Voluntary COVID-19 vaccination of children: a social responsibility

Abstract

Nearly 400 million adults have been vaccinated against COVID-19. Children have been excluded from the vaccination programmes owing to their lower vulnerability to COVID-19 and to the special protections that apply to children’s exposure to new biological products. WHO guidelines and national laws focus on medical safety in the process of vaccine approval, and on national security in the process of emergency authorisation. Because children suffer much from social distancing, it is argued that the harms from containment measures should be factored in a broader perspective on the good of the child. Considering the available knowledge on the disease, vaccine, and coping strategies, the decision about vaccine access to children is a public responsibility. The ultimate choice is a matter of paediatric informed consent. Moreover, jurisdictions that permit non-participation in established childhood vaccination programmes should also permit choice of vaccines outside of the approved programmes. Even if vaccine supply is too short to cover the paediatric population, the a priori exclusion of children is unjust. It may also exacerbate local and global inequalities. The second part of the paper delineates a prudent and ethical scheme for gradual incorporation of minors in vaccination programmes that includes a rigorous postvaccination monitoring. This is a theoretical paper in ethics that uses the Pfizer vaccine as a stock example, without discussing possible differences among existing vaccines. The key purpose is reflection on the good of the child in emergencies and vaccine policymaking.

COVID in Pediatric Age: an opinion paper

“…Thus, the main ethical arguments in support of COVID 19 vaccination include the following [92][93][94][95]:…”

How low can you go? Justified hesitancy and the ethics of childhood vaccination against COVID-19

“…Brusa and Barilan set out two reasons for vaccinating children against COVID-19: that this does clearly benefit children-for example, through reducing school absences (in effect, denying the prudential interests claim); that vaccination benefits other members of the community (in effect, denying the ethical claim). 7 Both sorts of concerns were raised against the JCVI's recommendations. 8 Ultimately, the UKs' Chief Medical Officers recommended going ahead with childhood vaccination.…”

The COVID-19 pandemic in children and young people during 2020-2021: A complex discussion on vaccination

“…There are real differences in innate and adaptive immunity between children and adolescents, which may affect vaccine efficacy [ 7 ]. Early ethical considerations have concluded, based on appropriate frameworks, that there are strong ethical reasons to vaccinate the young to protect the old, as well as those children, should not be excluded and allowed to get infected, and that this argument should also be considered in policy-making [ 4 , 11 ]. While forming vaccination policies and designing programs, it was expected for the risks imposed on children to be reasonable and carefully considered [ 4 , 5 , 13 ].…”