SAGE/WHO interim statement on COVID-19 vaccination for children and adolescents
On 24 November, WHO's Strategic Advisory Group of Experts on Immunization (SAGE) released an interim statement examining the role of COVID-19 vaccines in adolescents and children in the global context of inequitable vaccine distribution across countries and globally limited vaccine supply. This statement analyzes aspects such as the burden of disease in children and adolescents, the role of this age group in the transmission of SARS-CoV-2, the socio-economic impact of the COVID-19 pandemic and of the pandemic response on children and adolescents, the efficacy and safety of COVID-19 vaccines in adolescents and children, global equity and public health goals, and the rationale for vaccinating adolescents and children. The group’s conclusions were as follows:
- When developing their COVID-19 immunization policies and programs, countries should consider the individual and population benefits of immunizing children and adolescents given their specific epidemiological and social settings. As children and adolescents tend to have milder disease compared to adults, unless they are in a group at higher risk of severe COVID-19, it is less urgent to vaccinate them than older people, those with chronic health conditions, and health workers.
- There are benefits of vaccinating children and adolescents beyond the direct health benefits, in terms of decreasing the transmission of COVID-19. Countries’ strategies related to COVID-19 control should facilitate children’s participation in education and other aspects of social life, and minimize school closures. UNICEF and WHO have developed guidance on how to minimize transmission in schools and keep schools open, regardless of vaccination of school-aged children.
- Aligned and coordinated action is needed to achieve the global COVID-19 vaccination targets. Given current global inequity in vaccine access, the decision to vaccinate adolescents and children must account for prioritization to fully protect the highest-risk subgroups through primary vaccination series and, as vaccine effectiveness declines with time since vaccination, through booster doses.
Before considering implementing primary vaccination series in adolescents and children, attaining high coverage of primary series – and booster doses as needed based on evidence of waning and on optimizing vaccination impact – consideration should be given to vaccinating the highest-risk subgroups, such as older adults.
- As a matter of global equity, as long as many parts of the world are facing extreme vaccine shortages, countries that have achieved high vaccine coverage in their high-risk populations should prioritize global sharing of COVID-19 vaccines through the COVAX facility before proceeding to vaccinate children and adolescents who are at low risk for severe disease.
The full statement is available at: https://www.who.int/news/item/24-11-2021-interim-statement-on-covid-19vaccination-for-children-and-adolescents