The U.K.'s vaccine advisors declined Friday to recommend the vaccination of healthy older children against COVID-19, saying the direct health benefits are "marginal." However, the British government said it may join others around the world in offering the vaccines after assessing wider societal issues.
In its analysis of whether the rollout of coronavirus vaccines should be expanded to children aged between 12 and 15, the Joint Committee on Vaccination and Immunisation concluded that the benefits are "marginally greater than the potential known harms."
With just two per million of healthy children needing intensive care treatment for COVID-19, the JCVI said the "margin of benefit, based primarily on a health perspective, is considered too small to support advice on a universal program."
In contrast, the rate among children with underlying health conditions is far higher at over 100 per million. As a result, the JCVI did expand the group of older children with underlying health conditions who should be offered the vaccine. These include those with chronic major heart, lung, kidney, liver and neurological conditions. It means about 200,000 more children will be invited for either the Pfizer or Moderna vaccines.
Though the JCVI failed to back a universal rollout to older children just as schools reopen for the new year, the U.K. may still end up joining others such as France, Germany and the U.S. in offering vaccines to that group.
The health ministers from the four U.K. nations—England, Scotland, Wales and Northern Ireland—said they have asked their respective chief medical officers to make their own assessments in light of the JCVI's analysis.
"People aged 12 to 15 who are clinically vulnerable to the virus have already been offered a COVID-19 vaccine, and today we'll be expanding the offer to those with conditions such as sickle cell disease or type 1 diabetes to protect even more vulnerable children," said British Health Secretary Sajid Javid.
"We will then consider the advice from the chief medical officers, building on the advice from the JCVI, before making a decision shortly," he added.
One risk that has been identified is a condition known as myocarditis, which involves inflammation of the heart muscle. The condition can result in short periods of hospital observation, followed by typically swift recoveries, but the JCVI concluded that the medium to long-term outcomes are still uncertain and more follow-up time is needed to get a clearer picture.
"This was a very finely balanced decision," said Anthony Harnden, the JCVI's deputy chairman. "But while the benefits slightly outweigh the risks, the risks are very uncertain at the moment."
Though the JCVI opted against a universal rollout to older children, it stressed that it was not within its remit to assess wider societal impacts, such as on education or children acting as sources of transmission.
Javid has already asked the National Health Service to prepare to roll out vaccinations to older children should it be be recommended by the chief medical officers.
The NHS is also preparing for possible "booster" shots for older adults. The JCVI is expected to decide soon whether third doses should be offered to all adults or just to those above a certain age or with certain health conditions.
The government is being urged to make the decision soon, potentially before the JCVI has made its conclusion, not least because winter is approaching, a time of year when the virus finds fresh legs.
Though nearly 80% of the U.K.'s adult population has been fully inoculated, the country has seen infection numbers edge higher over the past month following the lifting of lockdown restrictions. On Friday, Britain recorded another 42,076 infections, the highest daily total since July 21. Virus-related deaths have also been rising, with another 121 recorded on Friday, taking the U.K.'s total to 133,041, Europe's highest.
Jeremy Hunt, the former health secretary whom Prime Minister Boris Johnson defeated in 2019 in the race to become Conservative Party leader, said time is of the essence.
"In a pandemic I think even a few days can make a big difference," he told BBC radio. "So I think we should just get on, not wait for that advice, get on with a booster program."
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