The story so far: India started vaccinating adolescents (15-17 years of age) from January 3, this year. The Union Government decided to extend vaccination coverage to the adolescent group in view of the increasing cases of Omicron globally, and on the strength of the recommendations of the ‘COVID-19 Working Group of National Technical Advisory Group on Immunization (NTAGI)’ as well as its Standing Technical Scientific Committee. Registration is to be done on the CoWIN app, and walk-ins would also be allowed. Covaxin is the only vaccine that is now available for children, in the same configuration as used for adults, though two vaccines, including ZyCoV-D, have been cleared for use. All those whose birth year is 2007 or before, are now eligible for COVID vaccination.
As per figures on the CoWIN portal, 30.8% of those in the 15-17 age group have received their first dose, as on January 8.
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Do children need to get a vaccine?
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This was a question on the minds of many parents, confused by conflicting information coming on social networks. While experts, including at the World Health Organization (WHO), indicated that children are relatively safe from COVID-19 and that the disease did not affect them as severely as it affected adults, basing the decision to open schools on such immunological evidence, vaccination for children had commenced in the U.S. and the U.K. Children as young as 5 years were eligible to get a shot in the U.S.
While the jury is still out on that, divergent views continue to prevail on whether children need vaccination or not, outside the anti-vaxxer’s bubble too. T. Jacob John, retired Professor of Clinical Virology, CMC Vellore, who has also served on NTAGI earlier, says ultimately it is the decision of the parent, but as far as safety goes, “Covaxin as such is absolutely safe, since it uses an inactivated virus. Efficacy also rests in the number of doses one gets —the more means better protection.” He recommends that a virus neutralisation antibody test is done in a small sample size, and if the results are problematic, additional doses may be advisable.
He also stressed the importance of planning ahead for booster shots.
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What about a vaccine’s shelf life?
Some parents who took their children in for vaccination on day 1 to private hospitals were asked for consent to administer the vaccine since the shelf life of the vaccine to be used had been ‘extended’. After media reports claiming that expired vaccines were being recycled for use emerged, the Union Government sought to clarify this on January 3.
While they did not provide data in support of the decision to extend the shelf life of the vaccines, the Government claimed that the Central Drugs Standard Control Organisation had responded to a request from Bharat Biotech to extend the shelf life of Covaxin from 9 months to 12 months.
The national regulator then decided to approve the request, “based on comprehensive analysis and examination of stability study data” provided by the manufacturer. It pointed out that the manufacturer of Covishield had also petitioned for, and secured, an extension of shelf life to 9 months from the earlier six months.
There was no dilution in the efficacy of the vaccines, a source in the health department added.
Does the vaccine have side effects?
As with adults, post vaccination side effects in adolescents reported so far included fever, headache, body ache and heaviness or pain in the injected arm. Major adverse effects following immunisation have not been recorded so far. Meanwhile, Bharat Biotech issued a statement dissuading children from taking paracetamol to counter the side effects of the vaccine.
"We have received feedback that certain immunisation centres are recommending taking three paracetamol 500 mg tablets along with Covaxin for children. No paracetamol or pain killers are recommended after being vaccinated with Covaxin.” The release added: “Through our clinical trials spanning 30,000 individuals, approximately 10-20 per cent of individuals report side effects. Most of these are mild, resolve within 1-2 days, and do not require medication. Medication is only recommended in consultation with a physician,” it said.
What’s the future?
Immunisation experts have urged the Government to monitor all AEFI (adverse event following immunisation) carefully, and report it on a database.
“This disease is going to stay with us for a long while. Vaccination is definitely on the cards, even for children. We have to proceed to lower age groups, if it is safe and reasonably efficacious in 15-year-olds, it should be extended to 12 years plus, and then, to five-year-olds too,” Dr. Jacob John adds. There is no word yet on extension for lower age groups from the Government.