There is understandably considerable interest among paediatricians and their patients in the rollout of the COVID-19 vaccination programme. This is particularly so in those patients who have been shielding for much of the last year due to their extreme clinical vulnerabilities.
We are now in the first phase of the programme during which young people (aged 16 years and over) with specific clinical vulnerabilities will be offered vaccination.1
The only other group identified by the Joint Committee on Vaccination and Immunisation (JCVI) and the Green Book2 that should be considered for the vaccine during phase 1 are older children (aged 12 years and over) with severe neuro-disabilities and recurrent respiratory tract infections who require residential care. Such vaccinations would be considered unlicensed use,3 and paediatricians should discuss the benefits and risks and limited safety data with children, young people and their parents/guardians. Any vaccination would need to be authorised by a prescriber (usually a doctor).
It is important to stress that at this time the JCVI consider that there are no data to support use of the vaccine in younger age groups or other clinical groups, and we support this view. While this is the case, vaccinations should not be offered to children and young people who fall outside the categories advised by the JCVI and the Green Book. With studies to generate the data for children and young people due to start, evidence will be generated as quickly as possible to enable safe rollout to children and young people.
7 January Lockdown ‘advice’ letters for clinically extremely vulnerable people in England
We are aware that clinically extremely vulnerable children and young people in England have received letters recently suggesting they would be invited for vaccinations in the next month despite not meeting the criteria outlined by the JCVI. We know these letters have caused confusion and upset for families and paediatricians. These letters should not be solely relied upon to identify those eligible for vaccination at this time; rather, we strongly advise all paediatricians and others involved in vaccination to adhere to the advice provided by the JCVI and the Green Book.
Update This article was amended on 29 January 2021 to address paediatricians only.
- 1. Those who are clinically extremely vulnerable will be eligible for vaccination in priority group 4 (after those aged 75 and over). Those with other clinical vulnerabilities specified by the JCVI will be eligible for the vaccine in priority group 6 (after those aged 65 and over). For further details see: www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-30-december-2020/joint-committee-on-vaccination-and-immunisation-advice-on-priority-groups-for-covid-19-vaccination-30-december-2020
- 2. The Green Book, chapter 14a, version 5 (published 21 January 2021)
- 3. The Pfizer BioNTech vaccine is authorised for 16 years and over, the AstraZeneca vaccine for 18 years and over.