To vax or not to vax? Discussing with your child

After much discussion and debate, the UK’s Chief Medical Officers have concluded that healthy 12-15-year-olds should all be offered one dose of the Covid-19 vaccine. Ministers must now decide whether to accept this recommendation, but the likelihood is that the vaccine will very shortly be available to everyone in the country over the age of 12.

This will bring us in line with many other countries who have been vaccinating 12-15-year-olds against the disease for some weeks, including France, Israel, the US and Canada. However, it has been no easy decision for the CMOs, who have been considering the finely balanced argument very carefully.

It is also no easy decision for parents. We all want what’s best for our children and to protect them at all costs. Choosing whether to vaccinate against a whole wrath of childhood and adult diseases is something that every parent must consider – and this can only be done by weighing up the balance of risk vs benefit relative to your own child. Your decision regarding the Covid vaccine should be no different.

So how do you decide what’s best for your child and what information should you be considering?

With most adults having taken up the offer of vaccination, we have seen the dramatic and life-saving impact of it. The irrefutable evidence is a stark reduction in hospitalisations and deaths of the double-vaccinated, despite infection rates remaining stubbornly high. This demonstrates a clear break in the infection-mortality chain.

The roll-out of the vaccination programme has been remarkably successful, enabling us to be where we are now, living (virtually) normal lives again after 18 months of restrictions.

Fortunately, the chances of a child becoming seriously ill from Covid has always been very small and deaths are incredibly rare, almost always linked to another life-limiting condition. This was why the Joint Committee on Vaccination and Immunisation (JCVI) stopped short of recommending the jab to all 12-15-year-olds a few weeks ago. They suggested instead that only those with specific underlying health conditions (and therefore at risk of Covid itself) in this age group should be eligible.

But as we know, children’s lives have been disproportionately impacted by Covid 19 despite them being at low risk from the disease itself. With ongoing school closures, social isolation, increased screen time and exam cancellations – our children have paid a huge price for our societal protection of the elderly and vulnerable.

Mental health issues among young people have risen dramatically, with anxiety and eating disorders at record levels; so much so that Child and Adolescent Mental Health Services (CAMHS) are at breaking point in most regions.

In making their latest recommendation, the Chief Medical Officers have made it very clear the direct health benefits of the vaccine for 12-15-year-olds are marginal. However, experts have chosen to look at a much wider picture, taking many other factors into account; of which the main concern is disruption to education.

Children in deprived areas are far more likely to be negatively impacted by school closures and it is universally agreed that any future closures must be avoided at all costs.

So, despite no clear and obvious advantage of the jab to the physical health of 12-15-year-olds, it is hoped that including them in the vaccination programme will reduce disruption to their education, as well as potentially protecting more vulnerable peers and relatives.

Parents may also be dealing with children who feel very anxious about Covid-19 and are keen to have the vaccine. Children with older siblings may well want to be afforded the same protection as the rest of their family and getting access to the jab will come as a relief.

For any younger children (under 12) worried about not having access to the vaccine, approval is being looked at by various health agencies in different countries – but reassuringly, the risk of Covid to this age group is extremely low. Younger children should be supported to feel confident that their chances of getting ill are incredibly small and hence why they are not being included in the vaccine programme at this stage.

What are the concerns around the vaccine?

For other people however, vaccine safety, remains a concern. No vaccine or drug can ever be 100% safe and a very small incidence of inflammation of the heart (myocarditis) has been seen, particularly in boys, following this particular jab.

To put this risk in context, for every million second doses of the Pfizer vaccine given to 12-17 year old boys – 60 were affected by the heart condition. There may also be a risk of myocarditis from the Covid infection itself, but no definitive answer is yet available, making it more difficult to weigh up the true health benefit of the vaccination for this age group.

Parents and children may also be concerned about longer term risks or side-effects of what is regarded as a very new vaccine. The huge advance in scientific modelling and expertise that has gone into creating these life-saving vaccines must be taken into consideration and deserves widespread confidence – but promising 100% safety is simply not possible.

Informed choice and consent

By making this recommendation for 12-15-year-olds, the CMOs and Ministers are offering parents and their children an important choice. But there is concern over the issue of consent. With the vaccine likely to be given in schools, parents will be asked to give consent – but in the event of the child and parent having opposing views, the child will get the final say if considered ‘competent’.

This is an extremely thorny issue and many parents will feel extremely concerned about the lack of say and control over something so incredibly significant. It is essential that parents sit down with their teenagers – and indeed their schools -to discuss views, concerns and wishes. Schools will be under huge amounts of pressure too and will want to work with parents to ensure that consent is provided.

When talking to children, be armed with accurate, impartial information. Listen to what your child has to say, any concerns they might have and be clear that together, you do have choice. Many parents are concerned about peer pressure on their child to either have or not have the vaccine – but the best way to tackle this is to ensure they are fully informed and therefore confidently empowered by their own knowledge.

We have all been living in tumultuous times since March 2020 and our lives have been affected in ways we could never have imagined. We have all had to make difficult decisions, weighing up what is best for each of us personally and our families – with people having strong and passionate feelings.

The experts have now spoken and set out their clear reasoning behind the recommendation to vaccinate children, relating predominantly to continuity of education. They have been open about the complexity of this decision and the vast range of factors that have been taken into consideration.

It is completely right that over 12s are being given access to the vaccine. However, informed consent means just that. It must now be up to parents and children to talk openly about the choice on offer, with full respect being given by everyone to whatever decision families make.