Spotlight on vaccines: COVID-19 vaccinations for children and new vaccines in development

More than two-thirds of the global population had received at least one dose of a COVID-19 by mid-May 2022 - with more than 11 billion shots in arms.

The speed with which the COVID-19 vaccines have been created and rolled out has been unprecedented, but inequalities persist. While 66% of people had been vaccinated at the time of writing, only 16% of those in low-income countries had received at least one dose.

In many countries, the focus has now shifted to vaccinating children in an effort to further limit the spread of the coronavirus. The success of COVID-19 vaccines also raises hopes for the creation of other vaccines to slow transmission of and even eradicate other illnesses.

But is it safe to vaccinate children against COVID-19 and what other vaccines are in the pipeline? Two experts from the World Health Organization (WHO) explained in recent 'Science in 5' videos.

The WHO recommends that children above the age of five receive COVID-19 vaccinations for three reasons, says WHO’s Chief Scientist Dr Soumya Swaminathan: To protect the children from getting sick, reduce transmission in the community, and enable economies and educational institutions to stay open without the risk of having to shut down.

All parents worry about their children’s health and safety, Dr Swaminathan adds, but most healthy children and adolescents don’t get sick, even if they catch COVID-19.

There are some children at a higher risk of severe illness from the coronavirus, including those who have underlying neurological conditions or illnesses such as obesity, diabetes, severe asthma and upper respiratory diseases. A percentage of people then go on to have ‘post-COVID syndrome’ or ‘long COVID’.

“This can be fatigue, headaches, different types of symptoms that sometimes persist for weeks or months,” says Dr Swaminathan.

In rare cases, some children can get an inflammatory disease, called MIS-C, so it’s good to protect children from COVID-19, he adds.

“The WHO examines the dossiers provided by companies and provides the emergency use listing. At this point of time, the Pfizer-BioNTech vaccine is approved for children above the age of five and the Moderna vaccine is approved for children above the age of 12,” Dr Swaminathan explains.

Dossiers from other companies are currently being examined by the WHO, but many countries have licensed different vaccines for use in children based on their own regulatory agencies having examined the data on safety and efficacy.

“The best thing is to follow the country's guidelines because all of them have looked very carefully and have made sure that the benefits of vaccination exceed the risks,” adds Dr Swaminathan.

“So far from the millions of children who have been vaccinated around the world, we know that side effects are very rare.”

Children can get fever and pain at the site of injection, as well as body aches that last for a day or two, similarly to adults.

There’s a whole pipeline of vaccines under development against other illnesses, and they fall into two main categories, says the WHO’s Dr Katherine O’Brien.

“The first is vaccines for germs that we don't have vaccines for. The primary ones we're pursuing in that group are vaccines against RSV.

“That's a virus that is one of the most common causes of serious lung disease in young children and infants. It comes through in waves on an annual basis in pretty much every country around the world.”

Group B strep is another germ for which there isn’t currently a vaccine. It’s a bacteria that causes serious infections in young infants and can lead to death.

“This is an important target to prevent meningitis in infants and protect the lives of newborns,” says Dr O’Brien.

The second category is where existing vaccines are being improved, for infections including tuberculosis, influenza and second-generation COVID-19 vaccines.

“We keep calling the development of COVID-19 vaccines ‘unprecedented’,” says Dr O’Brien, but we shouldn't necessarily expect the pace of all future vaccine development to go as quickly.

For COVID-19, the whole world coordinated and collaborated, both in companies that manufacture vaccines and in academic and other research institutes.

Funding for COVID-19 vaccine development was unlike anything seen before and the infrastructure for clinical trials around the world was turned over to facilitate research.

“There was this one target that everybody was pursuing.”

The good news is that people are learning the lessons from the clinical development of COVID-19 vaccines and looking at the steps that can be shortened or run in parallel. So it may be possible now to reduce the time, effort and investment it takes to make life-saving vaccines available.

“It's commonly said that vaccines don't save lives, vaccinations save lives. A vaccine is really of no benefit if it sits on the shelf and doesn't actually get deployed,” says Dr O’Brien.

There are several reasons why vaccinations don't happen, even though vaccines are available. These include:

The convenience of the services. They might not be available at a time, place or distance where it's easy for busy people, especially mothers, to take their kids or adolescent teenagers to get vaccination. This can also be a problem for older adults.

Vaccine hesitancy. People who are opposed to vaccination are a small fraction of those who don't get vaccinated. And, usually, they're operating under some misinformation that's been shared with them, says Dr O’Brien. But some people may be hesitant because they have questions about how safe vaccines are.

“Vaccines stimulate your body's natural immune system to develop protections against the germ that is actually being vaccinated [against]. So that when you may be exposed to that germ in the future, in a real-life setting, your body already has defences.”