Are children neglected again in the Corona crisis? What is more dangerous for the little ones: an infection with SARS-CoV-2 or a vaccination? And should children be vaccinated against Covid-19 in particular to protect the vulnerable groups in society?
dr Jana Schroeder, chief physician at the Institute for Hospital Hygiene and Microbiology in Rheine, told Euronews "the most relevant and also most objectifiable reason for vaccinating children is to avoid the PIMS syndrome". PIMS stands for Pediatric Inflammatory Multisystem Syndrome, which is also known as Multisystem Inflammatory Syndrome in Children (MIS-C). It is a severe inflammatory syndrome that can occur in children several weeks after contracting the coronavirus, even if they are had only very mild or hardly any symptoms of Covid-19 In Germany, more than 660 children have been affected by PIMS since the beginning of the pandemic, but the number of unreported cases is probably much higher.
In an interview with SPECTRUM, Johannes Tück, pediatric immunologist at the University Hospital Zurich, says that about half of the children suffering from PIMS have to go to the intensive care unit. "Most make a full recovery, but some may have long-term problems." Tück explains that the consequences for the heart in later life are still unclear.
Studies from the US and France show that vaccination against Covid-19 does indeed protect children from PIMS.
In view of the still very high number of infections among children in Germany, physicians from various disciplines demand in an open letter: "Measures to protect against infection and child protection must now be considered and implemented together in order to protect children, young people and families as best as possible." It is also about protection against PIMS.
And the co-signatories around Julian Schmitz, Professor of Clinical Child and Adolescent Psychology, continue to write: "Child vaccinations should be carried out efficiently, offered in a low-threshold manner and advertised in the sense of a vaccination campaign. Vaccination at schools could mean that a large number of children could be offered vaccinations ."
Less than 20 percent of children aged 12 in Germany are vaccinated
But in Germany, less than 20 percent of children under the age of 12 are vaccinated against Covid-19.
According to a survey quoted by the medical journal, parents who are not vaccinated against Covid-19 believe far more often than vaccinated parents that natural immunization through infection with a pathogen is safer for their child than through vaccination. For the non-vaccinated parents it is 42 percent, for the vaccinated only 16 percent.
After the European Medicines Agency EMA had approved vaccinations with BioNTech/Pfizer for children, the Standing Vaccination Commission (STIKO) in Berlin did not issue a general recommendation, but instead saw "after careful analysis of the available data – including from the current fourth wave of infections – in the opinion of the STIKO currently only has a low risk of severe COVID-19 disease, hospitalization and intensive care for children without previous illnesses between the ages of 5 and 11. After a final risk-benefit analysis, STIKO has therefore decided at this point in time, initially only an indication vaccination recommendation and not to make a general COVID-19 vaccination recommendation for 5- to 11-year-olds."
Prof. Dr. At the end of 2021, Philipp Henneke from the Freiburg University Hospital spoke of the discrepancy between incidences and disease burden and explained: “There is little to be gained from the vaccine for the individual child to be vaccinated and therefore this vaccine must really be beyond any doubt as far as safety is concerned ".
At the end of December 2021, the US health authority CDC published data showing that the risk of heart muscle inflammation after vaccination against Covid-19 is significantly lower in children between the ages of 5 and 11 than in adolescents. In the US, the vaccination campaign for children had started much earlier than in Europe.
In Austria, Health Minister Wolfgang Mückstein said immediately after approval by the EMA at the end of November 2021 that it was important to have children vaccinated – not only because they too can have serious illnesses, but also because of the danger posed by "Long Covid".
The child and adolescent psychologist Julian Schmitz says: "If we had had a STIKO recommendation for children from the age of 5 last autumn, as well as a strong and low-threshold vaccination campaign, children and families would probably get more normality back now."
The virologist Isabella Eckerle from the Geneva University Hospital now writes in a guest article for the Berliner Tagesspiegel: "Even if the individual risk of omicron compared to Delta is also lower for children, Sars-Cov-2 still has a disease burden that is magnitude of other vaccine-preventable childhood diseases."
And Eckerle also warns of Long Covid: "Precisely because many aspects of Covid-19 are not yet understood, the precautionary principle should continue to apply. Let's not fool ourselves: Sars-Cov-2 is still a virus that has only been known for a relatively short time and still a long way from classifying itself as one of the harmless cold viruses. The long-Covid clinical picture has not yet been adequately researched, but for that very reason it cannot simply be ignored. As yet unknown long-term consequences cannot yet be ruled out."
In SPECTRUM, immunologist Onur Boyman from the University Hospital Zurich compares the vaccination of children with infection with Covid-19: "Is it safer to expose yourself to a natural infection with an unpredictable virus dose or to expose yourself to a clearly defined dose of a vaccine? The side effect profile of vaccination is very positive. Vaccination in children makes sense."
A study from the USA is also trying to answer the question of whether PIMS – the serious illness affecting children – can also occur after vaccination. And two-thirds of the children suffering from PIMS despite vaccination against Covid-19 had previously been infected with the corona virus, as also Dr. Georg Hillebrand from Itzehoe summarizes.
According to a study published in the New England Journal of Medicine, infection with the omicron variant of the coronavirus means less immunization and not necessarily protection against other variants of SARS-CoV-2, especially if the course is mild.
Health Minister Karl Lauterbach therefore continues to warn of possible new waves in autumn.
In the past two years, there was already a fear of infection in the classrooms at the start of school after the rather relaxed summer holidays.
Head physician Jana Schroeder has made her analysis of vaccination vs infection clear in a diagram.