With Pfizer’s approval for children between 5 and 11 years old in the US and the start of inoculations, it is assumed that soon we will also find ourselves in Europe and in Italy, specifically, to discuss this issue. How to reassure parents that we are talking about a safe and necessary vaccine even for the little ones? We asked Professor Carlo Federico Perno, head of the Microbiology and Diagnostic Immunology Unit of the Bambino Gesù Pediatric Hospital in Rome and Professor of Microbiology at Unicamillus University.
“A premise: SARS-CoV-2 currently circulates largely in the unvaccinated population. The unvaccinated population is made up of two broad categories: those who currently cannot get vaccinated, ie children up to and including 11 years of age, and those who for some reason have chosen not to be vaccinated ”, explains the Professor. “The result is that this virus continues to circulate in Italy, albeit in small quantities, and continues to do damage, because hospitalizations in intensive care and deaths are largely the responsibility of unvaccinated people. The point is that Covid affects children like adults: if we want to block the circulation of the virus and we want to avoid that children can have forms of Covid that can also be serious, more rare than in adults, but always serious, we must vaccinate them too “.
Therefore, the first objection lapses: that is, that children get the virus in a completely asymptomatic way. This is not always true …
“Exactly. Let’s try to think on three levels: the first is why vaccination, the second is the effectiveness of the vaccine, the third is safety. Coming to the first: it is not true that in children this infection always starts asymptomatic or with few symptoms. In international statistics, hundreds of children who have died from Covid are reported. We have had children, at Infant Jesus as in every part of the world, in intensive care, we have had very serious children, we have had children who have had consequences of Covid that have lasted for months. Fortunately, children have a very stimulated basic immune system, precisely because they are children, so let’s say that the course of the infection is on average more benign than in adults, always in the absence of a vaccine. But on average, let it be clear: because children died, children had serious illnesses, others were in intensive care, etc. etc. I think it is profoundly wrong to start from the principle that in children, however it goes, this virus is harmless: it is less serious, but it can also do a lot of harm.
So is it important to vaccinate them?
Vaccination in children has a double meaning: to preserve them from the virus and reduce their circulation because we know that a virus that circulates, replicates, changes. If it does not circulate, it does not replicate and if it does not replicate, it does not change. This is the dogma of virology: if it does not change, we will not generate variants that could be harmful because they will hit fragile people more intensely. Let’s not forget that there are also many fragile children: at Bambino Gesù we have children with cancer, with genetic diseases, with surgeries that are heavily at risk of Covid. The second point of the reasoning is the effectiveness of the vaccine.
Already. How effective is it in the 5-11 age group?
The response to vaccination is at least similar to that obtained in adult adolescents, both in terms of immune response, i.e. stimulation of the immune system, and in terms of protection. We are talking about an effectiveness that is around 91%. The third point is the security plan. All 3,000 children who were studied for this vaccination had no serious side effects.
Some will argue that 3,000 children for such an experimental study are few.
If we want to find a good excuse not to vaccinate, we will say that even 30,000 or 300,000 children are few. I believe they are significant numbers in a pandemic phase to move forward. If we were talking about protection from a disease that does not exist, we could allow ourselves to increase the number of cases. But the objection “there are few” I find quite instrumental: it is the main argument of NoVax, for them there will always be few, because the mental condition is that of wanting to refuse the vaccine regardless of everything.
So what is science’s response to this objection?
This is a safety rating of 3000 children which I find more than significant. If anything, we could discuss the confirmation of the efficacy that could benefit from even greater numbers (even if the available data are already perfectly in line with the results of adolescents and adults). But on safety it is difficult to call it a small number. Then keep in mind that there are the Post Authorization Studies: from now on the vaccine will be administered to children and the very careful observation of side effects will continue after each administration. So the study on 3000 children will continue with an observation on much larger numbers. Someone could repeat the banality that “therefore it is an experimental vaccine”, where all, I repeat all, vaccinations require a record of observation of adverse reactions that continues for years. So not experimentation, but observation.
