Vaccinating teens is balancing possible risk with benefit to society

Torbay Weekly

Now that the Pfizer vaccine is approved for children over 12, is it time to roll out the vaccine to secondary school pupils?

The Joint Committee on Vaccination and Immunization (JCVI) are reluctant and I will leave the detailed scientific arguments to the experts but are there ethical problems with giving the jab to teenagers?

When many older people around the world have not had any vaccines, is it ethical for us to start vaccinating young people who do not carry same risk?

If we do vaccinate, why? For most teenagers, it is a mild disease.

The logic is that the more people we protect the less likely it is that older at-risk people will catch it.

Giving it to younger people is not to protect themselves but to protect others.

There is a precedent. We now give all children, boys and girls, the MMR vaccine. R stands for rubella or German Measles. In most cases, rubella is a mild disease but in pregnancy it can be a disaster. Rubella vaccination is of no direct benefit to boys.

In 1941, an eye specialist in Australia noticed that many children born with a cataract had a mother who caught rubella in early pregnancy.

Other doctors in the UK and America then noticed that it caused heart problems and deafness.

It was only when there was a widespread rubella epidemic in America in 1963 that the full effect of the disease in pregnancy was understood.

It was then named Congenital Rubella Syndrome.

In the early 1970s about 80 per cent of people caught rubella at some time in their lives. There were 200-300 cases of congenital rubella syndrome a year in the UK.

A vaccine was developed and in 1970 and was only given to girls.

The problem was that this vaccine was most effective if given soon after puberty but dangerous if accidently given in pregnancy.

When this was discussed at an international conference one scientist who had probably never left his lab, suggested: “Wwhy don’t we give it to girls when they get engaged to be married?”

The other scientists were too polite to point out the flaw in his plan.

When introduced in the UK, the number of cases of congenital rubella syndrome fell to an average of 48 a year with another 742 terminations.

The disease was still around so that any woman not vaccinated was at risk.

When the combined mumps, measles and rubella vaccine, the MMR, was introduced in 1988, it was given to boys as well as girls.

This led to a dramatic fall in the number of cases of congenital rubella syndrome from 167 in 1987 to one in 2003 and that was in a non-immunized woman who had caught rubella overseas.

Since 1994 Public Health England offered PCR and antibody tests in every case when doctors diagnosed measles, mumps and rubella clinically.

In 2020, no-one tested positive, in 2019 there was only one positive case.

For boys, rubella is a mild disease but, by vaccinating boys, the disease has been almost wiped out.

Unlike giving boys rubella vaccine there are some advantages to children who receive the Covid vaccine.

Some children can get severe Covid, although it is rare. Others may suffer long Covid.

If we reduce the level of Covid in younger people we can reduce the risk of having to self-isolate.

Children will be less likely to miss school.

Different countries are making different decisions.

Austria and France have started vaccinating the over-12s, Hungary are vaccinating 16 to 18 year olds while Germany are vaccinating children with pre-existing conditions.

Spain plans to start vaccinating children between 12 and 17 before schools start in September.

Around the world Israel, Dubai, Singapore and some US states are vaccinating children.

As other countries roll out the vaccine to young people so we will gain more information.

Whether to vaccinate teenagers is not straightforward. The experts and Government will have to balance any possible risk with the benefit to society.

Covid is not usually dangerous to teenagers but neither is rubella dangerous to boys but we still vaccinate.