Evidence from the UK and around the world has repeatedly shown us that children are highly unlikely to become seriously ill because of infection with COVID-19. However, since even before the first lockdown, the College has been extremely concerned about the indirect effects of the virus on children and young people, primarily because of many of the infection control measures in place.
The most important consequences of these have been the disruption to school attendance and children’s extra-curricular activities and the effect of this on their mental health and wellbeing. It has also reduced their access to health services delivered in school and the role schools play in wider health issues such as child protection. Reduced access to school has disproportionately impacted children from more deprived socio-economic groups and could have lifelong repercussions.
We are aware of the many hours of intense scrutiny the Joint Committee on Vaccination and Immunisation has given to the issue of assessing the health benefits and risks of healthy 12-15 year olds being offered the vaccine. The Committee's view was that the margin of benefit, based primarily on a health perspective was, at this time, considered to be too small to support a universal programme of vaccination of otherwise healthy children in this age group.
The RCPCH was subsequently asked by the UK’s Chief Medical Officers to consider the wider aspects of this issue, including that of access to school.
We believe that vaccination could benefit healthy children, irrespective of any direct health benefit, in enabling them to have less interruption to school attendance, to allow them to mix more freely with their friends, to give more protection to friends and family members whose health may be at risk from the virus, and to help reduce the anxiety some children feel about COVID-19. But vaccination of 12-15 year olds must be part of a concerted overall plan to ensure consistent and uninterrupted access to school.
Participation in activities inside and outside of school are key to children’s development, resilience, and mental health and wellbeing. We need to ensure that such participation returns to normal as a matter of urgency. Vaccination of this age group against COVID-19 is not a silver bullet and, in isolation, will not improve school attendance. Children who are vaccinated will have less risk of contracting the virus and less risk of passing it on to others, but they may still test positive and could still become ill, although illness is highly unlikely to be serious.
Routine testing of children without symptoms is still interrupting children and teenagers’ school attendance and we do not believe this should continue. Instead, schoolchildren should be tested only if they have symptoms of COVID-19. At the same time, and as with other infections, they should not go to school if they are unwell.
It is extremely important that any COVID-19 vaccination programme in schools does not interfere in any way with other school vaccination programmes where the health benefits are more clear-cut and have the potential to be lifesaving.
If COVID-19 vaccinations are to be offered to this age group, children, teenagers and their families or carers must receive clear and non-judgemental advice about the risks as well as the benefits. The decision should be a matter of choice and should never be mandatory.
We would be against any plans to make vaccination mandatory for certain activities or events for this age group – or indeed any under-18 year olds.
Children, young people and all of society will directly benefit from an increase in vaccination uptake in the adult population, particularly by those in their 20s, 30s and 40s. Tackling this pandemic, which is still ongoing, does not depend on vaccinating children, who have already borne a great deal on behalf of us all.