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Infectious diseases paediatricians and vaccine experts anticipate the Pfizer shot could be approved for use in Australian children as young as 12 before the end of the year.
However, it could be many months after the expected approval of the COVID-19 vaccine by the country’s Therapeutic Goods Administration before children and adolescents will be asked to roll up their sleeves.
Pfizer/BioNTech has made a submission detailing the safety and efficacy of its vaccine for the 12 to 15 age group.Credit:Bloomberg
Paediatric Infectious Diseases specialist Christopher Blyth said on Wednesday the emergence of highly contagious variants in Australia meant it was more important to get as many people vaccinated as possible, including children and adolescents.
He said Australia would probably follow a similar path to North America, Britain and Israel, where Pfizer has been approved for use in children aged 12 to 15.
“Yes, I do think children will be vaccinated against COVID in the future and that will be important to try and limit community transmission,” said Associate Professor Blyth, who is an adviser to the federal government on vaccines.
“Although children do not get as sick from COVID as adults, and are therefore not as great a priority, they are involved in transmission of COVID, particularly older children and adolescents, and so importantly, they do need to be part of our vaccine program going forward.”
Earlier this week, the Therapeutic Goods Administration received a proposal from pharmaceutical giant Pfizer/BioNTech that has also gone to medical regulators around the world detailing the safety and efficacy of its vaccine for the 12 to 15 age group.
Associate Professor Blyth predicted other mRNA vaccines such as Moderna, which is being examined for use in 12- to 17-year-olds by Europe’s drug regulator, could be soon approved for use in Australian children.
“I don’t have a exact timeline for when this will occur because clearly that will require the company to reach out to the TGA, but I expect this to occur in the coming months,” he said.
Clinical trials involving thousands of young people overseas have demonstrated the Pfizer-BioNTech COVID-19 vaccine is effective and well-tolerated in adolescents, while research into younger children is ongoing.
However, debate about when children should be immunised against coronavirus has drawn the ire of the World Health Organisation, which said wealthy countries should postpone their plans to immunise children and instead donate millions of doses to countries being ravaged by the disease.
WHO director-general Tedros Adhanom Ghebreyesus voiced outrage that a number of rich countries were now vaccinating children while poorer countries had barely begun vaccinating health workers and their most vulnerable.
Professor Andrew Pollard, who ran clinical trials of the Oxford-AstraZeneca vaccine, also deemed it “morally wrong” to prioritise children when COVID-stricken countries did not have enough vaccine.
University of Sydney vaccine and infectious diseases pediatrician Professor Robert Booy, who supports vaccinating Australian adolescents, said a national rollout must be balanced with being a “good global citizen”.
“We should take a step back and say maybe Australian teenagers can be vaccinated to help with herd immunity, but for goodness sake don’t forget that all the COVID mutations happen in countries where there is not great vaccine uptake,” Professor Booy said.
“We need to be good global citizens and help vaccinate our neighbours as well. That’s enlightened self-interest. We help them because they deserve to be helped, but it just happens to give us an advantage as well.”
University of Melbourne paediatrics professor Fiona Russell said there was no need to expedite the vaccine rollout in children when countries such as Fiji had hospitals overrun by seriously ill unvaccinated COVID patients, leaving women to give birth in tents.
“They are in a desperate state and it is absolutely critical Australia does its bit to help them,” she said. “They are … more a priority before vaccinating our children.”
Pfizer announced on Tuesday that it was moving ahead with testing its vaccine in children aged between five and 12 in the US and would begin testing small doses in infants as young as six months. The development means the coronavirus vaccine could be approved for use in young children in the US later this year.
Professor Russell said Australia was a “long way off” rolling out the vaccine to children under 12. When the time did come, a rigorous risk and benefit analysis must be undertaken, she said.
“We really don’t want to be in a situation where children aren’t benefiting from the vaccine directly and they are getting vaccinated to prevent old people from dying,” she said.
The US Centres for Disease Control and Prevention are looking into reports a small number of young adults vaccinated against the coronavirus may have experienced heart problems.
The condition, called myocarditis, is an inflammation of the heart muscle. Most cases appear to be mild and seem to occur in adolescents about four days after their second dose of mRNA vaccine.
Professor Booy, who predicts Pfizer will be approved for use in children between 12 and 15 in Australia before the end of the year, said one dose of the vaccine might offer enough protection.
“They may actually respond to just one dose of the vaccine as their immune system is so strong,” he said. “So, while you’re giving other Australians their second dose, you could start giving one dose to every teenager.”
Experts agree transmission of coronavirus in adolescents is much lower than in adults, but it is more frequently spread by teenagers because they often congregate together and are more likely to be physically affectionate.
Compared with adults, children are much less likely to develop severe illness following infection with the coronavirus. A minority of children globally, including a small number in Australia, have suffered a debilitating condition as a result of COVID-19 infection called multi-system inflammatory syndrome.
Most make a full recovery, although there is an indication of some lingering longer-term effects. Few children have died worldwide from the condition.
Under the national coronavirus vaccine program, Australians aged under 16 are not prioritised for a vaccine until a third and final phase of the rollout, which is not likely to begin until at least next year.
If the TGA approves Pfizer for children, then the Australian Technical Advisory Group on Immunisation will make a recommendation to the federal government on when it should be given.
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