Is healthy children need COVID vaccine boosters?

WHO react on COVID -19 Booster for kids

On Jan. 18, World Health Organization Chief Scientist Dr. Soumya Swaminathan said the focus should be on vaccinating the most vulnerable people in each country’s population.

This comes two weeks after the CDC endorsed Trusted Source the use of booster shots for adolescents 12 to 15 years old.
Other countries, such as Israel and Germany, have also recommended COVID-19 booster doses for children ages 12 and 17.
There’s “no evidence right now” that healthy children and adolescents need a booster dose to augment their COVID-19 vaccinations, according to World Health Organization (WHO) Chief Scientist Dr. Soumya Swaminathan during a media briefing on Tuesday, Jan. 18.

• This comes just two weeks after the Centers for Disease Control and Prevention (CDC) authorized trusted Source booster doses for adolescents ages 12 to 15, amid a surge in pediatric cases during the current Omicron wave.
• For the week ending January 13, over 981,000 cases of COVID-19 were reported in children, a 69 percent increase from the week before, according to the most recent data from the American Academy of Pediatrics.
• Many states, including Alabama and Michigan, also see a sharp rise in child COVID-19 hospitalizations.
• CDC data show that this increase has been exceptionally high in children under 5, who are not yet eligible for a COVID-19 vaccine.

Other countries, such as Israel and Germany, have also recommended COVID-19 booster doses for children ages 12 and 17.

Boosters offer additional protection.

Two doses of an mRNA COVID-19 vaccine protect children and adolescents against severe illness — the kind that would land them in the hospital or an intensive care unit.

• This includes protecting against multisystem inflammatory syndrome in children (MIS-C), a potentially serious condition in some children who develop COVID-19.
• A recent CDC study trusted. Source found that two doses of the Pfizer-BioNTech vaccine were 91 percent effective at preventing MIS-C in adolescents ages 12 to 18.

“This medical condition can make children very ill and put them in the intensive care unit,” said Dr. Christina Johns, pediatrician and senior medical advisor for PM Pediatrics.

“The good news is that kids can recover if [MIS-C is] caught early. But why put your child through that if there is a way that’s so effective at preventing it?” Johns said.

• Doctors and experts strongly recommend trusted Source COVID-19 boosters for children who have health conditions that raise their chances of developing severe illness, including obesity, diabetes, asthma, chronic lung disease, sickle cell disease, and immunosuppression.

For healthy kids, Johns said she would also recommend a booster.

• “We do know that immunity [after vaccination] wanes over time,” she said, “so giving [adolescents] a booster is not an unreasonable thing to do.”
• Most COVID-19 cases in fully vaccinated children will be mild, but a booster dose can provide additional protection against transmission.
• “With the [high] presence of Omicron, we are trying to be very careful and boost everyone we can,” said Dr. Judith Flores, a pediatrician in Brooklyn, New York.
• Boosters also protect other people around children — older family members and neighbors, other children with weakened immune systems, and kids under age five who cannot get vaccinated yet.

“The main thing is to make sure that children — and adults — who are vulnerable get the primary vaccine series,” said Flores, “but they probably should get boosted in addition.”

Although Johns has no safety concerns about booster doses for kids ages 12 and older, she said if parents have any questions or worries, they should talk with their child’s pediatrician.

 

Vaccinating the unvaccinated first

Swaminathan said during the WHO media briefing that the agency’s Strategic Advisory Group of Experts on Immunization (SAGE)Trusted Source will meet on Friday to consider how countries should think about giving booster doses, with a view toward “protecting people” and “reducing deaths.”

• “The aim [with boosters] is to protect the most vulnerable and those at highest risk of severe disease and death,” she said.
• “Those are our elderly populations, immunocompromised people with underlying conditions, and healthcare workers.”

According to Our World in Data, 60 percent of the world’s population have received at least one dose of a COVID-19 vaccine.

However, this drops to under 10 percent in low-income countries — a concerning statistic driving the WHO’s push to protect those most at risk before rolling out boosters to healthy populations.

