and efficacy information submitted in March.

Professor Keymanthri Moodley, director of the Centre for Medical Ethics and Law at Stellenbosch University, has been an advocate of mandatory vaccination in adults in specific industries.

However, when it comes to children, she said: "My arguments have been constructed for adults as we currently have a sufficient supply of vaccines for them. As things stand, we do not appear to have sufficient vaccines for all children 12 years and older, and under such circumstances, a mandate would not be reasonable."

She said any decisions relating to children "must always be in the best interest of the child and, in the case of vaccines, must benefit all children and be in the public interest".

This mirrored the policy behind other childhood vaccines too. "Vaccines to protect children in South Africa against a wide range of diseases like polio, measles, mumps, rubella and so on are not compulsory but are required for school entry," she said.