Answers to your questions about vaccinating children against Covid-19

There are the parents who jumped at the chance to have their child over the age of 12 vaccinated, those who categorically refuse it and others who are still waiting to decide... The questions surrounding this vaccine against Covid-19 are still numerous. To try to see more clearly, Professor Gras-le-Guen* answered our questions with pedagogy.

Why is the vaccine recommended from the age of 12?

Covid-19 is an unprecedented virus and it has a very different effect depending on age. Small children are infected little, young people a little more but often mild or even symptomless forms and adults can develop serious or even fatal forms. The older you get, the greater the effects. It was therefore logical to focus first on the most vulnerable and the oldest.

Now that this first phase is over, we have decided to target vaccination between 12 and 18 years old since this summer because the virus circulates more in colleges and high schools than in crèches, kindergartens or primary schools.

Today, we have enough data to say that very few severe forms of Covid-19 develop between the ages of 12 and 18. The severe forms of COVID in children are called PIMS (pediatric multi-system inflammatory syndrome) of which around 600 cases have been observed since the start of the pandemic. These cases give rise to great fatigue, high fevers and heart failure. Even if this is disproportionate to the weight of the disease in adults, we cannot trivialize these syndromes. Vaccinating is also a way to prevent these PIMS.

Finally, getting vaccinated also means getting a health pass and getting back to a normal life: resuming sport, seeing your friends... We have seen the weight of the health crisis on the psychology of children, mental health has been very tested during of this pandemic. We need a return to normal life.

Is the vaccine the same for adolescents as for adults?

Yes, knowing that we only use the messenger RNA vaccine for this age group, that is to say that from Pfizer. Like the virus, the vaccine also has different effects depending on age. The AstraZeneca vaccine gave stronger side effects in younger people (medical students who had been vaccinated with it had high fevers). We therefore reserved it for older people. We adapt according to the discoveries and what we observe.

Editor's note: the Pfizer laboratory announced in a press release that concerning the vaccination of 5-11 year olds, the dosage had been adapted to 10 micrograms per injection, against 30 micrograms for older groups.

What are parents afraid of and how can they be reassured?

The first thing that worries is what circulates on social networks, this cacophony where everyone is an expert and gives their opinion. It's terrible, it has led to chaos in people's minds.

Parents wonder about vaccinating growing children, but I tell them that it is not a problem since that is what we have been doing since the discovery of vaccination. Children and adolescents have already received many vaccines for a long time and it is the same principle.

On messenger RNA, they wonder if there will be side effects, say that we lack hindsight... Concerns about a new product are legitimate, but more than 10 million doses of this vaccine have already been distributed and the side effects identified as they were observed. In particular on young boys, there were 33 cases (out of 238) of myocarditis in children under 19, according to ANSM data in mid-September. However, it should be noted that the side effects observed occurred within a week of vaccination. In general, the side effects associated with vaccines are immediate or in the days that follow but not observed over the long term. The benefits/risks to date are clearly in favor of vaccination.

Do you think that in the long term, it will be necessary to vaccinate children under 12?

Vaccination of children under 12 is not yet topical in France, but it will not be long in coming. Indeed, the Pfizer and BioNtech laboratories announced that the results of the trials of their vaccine in children qualified it as "safe" and "well tolerated" in 5-11 year olds. To date, there are not enough studies that would validate the vaccine in children under 12, but they are in progress and the national health agencies should give their conclusions at the end of the year or the beginning of next year. . Three factors are at play: the effectiveness of the vaccine, the side effects and the evolution of the pandemic. Indeed, if the virus circulates less, we will not need it.

Vaccination of children can contribute to herd immunity, so it is up for discussion. And when we see the number of primary classes that are closing, the children forced to wear a mask… We would like children to be able to have a normal life as well, which requires changing the barrier measures to the circulation of the virus.

Today, the whole health policy around the virus is to organize to limit deaths and visits to intensive care and the vaccine we have protects 98% of deaths and visits to intensive care. The message to remember: to reduce the pressure that we put on children and adolescents and limit the constraints that we impose on them, we must start by getting adults vaccinated! To protect children from the deleterious effects of the health crisis, parents and grandparents: get vaccinated!

*Head of the Pediatric Emergencies and General Pediatrics Department of the Nantes University Hospital and President of the French Society of Pediatrics.