DECRYPTION – The High Authority of Health recommends protecting 360,000 children, without ruling on all the others.
A first round of vaccination targeting fragile children now, before a carefully concerted decision for all 5 to 11 year olds. In an opinion published on Tuesday, the High Authority for Health recommends a two-step procedure for the delivery of the Pfizer vaccine to children.
If the idea is taken up by the Minister of Health, the pediatric formula of Comirnaty, authorized last week by the European Medicines Agency, will initially be reserved for the 360,000 children at risk of severe form of Covid and to those who live in the entourage of immunocompromised people.
“Case by case”
Children with chronic hepatic, cardiac or respiratory disease (including severe asthma treated continuously), neurological pathology, immunodeficiency, obesity, diabetes, hematologic malignancy, sickle cell anemia and trisomy 21 are concerned. HAS also suggests including children with diseases involved in severe cases in adults, such as recent cancer, chronic kidney disease, neurological disability, etc.
Vaccination can finally be offered “case by case” by medical specialists. “21% of those under 17 who have suffered from a severe form of Covid-19 presented with co-morbidities, while these children represent only 6% of their age group”, justifies the agency, for which the individual profit in this group is established.
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The pediatric formula, the dosage of which corresponds to one third of the product administered to adults, should be available in Europe from December 20. HAS, on the other hand, gives itself the time “To hear the stakeholders” (pediatricians, general practitioners, parents’ associations) before deciding on a possible enlargement. One of the objectives will be to assess the benefit-risk balance of the vaccine in children, most often suffering from mild symptoms during infection with Sars-CoV-2. In the event of Covid, their risk of developing a severe form is very low. Since the start of the epidemic, three deaths and 228 critical care admissions have been recorded for 5.8 million children aged 5 to 11.
On the other hand, the epidemic is on the rise, and this age group is the one, among school children, which has the highest incidence rate. “Vaccination will have a collective benefit, note the Pr Odile Launay, infectious disease specialist and coordinator of the Covid-19 vaccine scientific committee. Even if it does not prevent it completely, the vaccine reduces transmission because it prevents infection very effectively in children. ”
Can general interest alone be sufficient to guide the administration of a vaccine? Or is it better to let children encounter the virus naturally, the infection giving a priori more robust immunity than vaccination? The question is still debated. Experts are also awaiting feedback from the United States, where several million children have already been vaccinated. “We will then have more certainty about the safety of the vaccine”, emphasizes pediatrician Robert Cohen. The Ministry of Health, for its part, is awaiting the opinions of the National Consultative Ethics Committee and the Vaccine Strategy Orientation Council before making a decision.
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