COVID-19 Vaccination in Pediatric Population: A Necessity or Obstruction to the Protection of the Right to Health? Biojuridical Perspective

Abstract

One of the most recently debated topics worldwide is the mass vaccination of children against coronavirus disease 2019 (COVID-19). Next, the risk/benefit ratio of COVID-19 vaccination and infection in children are compared. Nonetheless, the real question in this debate is as follows: Does the vaccine represent a necessary tool or is it an obstacle in protecting the right to health? From a public health point of view, the Supreme Court of Nova Scotia, in Canada, recommends COVID-19 vaccination in the pediatric population. Based on Article 25 of the Draft Articles on State responsibility, vaccination can be considered a social act necessary for protecting the individual's right to health. The 1989 New York Convention on the Rights of the Child and the European Regulation number 219/1111 state that the opinion of a minor aged >12 years is considerable. However, this validity of opinion is related to age and degree of discernment. The onset of adverse events following the administration of the COVID-19 vaccine may lead to compensation in the near future. Recent studies have identified a new COVID-19-related pediatric pathology, known as multisystem inflammatory syndrome. Other studies have demonstrated that myocarditis in the pediatric population might occur following COVID-19 vaccine administration. In June 2021 in the USA, the Center for Control and Prevention of Infectious Diseases Advisory Committee on Immunization Practices declared that the benefits of vaccination against COVID-19 in the pediatric population outweighed the risks. In the meantime, whereas the bioethical debate remains open, monitoring the real risk/benefit ratio of vaccination in the pediatric population is crucial.

Myocarditis and pericarditis associated with SARS-CoV-2 vaccines: A population-based descriptive cohort and a nested self-controlled risk interval study using electronic health care data from four European countries

“…However, accurate quantification of the risk of rare side effects is crucial to be able to accurately establish benefit-risk profiles of each of the COVID-19 vaccines in specific age groups. Younger people are generally at a lower risk of serious consequences of COVID-19, and the benefit risk balance needs to always be weighed carefully ( Bilotta et al, 2022 ). The EMA is responsible for monitoring the benefit risk balance and in their assessment of the mRNA vaccines has stated that the balance remains positive ( European Medicines Agency, 2021b ).…”

Analysis of spontaneous reports of suspected adverse reactions after vaccination against COVID-19 in Slovakia

“…Moreover, after close evaluation of more relevant scientific data, it will be possible to understand the risk/benefit ratio in all relevant subsets, including the paediatric population ( Bilotta et al, 2022 ). However, clinical trials are not designed to detect very rare adverse events—this requires post-authorisation monitoring.…”

“…Even for these conditionally registered preparations against COVID-19, it is mandatory that during the entire period, their benefits for the patients’ health must exceed the potential risks of damage to health. Close monitoring and studying of complications associated with COVID-19 vaccines in both adult and paediatric populations is urgently required ( Bilotta et al, 2022 ).…”

Anti-SARS-CoV-2 Vaccination and PIMS-TS—Friends or Foe? Case Reports and Literature Review

“…Pediatric inflammatory, multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS), also known as a multisystem inflammatory syndrome in children (MIS-C), is diagnosed in children who develop an inadequate inflammatory response after exposure to the SARS-CoV-2 virus [ 1 ]. The pathogenesis of this abnormal response to viral antigens is not entirely clear; however, it is postulated that many immunological mechanisms and responses to the so-called superantigen take part in hyperinflammation [ 2 , 3 , 4 ]. The symptoms of PIMS-TS resemble Kawasaki disease (KD), systemic juvenile idiopathic arthritis (JIA), and macrophage activation syndrome (MAS), and they require thorough investigation to be properly differentiated.…”