With winter quickly approaching, parents are faced with important choices about COVID-19 vaccinations for their children. Current guidance issued by health authorities illustrates the complexities involved in making vaccine recommendations for different age groups. Relatedly, the Food and Drug Administration (FDA) in the United States has primarily restricted its COVID-19 shot approvals to adults 65 and older. In stark contrast, the Australian government has extended its advice beyond Australian adults to all children and adolescents.
Here in Australia, the Australian Immunisation Handbook is the gold standard for all things COVID-19 vaccination. It’s primarily focused on people who have not yet been vaccinated. This guidance is crucial, given that public health leaders are considering the benefits and risks of vaccinating children against COVID-19.
Current Recommendations in Australia
The Australian Technical Advisory Group on Immunisation (ATAGI) recommends COVID-19 vaccinations for children and adolescents aged 5 to 18 years who are severely immunocompromised. They recommend that these people get a dose every 12 months. In fact, the Australian government recommends that healthy infants, children or adolescents should not be vaccinated. This recommendation is for people who do not have other underlying medical conditions that increase their risk of severe illness. Immunocompromised children under five are eligible for vaccination.
Dr. Norman Swan advises that vaccination needs to be decided in view of a child’s vaccination history. He thinks that’s a better measure than taking into account previous infections. He stated, “The easy thing to do is if you’re getting your child a flu vaccine you could get them that too if they’re in the group recommended by ATAGI.” This two-pronged approach is intended to make getting vaccinated as easy as possible for families.
ATAGI’s first recommendations from 2021 certainly added complications to the picture. They missed big by not fully addressing the new and growing long COVID issues for children. Dr. Kristy Short notes, “ATAGI made its initial recommendations on COVID vaccinations back in 2021 and we’ve now become aware of long COVID… that doesn’t factor into the risk benefit analysis that ATAGI has done.”
U.S. Vaccine Guidance and Implications
In contrast to Australia’s approach, the U.S. government has recently decided against recommending COVID-19 vaccines for children and healthy pregnant women. Health Secretary Robert F Kennedy Jr called this decision a “commonsense” decision based on good science. While this shift is welcome news to many, it has alarmed some health experts, especially in relation to the persistent threats of COVID-19 to at-risk groups.
Dr. Short expressed her discontent with the U.S. decision, stating, “What is really shocking is that they’re no longer recommending COVID vaccination for pregnant women.” She added, “There is no question in my mind that it should be available to pregnant women.” This feeling speaks to a larger, more dangerous struggle over the importance of vaccination itself. Their efforts are key to continuing to guard mothers and their unborn children from the potential dangers of COVID-19.
Dr. Norman Swan highlighted the risks COVID-19 poses to pregnant women, noting, “Because COVID affects pregnant women more than otherwise healthy people… they need to talk about this with their doctor.” The knock-on effects of poor guidance can have far-reaching and grave consequences for public health aimed particularly at vulnerable populations.
Understanding Long COVID Risks
The arrival of long COVID has added a new layer to conversations about vaccination. Dr. Short underscored that healthy children have a very high level of protection against serious illness. There’s still a possibility they might go on to experience long COVID, which can manifest in a variety of ways. “The main thing with kids is there is still a chance of long COVID… which is reduced by immunisation,” she explained.
These complexities surrounding children’s health and vaccination are layered on top of the varied impact of COVID-19 on different age groups. Dr. Short remarked on the confusion parents may face due to inconsistent advice, stating, “It does become really complicated and I as a parent get that it is confusing advice and it’s partly because the situation with children is not as black and white as it is in adults.”
Despite the challenge of ever-changing scientific understanding, health experts have long pushed for greater clarity and consistency in vaccination guidelines. According to the Immunisation Handbook, while the overall risk of severe illness is low, many healthy children are at an increased risk. The risks of long COVID are too serious to ignore.
