The vaccination of adolescents against Covid-19 has moved very quickly in Spain. Despite the fact that their turn mostly came in August – a complicated month, due to the vacation season – 75.3% of 12- to 19-year-olds have received at least one dose of a vaccine and four out of every 10 have the full protection offered by the shots. As such, the new school year will be starting in most places today with wide vaccine coverage, which will be completed during the first weeks of class. The under-12s are yet to be included in the campaign, given that no vaccine has yet been approved for this age group in the European Union.
The progress among adolescents has been so rapid that coverage already exceeds that of the 20-30 group in terms of the first dose (74.3% vaccinated) as well as the 30-39 group (75.1%), despite the process having started later for the younger sector. This has a positive and negative interpretation. On the good side is the fact that the vaccine is much more widely accepted among young people, even more than the experts expected. “In this sense, adolescents have done their part,” says Quique Bassat, an epidemiologist and member of the Spanish Pediatric Society. The down side is the fact that the progress of the vaccination campaign among the 20-40 age group is clearly slowing down, with a quarter left to immunize. And this group is more vulnerable than the 12-19 segment.
While the percentages of those who suffer serious illness or die from Covid-19 are low among young people, they rise bit by bit as the age increases too. Until the most recent fifth wave – when just a small minority of under-40s were vaccinated – of every 100,000 30- to 39-year-olds diagnosed, 200 ended up in intensive care units (ICUs) and 28 died. Among the 20-29 group, the figures fell to 75 in the ICU and 11 deaths for every 100,000 cases. For children and adolescents aged 10-19, there were 28 ICU admissions and three deaths for every 100,000 cases, according to data from the Carlos III Health Institute.
These figures show that the vaccine is more important as age rises, given that its main benefit is to avoid hospitalization and death due to Covid-19. The risk for adolescents is very small – so much so that countries such as the United Kingdom have opted, for now, not to vaccinate the under-15s. Their experts argue that there is no scientific data that proves that the benefit for this segment of the population outweighs the risk.
But as pointed out by Federico Martinón, a pediatrician and vaccine consultant for the World Health Organization (WHO), the shots have a role beyond just the benefits for one’s own health, which in this case “are marginal.” He explains: “It’s true that what needs to be prioritized, beyond the vaccination of adolescents, is the most vulnerable people. But taking this into account, the vaccination in this group also has indirect benefits.”
One of these benefits is for the community. “It will contribute to controlling transmission,” Martinón argues. “We don’t know how much, but no less than in other groups.” The vaccines that are currently being used do not impede the transmission of the coronavirus, but they do reduce the risk. In the case of the more-infectious delta variant, this fall has been estimated by some research at around 30% to 40%, but this is not clear yet and this figure appears to fall with the passing of time, even though protection against hospitalization and death is maintained.
The second benefit that this expert points to is for adolescents themselves, given that “it will help them to have a fuller and more normal life.” Quarantines for contacts, for example, are not obligatory for people who have been vaccinated, which will allow thousands of children to attend class when a positive case has been identified among their classmates, avoiding missing more time from school.
Unlike the last school year, this year will see teachers and a section of students vaccinated, but also the delta variant is circulating – a much more contagious strain than was present in September 2020. Bassat is optimistic and believes that the successful approach taken in Spain – schools remained open throughout the year – could be repeated this year.
“There is a certain uncertainty as to what could happen,” he explains. “I trust that with the return to the routine, the prevention rules will be observed once more. June and July [when there was an explosive wave of the virus, in particular among young people] was kind of crazy due to the start of vacations, the end of term and the rebound effect from so many measures. The return to the routine will help.”
An advertisement from the Health Ministry on Instagram encouraging young people to get vaccinated.
The Health Ministry has this week launched a campaign to move the vaccination campaign along among young people. While progress has been good among this segment, there are concerns over the slowdown among the 20-40 groups, explain sources from the health departments. “This campaign coincides with the end of the summer and the start of the school year and is seeking to reinforce confidence in the vaccines, in particular among young people and adolescents, to be able to continue with the implementation of the vaccination strategy,” explains the Health Ministry in a press release. The campaign will be distributed via platforms such as Spotify, Instagram and TikTok, as well as on TV, radio and billboards in places such as metro systems, buses and universities.
Vaccines for children
For now, Cuba is the only country that has approved a vaccine for children aged under 12. They are using Soberana, which is a medication produced domestically. The main pharmaceutical countries that are supplying Spain – Pfizer and Moderna – are still in the trial stage for this younger age group and the results could be available before the year is out.
The use of the Pfizer medication for children is being studied in Spain, among other countries. The company has reported that phase 1 has been completed, and has established the dosage for children aged five to 11, two to five and six months to two years. “Now we have started with the studies from phase two out of three to more fully evaluate the safety, tolerability and immunogenicity,” a spokesperson from the company reports.
Martinón, however, does not believe that the results will be available before the end of the year. “We need to have the same guarantees to vaccinate small children as adolescents or adults,” he says. “That doesn’t mean that when we have the data we have to vaccinate that population.” Once the vaccines have been approved for children, the experts who are advising the health authorities will have to evaluate the extent to which it is necessary to inject the under-12s, who account for 11% of the Spanish population, but among whom Covid-19 manifests itself in a very mild way in the large majority of occasions.
English version by Simon Hunter.