India begins vaccine trials for 2-18 age group; fresh debate rages

Amid warnings of a third COVID wave which is feared to affect children the most, the Drugs Controller General of India early last week in May allowed phase 2/3 trials of Bharat Biotech’s Covaxin in the 2-18 age group. Trials are expected to begin in the next 10-12 days. As many as 525 children will be a part of the trial at various sites.

However, there is a debate going on across the world over the need to inoculate all children against COVID-19.

The US and Canada, Singapore and the United Arab Emirates have approved the Pfizer-BioNTech COVID-19 vaccine for emergency use in the 12-15 age group. The European Medical Agency is also in the process of reviewing the use of Pfizer vaccine in kids.

Also read: Explained: COVID-19 affects children but they are off danger grid

At the same time, experts continue to grapple with the question whether vaccinating children would save lives. BBC quoted Prof Adam Finn, who sits on the UK’s Joint Committee on Vaccination and Immunisation. “Fortunately one of the few good things about this pandemic is children are very rarely seriously affected by this infection,” he said.

A study across seven countries, published in the Lancet, says fewer than two out of every million children died from COVID during the pandemic. Even children with medical conditions that would raise the dangers of a COVID infection in adults are not being vaccinated in the UK at the moment. Only those at “very high risk of exposure and serious outcomes” are recommended to be vaccinated.

In the UK, experts refer to the approach already used for flu. British children aged from two to around 12 are given the nasal spray, largely to protect their grandparents, each year. One argument is doing the same with COVID vaccines could help contribute to herd immunity — the point at which the virus struggles to spread because so many people are protected.

In India the question of starting vaccine trials on children below 12 was discussed at a meeting of the Indian Medical Association’s Standing Committee on Child Health. Chairman of the Standing Committee Dr S Srinivasa, who is from Karnataka, said he has asked the national president Dr J A Jayalal to write to the Centre on permitting clinical trials in children as it is “very important to safeguard them. They are carriers of the novel coronavirus and can spread the disease easily.”

Also read: BioNTech-Pfizer claim success in COVID vaccine for children

Experts say COVID-19 mortality is low in children due to less lung penetration, fewer Ace2 receptors (associated with entry of SARS-C-oV-2) and reduced cytokine storm. While data shows that mortality from Covid-19 in children is low, experts differ on the rate of infection spread.

“In children respiratory infections spread fast because of close contact and droplet spread,” Dr Srinivasa has been quoted in the media as saying. However, other experts say the infection did not spread as much among children as it did among adults.

“There have been no COVID vaccine trials on children (below 12) so far and the current idea would be to vaccinate as many adults as possible to develop herd immunity, so they do not spread the disease to children,” media reports quoted said Dr Ravi Kumar, executive body member, Bangalore Paediatric Society, and consultant paediatric neurologist as Aster CMI Hospital, as saying.