Vaccination against Covid-19: what speaks for and against child vaccination

According to the register of the Society for Pediatric Infectious Diseases, 464 cases have so far occurred in Germany. That would correspond to about one PIMS for 1,600 Covid cases in children. Since the actual number of infections among children is probably many times higher than the official number due to the high number of unreported cases, the proportion is likely to be lower. In the USA one currently assumes 0.03 percent PIMS cases. “Nevertheless, for me it would be an argument in favor of the vaccination,” says Tim Niehues. “But we don’t yet know whether the vaccination really protects against PIMS.”

Then there is the great unknown – Long Covid. Is there a risk that the children will be deprived of all joie de vivre for months or even years, as reports suggest? “We have to assume that Long Covid also exists in children and adolescents,” says Jörg Dötsch. “What is relatively clear: the younger the children, the less likely.” There are studies according to which every seventh child could be affected.

The problem with long-covid studies

“The study situation is still unclear, however,” says Dötsch. “On the one hand, this is due to the fact that Long Covid is not precisely defined – fatigue and exhaustion could also be consequences of depression as a result of the pandemic.” A study from Switzerland found symptoms with a similar frequency in childrenwho had been infected with Sars-CoV-2 and children who had not. “Such a control group is usually missing in the Long Covid studies,” says Jörg Dötsch.

“We have to assume that Long Covid also exists in children and adolescents”(Jörg Dötsch)

The study by the authors led by Thomas Radtke from the University of Zurich also had the advantage that the children did not know whether they had become infected (antibody tests were carried out at longer intervals). “This is the effect of a self-fulfilling prophecy,” says Jörg Dötsch. The pediatricians see no reason in Long Covid to advise vaccination now and refer to experience with other viruses, such as the Epstein-Barr virus (EBV), the causative agent of Pfeiffer’s glandular fever.

“Long-term consequences from excessive activation of the immune system after virus infections are rare,” says Niehues. “EBV activates the immune system as much as possible, 90 percent of the population also have antibodies – and yet” Long EBV “is relatively rare.” The individual fates are bad, but no reason for horror scenarios. “I would expect something similar for Sars-CoV-2: yes there is Long Covid, but no, so far there are no studies and clinically valid data that suggest that we are getting an epidemic among children.”

The risks of vaccination

But wouldn’t it be ethically advisable to protect individual people from such a fate? And in view of the unclear data: what if the side effects of a Sars-Cov-2 infection for children were different and worse than the pediatricians expect? What do you risk if you vaccinate your five- to eleven-year-olds as a precaution to protect them from possible Covid consequences?

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