The government’s independent vaccine advisers recommended against Covid shots for healthy teenagers despite considering evidence that the jabs would reduce infections, hospitalisations and some deaths in the age group. Modelling reviewed by the Joint Committee on Vaccination and Immunisation (JCVI) in June showed that fully vaccinating 80% of 12- to 17-year-olds would lead to “large reductions” in infections and a “substantial reduction” in hospitalisations in the age group. The modelling from the University of Warwick was considered alongside calculations from Public Health England that found vaccinating healthy young people in an overlapping age group – those aged 15 to 19 – could reduce intensive care admissions and prevent two deaths per million in the teenagers receiving the shots. Details of the models, described in minutes from JCVI meetings held over the summer, have led some researchers to question why the committee did not approve mass vaccinations for healthy young teenagers, but instead passed the decision to the UK’s chief medical officers. “They had two models, one from Warwick and one from PHE, both showing significant benefits of vaccination,” said Prof Christina Pagel, the director of the clinical operational research unit at University College London (UCL) and a member of the Independent Sage group. But they appeared to have “dismissed it”, she said.
The JCVI concluded that the benefits of vaccination were too marginal to justify in healthy 12- to 15-year-olds who rarely get severely ill with Covid. Explaining the decision, the committee cited uncertainties about a rare and typically mild side-effect called myocarditis, and concerns about the impact that a Covid vaccination programme could have on other school immunisations. The UK Health Security Agency said the modelling was “integral” to the committee’s decision. But Pagel believes the JCVI was more concerned than it should have been about the risks from the vaccine and underplayed the potential harm caused by the virus. “The JCVI consistently minimise the chance of bad outcomes of Covid in children as being very rare, but emphasise the rarer chance of developing myocarditis following vaccination,” she said. The UK’s chief medical officers later approved single shots of Covid vaccine for healthy 12- to 15-year-olds after considering the impact on children’s education. The delay in the decision meant that unlike those in some countries, secondary school children in the UK were largely unprotected when they returned to classes in the autumn term. At several points, the JCVI minutes state that natural infection might be better than vaccination for children. The criticisms of the JCVI came as members of Independent Sage and other researchers published work in the Journal of the Royal Society of Medicine suggesting that fully vaccinating healthy adolescents would reduce hospital admissions, deaths and cases of long Covid at the high case levels now seen in the UK. Ravi Gupta, a professor of clinical microbiology at the University of Cambridge and a co-opted member of the government’s New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) said he shared some of the concerns raised about the JCVI. “Besides apparently ignoring the modelling, I’m worried about the lack of appreciation of the negative impacts of mass infection in children, such as long Covid and the risks of new variants emerging because of the low vaccine coverage in 12- to 15-year-olds. “Another issue from my point of view is the lack of internationally known and active researchers on the committee who know the virus. With better representation things would have been very different. The government needs to answer why this group was not radically modified for a Covid remit given the range of expertise available.” Danny Altmann, a professor of immunology at Imperial College London, said: “Among the numerous contributory factors to the currently high caseload and deaths in the UK relative to mainland Europe, a significant one is certainly the impact of having delayed vaccines in secondary schools such that children returned unprotected for the autumn term.” In October, the British Congenital Cardiac Association said that with case rates very high among under-18s in England and Wales, the “balance of benefits versus risks clearly weighs in favour of the Covid-19 vaccine.”