• “Our focus, considering that we still have so many unvaccinated people in the world, is to… provide primary doses to those who have not been vaccinated… while at the same time trying to protect the most vulnerable in every country’s population,” said Swaminathan during the media briefing.
• However, even in the United States, many people are unvaccinated, with children and young adults being the least vaccinated parts of the population.
• More than 70 percent of 5- to 11-year-olds in the United States — and over 34 percent of 12- to 17-year-olds — have not received a single dose, according to data from the Mayo Clinic.

“We don’t have enough children vaccinated with the primary series,” said Flores, “which is my goal when caring for patients and families.”

Omicron vs Delta: Vaccines seem less effective

Early estimates suggest that vaccine effectiveness against symptomatic infection with Omicron is significantly lower compared with the Delta variant.

A report by Imperial College London indicated that the risk of reinfection with Omicron was 5.4 times greater than the Delta variant. I was previously having COVID-19, also afforded little protection against reinfection with Omicron.

“This is such a contagious virus that it can spread not only among the unvaccinated, where I think it still has a very substantial risk of causing serious disease that might require hospitalization, but it can also spread among vaccinated persons, although the illness it produces among the vaccinated, particularly if you’ve had a boost, is generally mild and even without symptoms,” said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center in Tennessee.

However, the Imperial College London study suggests there is “no evidence of Omicron having different severity from Delta,” despite hospitalization remaining relatively low for the time being.

“[Even if] Omicron may not lead to more severe illness than Delta, a rapid and massive infection surge could overwhelm hospitals with sick patients. Unvaccinated people remain at the highest risk and those who have not received the third dose of an mRNA vaccine,” said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City.

2-dose Pfizer vaccine vs omicron

Few real-world studies have managed to estimate effectiveness for the Pfizer-BioNTech vaccine, and several laboratory studies show that a booster increases antibody production significantly.

• “The studies are largely laboratory studies that would indicate that antibody levels induced by boosting will have a noteworthy impact on preventing serious disease,” said Schaffner.
• A preprint study conducted by Oxford University reported that two doses of the AstraZeneca or Pfizer-BioNTech vaccines offered little protection against infection with the Omicron variant.

However, a real-life study from South Africa found that two doses of the Pfizer-BioNTech vaccine still protected people from severe disease.

• Researchers found that two doses provided 70 percent protection against hospitalization and 33 percent protection against infection. This was a drop from about 93 percent and 80 percent, respectively, for the Delta variant.
• A study published in the New England Journal of Medicine echoed these figures, finding that a two-dose regimen of the Pfizer-BioNTech vaccine was 70 percent effective against hospitalization with Omicron.

Dr. Monica Gandhi, an infectious diseases specialist with the University of California, San Francisco, told Healthline that although these lab studies show that antibodies, the body’s main line of defense against the coronavirus, can wane over time or be affected by mutations along with the virus’s spike protein, vaccines were able to generate other types of immune cells to fight off infection.

“We know now that T cells from the vaccines still work against Omicron, and B cells generated by the vaccines adapt the new antibodies they produce to work against variants. So, I think the clinical scenarios in those with prior immunity, vaccinated, and even boosted individuals [show that] the vaccines are likely still protecting Omicron-infected individuals from severe disease,” she said.

Pfizer booster vs. Omicron

• Early analysis from the United Kingdom has suggested that boosters have moderate to high vaccine effectiveness against symptomatic infection, offering 70 to 75 percent protection in the initial weeks after the champion.
• Researchers found a slight difference depending on whether the initial doses were from the AstraZeneca vaccine or Pfizer-BioNTech vaccine. Both groups had Pfizer-BioNTech boosters.
• Two weeks after a Pfizer-BioNTech booster dose, vaccine effectiveness for people who received the AstraZeneca vaccine increased to around 71 percent and 76 percent for those who initially got the Pfizer-BioNTech vaccine.

As for severe disease, modeling by Imperial College London found that the Pfizer-BioNTech vaccine with a booster was around 85.9 percent effective against Omicron, compared with about 97 percent against Delta.

Early data from Pfizer had indicated that a booster dose significantly increased neutralizing antibodies, bringing the vaccine’s protection close to what two doses provided against the original variant of the coronavirus.

The data comes from a series of lab experiments testing the neutralizing ability of blood samples from people who had two doses of the vaccine and those who had received a booster.

The neutralizing ability of the antibodies collected from those who did not have a booster had a more than 25-fold decline against Omicron than the original variant.

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