Children can wait, adults still priority: Experts

With Europe the epicenter of the pandemic once again and countries like the US, too, seeing a surge in Covid-19 cases, a growing concern in India is whether its large pool of unvaccinated children between 2 years and 18 years, numbering about 44 crore, pose an additional risk since the country is yet to begin vaccinating this group.

But experts in vaccination and public health are firm that while children will eventually need to be vaccinated, India’s priority must remain completing the vaccination of its adult population, unless there is an abundant supply of vaccines. Booster doses, too, can wait till a larger proportion of the adult population, who are more at risk of disease, is vaccinated. While there is little data yet on the new variant of concern, Omicron (B.1.1.529), the most vulnerable must continue to have the highest priority for early complete vaccination, they add.

So far, India has fully vaccinated less than half of its adult population of 940 million.

“If you have an abundance of vaccines, certainly children should also be vaccinated. Till that time, complete our adult vaccination programme as effectively as possible and then take up child vaccination, once more vaccines are available,” says Dr Srinath K Reddy, president, Public Health Foundation of India. Virologist Dr Shahid Jameel echoes this view. “In medicine, everything is about risk and benefit. If vaccines were available in unlimited amounts and we could give vaccines at scale, I’d say children should start getting the vaccine. But if those limitations are there, you have to prioritise based on who is likely to get more severe infection, and that’s adults.” Dr Reddy adds that if cases start to go up, there will be a need to protect not just the elderly with a booster but also healthcare workers on the frontlines. “This is a situation which will need periodic review.” Countries like the UK , which have begun rolling out booster doses, have an abundant supply of doses as well as a smaller population compared to India, points out Dr Jameel. The UK has already vaccinated 80% of its eligible population – all those aged 12 and above.

The National Technical Advisory Group on Immunisation, the top government expert panel taking decisions on vaccination, is likely to take up the key issue of vaccinating children against Covid-19 in its next meeting, scheduled for the end of this month, said people familiar with the matter. However, the government has signaled there is no urgency. Last week, VK Paul, who heads the Covid-19 task force, had also said administering booster doses was not an emergency, underlining that the focus must remain on two-dose coverage.

Dr Gagandeep Kang, virologist and professor, CMC Vellore emphasises that India is hampered by the fact that the local data needed to make decisions on vaccinating children is still not being collected. “Ultimately, we need vaccines for children. But there are questions on which vaccine you should use, how many doses you should give, what gives the best benefit-risk ratio – the problem is, we are not collecting age-stratified data of daily cases, such as how many healthy children are hospitalised or how many had comorbidities.” In the absence of our own data, India will again have to rely on data from abroad, though no country besides India has reported about 60% sero positivity among children. India also bore the brunt of the Delta variant earlier than other countries. “Are we then right in using their data directly? Not necessarily,” she says.

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