Opinion: Children must be vaccinated against COVID-19

Vaccination of children must be part of the COVID-19 vaccine rollout if Australia is to have any chance of reaching herd immunity, say leading experts in InSight+, the weekly news magazine of the Medical Journal of Australia.

Professor C Raina MacIntyre, Head of the Biosecurity Research Program at the Kirby Institute, and colleagues wrote that "vaccination of children must be part of our plan and our goal should be far higher than the minimal one preventing death."

"For economic recovery, our best bet is herd immunity, and we will never know if we can achieve it unless we try."

Professor MacIntyre, Dr. Andrew Miller, the President of the Australian Medical Association's WA Branch, and Dr. Julie McEniery, Chair of the Queensland Pediatric Quality Council, wrote that the debate around school closures during the current Melbourne lockdown, highlighted the growing need to vaccinate children.

"Valid motivations to keep children in school and the vulnerability of the older school staff and parent population to SARS-CoV-2 spread should be all the more reason for Australia to prioritize vaccination of children along with the rest of the school community," they wrote.

"The other reason is that with more contagious variants of concern, vaccinating children may be the only route to herd immunity, with consequent protection for the unvaccinated or those with poor immune response."

The US has begun vaccinating children over 12 years old. Singapore has prioritized the vaccination of 12-18 year olds ahead of adults aged 19 to 39 years.

"Children older than 10 years transmit the virus as much as adults, and some studies show they transmit even more than adults," wrote MacIntyre and colleagues.

"An outbreak in a high school in France had a 38% attack rate among students, and in the US surges in SARS-CoV-2 transmission were noted after school reopenings. Recent evidence has emerged from India of enhanced transmission among children."

MacIntyre and colleagues warned that Australia has "very little immunity from infection in the population."

"In Australia, B.1617 (now called Delta and Kappa) is fast becoming the dominant variant, and Kappa is responsible for the current Victorian outbreak," they wrote.

"The Delta variant has been estimated to be 50% more transmissible than the Alpha variant, and has some vaccine escape associated with it, especially for the COVID-19 vaccine AstraZeneca. The Kappa variant is likely to be even more vaccine-resistant due to the presence of the 484Q mutation.

"This is a concern, as it means outbreaks will be harder to contain, and herd immunity will be harder to attain—especially using vaccines of lower efficacy and without vaccinating children aged 12 years and over."