They have already left in America. There is talk of about 28 million children to be vaccinated
Well, try to imagine that all these children, assuming (and I fear not granted) that they all get vaccinated, one by one, will enter the evaluation when they are vaccinated and will be followed up to register any side effects that emerge.
Do you think that this message will pass in Italy or will we have difficulty vaccinating children?
I see three paths: the first is that of those who are convinced that vaccination is important. Keep in mind that we give a significant number of compulsory vaccinations to our children every year, so it escapes me why this vaccine should be refused over others, even considering it is a present and active disease. I expect that the majority of people, despite having some legitimate doubts, accept this type of intervention, helped in this also by correct and adequate explanations (which did not always happen in this period). Then there are the doubters, who are not the Boh Vax, but those who wonder ‘does it make sense to vaccinate children?’. To these people, a serene, calm and complete communication must be made, which clarifies that this is nothing more than one of the vaccines we give to our children to protect their health in the first place. Then there are those who will not vaccinate them regardless, and in this case very little can be done
Tell me more about the second group, that of the doubters. What could their objection be?
For example, they could say: ‘we do not know the side effects’, or ‘they are small, why do we need to expose them unnecessarily?’, Etc. The answer to the first question is: up to a certain point, because the data that exists is already very solid and says that there are no serious side effects. Myocarditis? No cases in the study of children aged 6-11, and sporadic cases among adolescents, with benign resolution. The second question is answered by a previous observation: it is not true that in children the course of Covid is benign; you get sick, you can die, there can also be long-term consequences due to Covid; therefore the vaccine is important to protect.
How important is the experimentation done on children between 6 and 11 years for the safety and efficacy of the vaccine in those between 5 and 11 years? In other words, what changes between a 5-year-old and a 10-year-old?
To be picky, we give mandatory vaccines to our children at an even younger age, between 0 and 6, yet we feel confident and confident in the effectiveness of these vaccines. That said, there may be a difference in vaccine response between 5 and 10 years, but I have to say that it was not noticed in the pivotal study. Furthermore, the difference between 0 and 6 years is much greater, yet we have not perceived this to be a problem for the administration of vaccines, for more than 60 years now. Having said that, we must continue to observe, monitor, and evaluate the situation over time, confirming the results obtained so far.
Will children between 0 and 5 years of age be vaccinated against Covid?
This is something to come, which will have to be decided on the basis of some elements. First of all, children between 0 and 5 years can happen to fall ill with Covid, we have not seen few of them! In addition to the opportunity to protect the little ones, I would add that vaccination in early childhood also depends on the goals we set ourselves. Do we want to work around the world for the eradication of the virus? So we must try to vaccinate everyone and therefore also children between 0 and 5 years. And that would be nothing strange, as we have 14 vaccinations that we administer to our children between 0 and 5 years of age already, and some of those vaccines are designed both to protect children and to help eradicate some highly dangerous viruses. Therefore vaccination in this age group is still to be evaluated, once the objectives are established, the appropriate decisions will be made
Some might say that here we are talking about new generation mRna vaccines, unlike the “old” ones …
We have vaccinated hundreds of millions of people with COVID mRna vaccines: huge numbers for not being convinced of their safety by now. However, it is always important to continue to observe and enrich ourselves with knowledge, even in children between 0 and 5 years old. The upcoming arrival of a recombinant protein vaccine, Novavax, is also to be considered, and it may be that this will be used in children. We will see, we will decide. We currently have no evidence that mRna vaccine can be more dangerous in children. One thing is certain. The mRna vaccine does not affect the child’s genome, because it has different characteristics from the genes of human cells. This is a key passage: statements that say otherwise are outside any scientific logic.
Is there a likelihood that anticovid antibodies are transmitted from mother to fetus during pregnancy?
It is not a probability, it is a certainty. The placenta is permeable to immunoglobulins of type G (IgG), not to those of type M. And the vaccine generates above all the first ones: therefore the baby sees and is “wet”, so to speak, by the mother’s antibodies. Not just from those against Covid, but from any type G antibody the mother has. So if the mother has a sufficient antibody titer, they will pass to the baby, as well as go through breastfeeding. And this is important for the protection of the baby.