The World Health Organization (WHO), with support from epidemiology and immunization advisors, is reviewing emerging evidence on the need for and timing of vaccinating children and adolescents with currently available and approved COVID-19 vaccines.
Although the majority of COVID-19 vaccines are only approved for use in adults aged 18 years and above, an increasing number of vaccines are now also being authorized for use in children. Some countries have given emergency use authorization for mRNA vaccines for use in the adolescent age group (aged 12-17 years): BNT162b2 developed by Pfizer, and mRNA 1273 developed by Moderna. In November 2021, one stringent regulatory authority approved the mRNA vaccine BNT162b2 for the use in children aged 5-11.
Trials in children as young as age 3 years were completed for two inactivated vaccines (Sinovac-CoronaVac and BBIBP-CorV) and these products were approved by Chinese authorities for the age indication of 3-17 years. Those vaccine products have received Emergency Use Listing (EUL) for adults, but have not yet received WHO EUL for children.
Covaxin, an adjuvanted inactivated vaccine developed by Bharat, was approved in India for the age indication of 12-17 years; but not yet received WHO EUL for this age indication. The Indian regulatory authorities have given approval to ZycovD, a novel DNA vaccine, for ages 12-17 years; however, this vaccine has not yet received WHO EUL.
Despite their lower risk of severe COVID-19 disease, children and adolescents have been disproportionately affected by COVID-19 control measures. The most important indirect effects are related to school closures which have disrupted the provision of educational services and increased emotional distress and mental health problems.
When unable to attend school and in social isolation, children are more prone to maltreatment and sexual violence, adolescent pregnancy, and child marriage, all of which increase the probability of missing further education and of poor pregnancy outcomes. A range of follow-on effects of school closures occur. These include disruption in physical activity and routines and loss of access to a wide range of school-provided services such as school meals, health, nutrition, water, sanitation and hygiene (WASH) and services targeted to children with special needs such as learning support, speech therapy and social skills training.
Children not attending school face enhanced risks of cyberbullying from other children, and the potential for predatory behavior from adults related to spending more time online. Longer-term, prolonged school closures lead to education loss and exacerbation of pre-existing inequalities and marginalization of learning.