January 26, 2022

seven questions on immunization of children aged 5 to 11, which “could start on December 20”

Vaccination against Covid-19 is expanding to a new category of the population. The government announced on Monday December 6 that children aged 5 to 11 exposed to severe forms of Covid-19 could be vaccinated from December 15. But the Prime Minister, Jean Castex, added at the same time that for all of this age group, “It could start on December 20 in the vaccination center and on December 27 in town, with the same networks as adults.” Ads that have raised many questions among internet users of franceinfo. Here are some answers.

What is the dynamics of the epidemic within this age group?

“You can’t say there is an explosion [de l’épidémie chez les enfants], the word is too strong, there is an incidence rate which is increasing “, said the Minister of National Education, Jean-Michel Blanquer, on RTL on Tuesday. However, sAccording to figures from Public Health France, the incidence rate among children under 10 has multiplied by 12 in one month, from 45.7 on November 3 to 557 on December 3. For the rest of the population, over the same period, the incidence rate increased six-fold, from 68.78 to 414.

How does the government justify opening vaccination to “fragile children”?

The executive is based on the recommendation of the High Authority for Health (HAS) issued on November 30. The body decided in favor of vaccination of “fragile children” : she has it recommended “for all those who present a risk of developing a severe form of the disease and of dying, and for those living in the entourage of immunocompromised or vulnerable people not protected by vaccination”.

Jean Castex pointed out, Monday evening, a transmission “strongly accelerated” in children under 12 years of age.

Before the HAS, the Academy of Medicine, in an opinion issued on November 15 (in PDF), had also proposed to open vaccination to under 12 years but only for children at risk of severe form, due to co-morbidities, or for those who have other fragile people in their entourage.

How many people are affected?

Health authorities estimate that around 360,000 children in France are affected by these different pathologies. “But there are probably others because there are rare diseases that don’t show up in studies”, noted Daniel Floret, pediatrician and vice-president of the HAS technical committee for vaccinations.

“These are children who are carriers of chronic diseases, including heart disease, heart defects, severe lung disease, severe forms of asthma that require continued treatment, liver disease, kidney disease, and of course children who are treated for cancer, leukemia “, listed on franceinfo Daniel Floret.

The specialist explains that these children suffering from these chronic diseases presented “a higher risk of getting a severe form”, stressing that “Almost all of the children who died from Covid-19 were carriers of this type of pathology”.

Are children receiving the same doses as adults?

No, the dosage of anti-Covid vaccines for children is lower than that for adults. He is “three times lower than the dosage used in adults” since it contains “10 micrograms of antigens whereas the vaccine which is used in adults contains 30”, underlined on franceinfo the pediatrician Daniel Floret.

So far, only Pfizer-BioNTech’s vaccine has obtained marketing authorization for 5-11 year olds. Doses of this vaccine will be available in the European Union from December 13, according to European Commission President Ursula von der Leyen.

Is vaccination for all children 5-11 years old planned?

Before opening vaccination to all children aged 5 to 11, the government is still awaiting two notices “important”. After receiving a favorable opinion from the Steering Committee for the vaccine strategy, the Minister of Health, Olivier Véran, declared that the executive was awaiting that of the High Authority for Health and that of the National Consultative Ethics Council. The latter could pronounce “in the next weeks”, according to Jean Castex.

However, the executive is already ready to vaccinate all 5-11 year olds. The Prime Minister said the government was planning to open up the Covid-19 vaccination to these children “on the basis, of course, of voluntary service, if possible, before the end of the year”. For vaccination centers, this could start around December 20. For city medicine, it could start on December 27. “We organize all the logistics (…) to be able, when the time comes, to start immunizing children without delay”, insisted Olivier Véran.

Since 5-11 year olds develop very few severe forms, is vaccination useful?

The question of extending vaccination to all children of this age group is debated. Yazdan Yazdanpanah, member of the Scientific Council, stressed to the senators that “not all learned societies have the same position on the issue of childhood vaccination”, reported Public Senate.

In summary, for children the individual benefit is quite slim. We know that in general, they develop very little the disease and even less serious forms, as explained by franceinfo on November 26. But epidemiologist Dominique Costagliola, from Inserm, calls not to minimize the consequences of Covid in children: “79% of children aged 5-11 hospitalized have no comorbid factor”, she declared in “Télématin”, on France 2, Tuesday.

On the other hand, the vaccination of children presents an interesting advantage at the collective level. Insofar as the progression of vaccination stagnates in adults (some 6 million French people who have not received any dose), protecting the 5-11 year olds (who represent more than 5 million people) would make it possible to increase the rate vaccine coverage, and therefore reduce viral circulation as much as possible. “Even though only 30% of them [des 5-11 ans] are vaccinated, and especially in countries where there have been a lot of vaccinations among adults, this will help reduce the reproduction rate of Sars-CoV-2 “, argued Dominique Costagliola.

“The other children [ceux qui n’ont pas de fragilités], we are going to impose measures on them, but all this to protect adults who do not want to be vaccinated. It’s a bit annoying “, reacted on franceinfo professor Jean-Paul Stahl, infectious disease specialist, professor emeritus of infectious diseases at the CHU de Grenoble.

Are there studies in countries that have already started immunizing children?

Only a few countries have opened up vaccination against Covid-19 to children aged 5 to 11. On October 29, the United States authorized Pfizer-BioNTech’s Covid-19 vaccine for this age group, which represents a total of 28 million people. “No signal has appeared in the United States on more than 4 million vaccinated schoolchildren, but there is a lack of hindsight”, commented epidemiologist Dominique Costagliola, from Inserm, during a hearing in the Senate, reported by Sunday Newspaper.

For its part, Israel – one of the first countries to launch a vast vaccine campaign against Covid-19 in December 2020 – gave the green light, on November 14, to the vaccination of children aged 5 to 11 with the vaccine. developed by Pfizer-BioNTech.

According to laboratory data, the effects of the vaccine in children are similar to those seen in adults. They are “comparable”, noted in a joint press release the French learned societies of pediatrics (SFP) and infectious pathology (Spilf).

As franceinfo detailed, immunogenicity, that is, the vaccine’s ability to elicit an immune response, is similar. The antibody level was, on average, 1,197 among 5-11 year olds and 1,148 among 16-25 year olds. The efficacy of the vaccine on symptomatic forms of the disease is 90.7%. Three cases of Covid-19 occurred in the vaccinated group (out of 1,305 children evaluated) against 16 in the placebo group (out of 663 children evaluated). Again, this proportion is similar to that observed in adults. Same observation for the tolerance of the vaccine by children: the most frequent side effects (pain at the injection site, redness, fever, etc.) were comparable to those observed in adults.

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