Why can children under twelve now be vaccinated against COVID-19, and which vaccine will children receive? Lieke Sanders, paediatric infectiologist/immunologist at RIVM, answers five frequently asked questions about COVID-19 vaccination for children aged 5-11 years. 


Five questions about COVID-19 vaccination for children aged 5-11 years
Speaker: Lieke Sanders, paediatric infectiologist/immunologist, RIVM

VISUAL: Five questions about COVID-19 vaccination for children aged 5-11 years.

VISUAL: Which vaccine will children receive?

LIEKE SANDERS: Children will receive the child dose of the Pfizer vaccine. It will be given in two injections. And the interval between the two injections will be eight weeks. Longer than the three weeks stated in the package leaflet. This is a very deliberate choice. Because it helps the vaccine work a bit better and can reduce the side-effects somewhat. For children who have an underlying health condition, we want to shorten that interval to four weeks. Some children in that group will not respond as strongly to the first vaccination, so they need the second vaccination to protect them more quickly.

VISUAL: Is the vaccine used for children the same as for adults?

LIEKE SANDERS: Yes, it is exactly the same vaccine, but a lower dose. In children, we saw that giving them one-third of the dose resulted in the same high levels of antibodies after two vaccinations as seen in adolescents who received the adult dose. That lower dosage is sufficient for these children between the ages of 5 and 11 years.

VISUAL: Will children have side-effects from the vaccine?

LIEKE SANDERS: A child’s immune system works according to the same principles as an adult’s. So the way that the vaccine works is the same. And the side-effects are also the same. There are usually more side-effects after the second vaccination. These include pain at the injection site, headache or tiredness. Very occasionally fever. But just as with other vaccines, these side-effects are mainly seen in the first 48 hours. And they go away again within one or two days. The side-effects from this vaccine are mild to moderate.

VISUAL: Has research been done on the use of the Pfizer vaccine in children aged 5-11 years?

LIEKE SANDERS: Before EMA approval, research took place in children aged 5-11 years. That research showed that antibody levels were just as high, even after the child dose, as the levels among vaccinated adolescents. Researchers also looked at protection after vaccination among some of the children who participated in the study, about 2,000 children. The results showed that vaccinated children were 90% protected against coronavirus infection.

VISUAL: Why are children being given the opportunity to get a COVID-19 vaccine?

LIEKE SANDERS: Most children do not become ill at all if they have an infection with the coronavirus SARS-CoV-2, or only become mildly ill. They just have a cold for a day or two, or sometimes almost no symptoms at all. Hardly any different from the common cold. A very small percentage of children become more seriously ill and have to go to hospital. However, a more serious condition can also occur very occasionally. That has a difficult name: MIS-C. This stands for Multisystem Inflammatory Syndrome in Children. It involves inflammatory reactions in multiple organs, often including the heart. It is very serious. A child with MIS-C almost always has to be admitted to hospital, and often needs intensive care. The good news is: early detection enables effective treatment. However, this possibility is so serious, and is estimated to occur in 1 out of every 3,000 to 4,000 infections, that the Health Council has said: now that the Delta variant is circulating so widely among children in this age group, this is a valid reason to give parents the option to vaccinate their children. Other reasons included the huge impact that the pandemic has on children’s everyday lives. The risk of school closures, not being able to play sports, not being able to hug grandparents. All these reasons combined led the Health Council to advise giving parents the option to vaccinate their children.

VISUAL: More information? www.rivm.nl/en/covid-19-vaccination
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