COVID-19 vaccination campaigns have begun in most parts of the world. The question regarding vaccinations in children has arisen. The reality is that children under the age of 16 are only just beginning to take part in clinical trials with various COVID-19 vaccinations, so availability to children will take several months. Children represent a vulnerable population in whom ethics and consent issues are complicated, hence are almost never the first sector of the population to be tested in clinical trials for new drugs. An extensive safety record is needed in adults before clinical trials are started in children. A safety track record has now been established across many of the vaccinations under study, and therefore children (from the age of 5-6 years and upwards) are now starting to be recruited into various vaccine trials.

Children in general do not get severe complications of COVID-19, and in general do not spread the virus as vigorously as adults do- an exception being older teenagers, who for all intents and purposes form part of the “adult” population as far as vaccines are concerned.

So why, we may argue, do children need to be vaccinated at all?

We can argue several reasons in favour of children being vaccinated, when studies in children have been completed:

  1. It is of utmost importance for the educational, social , physical and emotional health of children to keep schools open as far as is possible, and this will be facilitated by widespread vaccination of children.
  2. Children, though they generally do not get very ill with COVID, can spread the disease to the more vulnerable adult and elderly population. Occasional, children themselves get very ill with COVID or experience the complication of multi-system inflammatory disease syndrome. Protection of children themselves as well as vulnerable adults around them can likely be achieved by vaccination across the age groups.
  3. In South Africa, children under the age of 14 years form almost ONE THIRD of the entire population, therefore children will need to be vaccinated in order to reach good herd immunity numbers.

However, vaccination of children is going to take months (perhaps a year?) to become reality. In the mean time, we can promote the following in order to protect our children and keep schools open:

  1. Universal vaccination of all older teenagers and adults; and overcoming vaccine reluctance/resistance in adults.
  2. Vaccination of all teachers, parents and caregivers.
  3. Early and effective isolation of school-going children if they have symptoms of COVID-19 or are exposed to COVID-19 cases.
  4. Use of masks indoors and, as far as possible, physical distancing in the classroom.

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