Spain began today the vaccination of children aged between five and 11, in a new qualitative leap in the fight against the coronavirus pandemic. The rise in cases registered in recent weeks in Spain has prompted the health authorities to take this step, which just a month ago was considered unnecessary by many experts. The Public Health Commission, which is made up of the central Health Ministry and the country’s regional governments, approved pediatric vaccinations at a meeting held on December 7. Here are the key elements of the process:
Who is going to be vaccinated?
There are 3.26 million children in Spain aged between five and 11, which is 7% of the total population. From today onward, the only group not included in the country’s vaccination campaign will be the under-fives, for whom a vaccine is yet to be approved by the European Medicines Agency (EMA).
Vaccination of the over-12s began in the summer in Spain, and currently, the country is among the leading European states in terms of the number of teenagers vaccinated (more than 85% have both doses, according to the Health Ministry). Portugal, Finland and Iceland are the other countries, according to the website Our World in Data.
Why vaccinate this group?
The vaccine is proven to be safe and effective. Clinical trials have shown an effectiveness of 91% in terms of avoiding symptomatic infections in children aged five to 11, who in general develop fewer adverse reactions to the vaccine.
The first reason for vaccinating children is to protect them from illness. While the vast majority of children diagnosed with Covid-19 have only mild symptoms – even asymptomatic in nearly half of cases – since the start of the pandemic a total of 399,000 cases have been detected in the under-nines, which ended up with 3,398 hospitalizations, 177 admissions into intensive care units (ICUs) and 20 deaths.
The second reason is that by immunizing children, infections among people of all ages can be avoided. Right now, in Spain, the under-11 group is seeing the highest incidence of infections. The average in Spain is around 412 cases per 100,000 inhabitants over 14 days, but for the under-12s the figure is 640, and in the Basque Country and Navarre regions, the figure exceeds 2,000.
Recommendations from the Inter-Territorial Council of the National Health System (CISNS), which brings together the central Health Ministry and the regions, state that vaccinating minors “can reduce the transmission in the family environment, in educational settings and in the community, contributing to the protection of the most-vulnerable populations.” What’s more, it should help to bring the pandemic under control.
What is the procedure?
Minors will be given two injections, separated by eight weeks to improve the immune response and safety profile.
Children who have had a coronavirus infection will receive a single dose at least four weeks after diagnosis or the start of symptoms. Those who get infected between doses will receive the second one after they recover and once four weeks have passed since the infection (when possible, the eight-week gap will be maintained).
Each injection contains a third part of the dosage administered to the over-12s, although those who reach that age between both doses will be given an adult measure for their second injection.
Those minors who have pre-existing conditions will be given a third injection at least four weeks after the second one. This latter group will be given priority to receive the vaccines first. The Interterritorial Council recommended vaccinated 10- and 11-year-olds first, but some regions – such as Catalonia and the Canary Islands – have decided instead to start vaccinating all ages at the same time.
Those children who are due to be vaccinated against other diseases around this time will be able to receive their Covid-19 shots without any contraindication, albeit in different parts of the body. As was done with adults and teenagers, children will have to wait for 15 minutes after their shots just in case they suffer an immediate adverse reaction. Should they have a history of serious allergic reactions, they will have to stay for 30 minutes.
Where will they be vaccinated and who will authorize it?
The majority of regions will vaccinate children in healthcare centers and the vaccination sites that have already been established during the campaign so far. The Valencia region, Extremadura, Castilla-La Mancha and La Rioja will also vaccinate in schools, while Madrid will use its hospitals.
Children will be able to get vaccinated with the verbal or written authorization of a parent. Extremadura and Valencia, however, have requested the permission of both parents. In the case of a mother or a father who is opposed to the vaccination in disagreement with the other, the parent in question must communicate this to the healthcare system. In the case of disagreement, as already happened with the 12- to 15-year-olds (in Spain, those 16 or over can decide for themselves), the case will be referred to the courts.
How is the vaccination progressing in other countries?
In Europe, the United States and a large part of South America the pediatric vaccine has already been approved and children aged between five and 11 are gradually becoming eligible to receive it. The major exception is many African countries, where the vaccine, for now, is only available for adults, in some cases those aged over 50.
The vaccination in young children is starting now in most countries. In Europe, only Austria has advanced so far, having started this part of its campaign in mid-November. It has now vaccinated 10% of children aged between five and nine. The United States is also ahead: it began vaccinating at the start of last month, and nearly 20% of children aged five to 11 have already received a dose.