South Africa has extended Vaccination with Covid-19 to adolescents between 12 and 17 years old. In the week of October 10-16, 2021, this age group accounted for 14.7% of new reported Covid-19 cases, down from a peak of around 20% in the middle of the third revival.
As of mid-October 2021, children ages 10-19 constituted 9.2% of all Covid-19 cases reported since the beginning of the pandemic.
Adolescent vaccination can reduce the duration of symptoms, limit transmission to others and allow an earlier return to school and normal activities.
It is particularly important for teens with underlying conditions such as diabetes, cancer, HIV, and obesity. Our data in the National Institute of Communicable Diseases has shown that adolescents with these underlying conditions have a higher risk of death from Covid-19 compared to adolescents without underlying conditions. These underlying conditions accounted for 22% of adolescents. admitted to hospital with Covid-19 but 60% of those who died from it.
When the plan to vaccinate adolescents was announced, there were some key differences between the vaccination schedule intended for adolescents and the one already used for vaccination in those over 18 years of age.
First, teens will only be offered the Pfizer Cominarty vaccine. This is the only SARS-CoV-2 vaccine currently approved by the South African Health Products Authority for use in this age group (per Section 21, Access for Emergency Use). Adults can get the Pfizer or Johnson & Johnson vaccine.
Second, adolescents will only receive a single dose of the vaccine, as opposed to the two doses given to adults. The decision was cautious as more safety information is accumulating for this age group.
Countries such as the United States, Denmark, France, Germany, Ireland, Italy, Spain and Switzerland have already vaccinated many millions of adolescents. His experience will guide the countries that Follow the example.
The Pfizer vaccine has been shown be safe in adolescents between the ages of 12 and 17 in North America and Europe. Side effects are similar in adolescents and adults. Myocarditis (inflammation of the heart muscle), a rare side effect of the vaccine, has been reported in Europe and North America, most commonly after vaccination. second dose of vaccine. It occurred in 20-150 cases per million doses of Pfizer vaccine administered and was more common in men than women. Most of the cases were mild and people recovered quickly with supportive care.
The use of a single dose has raised concerns about limited efficacy in reducing transmission, while diverting resources to vaccinate the elderly, 40 years and older, who are in advanced age. higher risk of serious illness and death.
Compared to adults, adolescents are more like have only mild or asymptomatic infections, less likely to suffer from persistent symptoms after Covid-19, and less likely to be hospitalized or die from Covid-19. But they can transmit the SARS-CoV-2 virus to others, especially in settings where the implementation of non-pharmaceutical interventions is poor.
in a clinical trial In the US, two doses of the Pfizer vaccine were shown to be 100% effective in reducing all new Covid-19 infections among children. A single dose reduced all new infections by 75%.
A great study of Israel found that one dose of the Pfizer vaccine was 59% effective 14-21 days after vaccination. The effectiveness increased to 66% 21-27 days later and to 90% after the second dose.
A growing number of studies, mainly among health workers and their household contacts, is it so demonstration that there is a gradual reduction in the risk of asymptomatic infection with the increasing number of Pfizer doses received. TO study in england found a 40-50% reduction in the risk of asymptomatic infection among household contacts of healthcare workers who received a dose of the vaccine. The risk of asymptomatic infection was a 70-80% lower reduction among contacts of healthcare workers who received two doses.
The effectiveness of one dose was higher against symptomatic infection compared to asymptomatic infection.
The efficacy of one or two doses of the vaccine in preventing transmission from healthcare workers also depended on the vaccination status of household contacts. New infections were fewer among contacts who were vaccinated with two compared to one dose or none.
Therefore, the extent to which the single dose marked in the adolescent ear is effective in limiting transmission to household members is likely to depend on the extent to which all other members of the household or around the adolescent are vaccinated.
Therefore, it is important that all adults, 18 years of age and older, are vaccinated to limit the transmission of SARS-CoV-2 to and from adolescents in their homes.
This vaccination offer should encourage conversation and discussions about Covid-19 vaccines among adolescents and adults. Adults could take this opportunity to vaccinate themselves and reduce their own risk of hospitalization and death.
Perhaps the most contentious issue surrounding adolescent vaccination is that of vaccine equity.
Is it justifiable to extend vaccination to younger age groups when there are older adults who are not yet vaccinated and are still at risk of severe Covid-19 and death? There is an urgent need to understand the reasons why vaccine coverage in older adults has remained low. Is it poor access? Is it lack of knowledge or misinformation? Can adolescent vaccines be used to improve access in older adults? These are the tough issues that policymakers must grapple with.
For parents, caregivers and adolescents, to vaccinate or not will ultimately depend on access, perception of risk and choice.
Tendesayi Die-Chakezha, Epidemiologist and Public Health Specialist, National Institute of Communicable Diseases; Melinda suchard, Chief, Center for Vaccines and Immunology, National Institute of Communicable Diseases, and Michelle J. Groome, Chief of the Public Health Surveillance and Response Division, National Institute of Communicable Diseases