Why is There No Covid Vaccine for Children?

Health and Gender Policy Brief # 122 | By: S. Bhimji | Aug 9, 2021

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Policy Summary

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For much of 2021, only the adult population has been getting vaccinated in the USA but children have not been a priority. Now that schools are about to open, people are asking why children have not been vaccinated.

In the USA, the plans were to only vaccinate the children in the later stages of the vaccine roll-out. As of yet no vaccine has been approved for use in children under the age of 12.

But why has it taken so long to make a Covid vaccine that is effective in children? Surely we have had at least a dozen childhood vaccines that have been used for close to a century with great effectiveness like the polio, rubella, mumps, rubella, pertussis, etc, vaccines. So how come there is no Covid vaccine for children?

Policy Analysis

Experts in infectious disease state that there are no childhood Covid vaccines as of yet is due to two reasons: 1) Unlike adults, children have been less affected by covid-19. When the Covid pandemic started only 3% of children were affected but the latest data indicate that there at least 23% of children have acquired covid-19. Yet death rates and hospitalization have been rare. 2) The majority of clinical trials have only involved adults.

As of Aug 2021, the safety of all Covid vaccines in children under the age of 12 has not been established. In the latest Pfizer Phase 3 clinical trial that involved more than 43,000 participants, not a single person under the age of 16 was enrolled. Hence, without clinical trial evidence, no manufacturer can claim that the vaccine is effective in children.

In the rush to get adults vaccinated ASAP, children unfortunately were left out of the trials. The key reason for this is that the early Covid experience revealed high mortality in older adults, especially those with comorbidities; children were rarely affected by the coronavirus. It has all been a question of priorities.

Photo taken from: The Washington Post

According to the latest figures released by the CDC, only 335 children under the age of 17 have died since the Covid pandemic started. In that same period, close to 49,000 children died from other causes-so the death rates from Covid-19 in children are very low. Further, children under the age of 17 represent less than 1.5% of hospital admissions and have much milder symptoms than adults.

It is not clear why children are less susceptible to Covid 19 but it is suspected that there may be fewer receptors in the airways for the virus to attach itself and/or that children may also be exposed to many other viruses which may offer defense from coronavirus-but these are only theories and not proven facts.

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The timeline for children being vaccinated in North America still depends on the results from clinical trials but it is expected that a roll-out may start at the time of the 2021-22 school year. Companies that make the vaccine are taking a more cautious approach and want to ensure that the vaccines are safe.

Another problem is that without data from clinical trials it is still too early to determine the dose of the vaccine in children. Children do have a robust immune system and may need a lower dose or even a single dose-but how they will respond is another story.