Will France follow the countries which are more and more numerous (United States, Israel, Canada, etc.) to authorize the vaccination of children? On November 25, the very day when the European Medicines Agency gave its approval for the use of the Pfizer vaccine in 5-11 year olds, the government announced the forthcoming referral, on this subject, to the National Consultative Ethics Council and of the High Authority for Health. The vaccination campaign for this age group could start in early 2022.
If the executive, while adjusting the protocol at the elementary school, advances on this track, it is that at the time of the fifth wave the incidence rate among 5-11 year olds has almost quintupled in three weeks: according to Public Health France, it reached, on November 25, 210 cases per 100,000 (against 193 all ages combined).
In children, hospital admissions are also on the rise, with admissions to critical care having even doubled in a week. But with figures that remain low: 0.2 cases per 100,000 inhabitants. “Pediatric services are saturated because of the bronchiolitis epidemic but not the Covid”, annoys epidemiologist Dominique Costagliola, convinced that“We got the wrong target”. 5-11 year olds, presenting “Very few serious forms”, they would not shoot “No direct benefit” to get vaccinated. “It comes down to asking them to protect the millions of adults who, refusing the vaccine, choose not to protect themselves. “
Sensitive to this ethical issue, the Academy of Medicine weighs the pros and cons in a recent opinion. It evokes the potential reduction in the circulation of the virus in the environment of the child and the possibility of avoiding “Class closures, learning delays and social and economic costs for families”. But she mentions the lack of perspective on possible side effects and the advantage that there could be, in terms of herd immunity, in letting the virus circulate. “In the least-risk groups”.
In the end, the Academy recommends extending vaccination only to children with co-morbidities or living in the entourage of vulnerable people. A study by the Institut Pasteur, published in The Lancet Regional Health Europe, shows that the presence of children in a household – especially when they attend primary school – very significantly increases the risk of contracting Covid-19.
“Before vaccinating children, you must ensure that the risk-benefit ratio is positive”, confirms Fabienne Kochert, president of the French Association for Ambulatory Pediatrics. “We must now draw up a profile of children who could be vaccinated as a priority”, she continues. And to remind: “Among the twenty or so young patients who have died in France from Covid since the start of 2020, almost all of them presented with severe comorbidity. “
There remains the unknown of the new variant and its possible effects on the youngest.“Without prejudging it, it should be remembered that the children have so far mainly suffered psychically from the measures taken to stem the pandemic, the weakening of social ties and school closures ”, emphasizes Fabienne Kochert. One more element to add to the debate.