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Our vaccine programme is on the whole going well, however despite falling case rates ( At least when I wrote this piece) the virus could well resurge in the autumn and winter.

I do not think restricting people’s (particularly those who have done the right and community minded thing) liberty is a step that should be taken again even if cases do rise. The vaccines are very very good at preventing hospitalisations and death – which is the metric any sane society, not cases might consider a “lockdown”. As these are available to all adults, with boosters incoming for the more vulnerable – and take up is high amongst the more vulnerable groups, the UK is in a good place there.

However I do admit to being troubled by the recent JCVI report  on 12 – 17 year olds, a category one of my nieces falls into.

The committee considers vaccine safety, and concludes the myocarditis risk for young people is not well understood – yet the vaccine is authorised by the US CDC; the Israeli health boards and indeed our very own MHRA who have concluded the Pfizer (And Pfizer is the only authorised vaccine globally having completed trials in adolescents) that the jab is safe and effectiveness in the younger age group, after conducting a ‘rigorous’ review of the vaccine alongside the Commission on Human Medicines (CHM) – the government’s independent advisory body.[2]
This strikes me as second guessing our own MHRA – a duplicated competence by the JCVI which muddies the waters rather than producing the clarity we need from our regulators.

Further on the report goes on to state that the incidence of severe outcomes in children and young people is ‘very low’. We are all thankful for this, but a hospitalisation rate of 100 to 400 per million is mentioned. More worryingly the report notes that Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-COV2 infection (PIMS-TS), also called Multisystem Inflammatory Syndrome in Children (MIS-C), is a rare inflammatory disorder related to previous recent SARS-COV2 infection. During the second wave, PIMS-TS was estimated to occur in 5 per 10,000 children infected with SARS-CoV2 in the UK, with a case fatality ratio of 1%.

Amazingly the report then goes onto state Specifically, it is not known how COVID-19 vaccination might influence the occurrence or severity of PIMS-TS.

Vaccines do decrease transmission. That’s straight from the mouth of Chris Whitty and Vallance. A good way to prevent PIMS-TS may well be to vaccinate adolescents.

The risk of long Covid is again noted as “very low” – the vaccine risk is very very very low though; the US CDC has been better and actually put some numbers against all this  – the balance come out in favour for vaccination for the most marginal group, 12 – 17 year old boys.

It seems no coincidence to me that cases are generally lower (Even allowing for lower testing) when schools are off as they are now. The normal and quite healthy everyday social mixing of youngsters presents an opportune ground for covid which makes the statement

Should the government wish to consider vaccination of children and young adults aged less than 18 years with the primary aim of reducing the SARS-CoV2 infection rate (asymptomatic and symptomatic cases) irrespective of other direct or indirect benefits as discussed above, the known benefits from vaccination are likely to be limited. perplexing to say the least. Even if the benefits are limited, should we not be stretching every sinew to try and achieve the fabled “herd immunity” or more realistically a lower level of endemic disease within the population at large.

The JCVI expplicitly does not consider supply in it’s report so “they’re delaying it because we don’t have enough” doesn’t make sense as an argument. If they’re delaying it because of insufficient supply or prioritisation behind 70+ booster doses then the Gov’t or JCVI should come out and say this. It is NOT mentioned.

Overall the report is a bit of a disappointing read and I’m sorry to say has a whiff of antivaxxery about it, particularly as it is in direct contradiction to our own MHRA who have concluded the vaccine is safe and effective for 12 – 15 year olds (Authorisation for 16 and 17 year olds was done some time ago).

Our vaccine program is going well, but it could do better – and with low uptake amongst pregnant women being a real issue the “Yes, no, stop, maybe” call from our regulators earlier on in the rollout can’t have helped. Hopefully when the vaccine is authorised for 12+ (I think the “new evidence” will get them there eventually…” equivocation from the JCVI on this won’t effect takeup.

 

Pulpstar