Vaccination with the new coronavirus is about to spread to elementary school age.
Pfizer, a major US pharmaceutical company, has announced that it will apply to increase the age range for vaccination in September from the current age of 12 to 5 years.
It is expected that discussions on child inoculation will begin in Japan as well.
We interviewed experts who are familiar with pediatric medicine and vaccines to summarize the current situation and what to think about it.
Apply to expand vaccine from 5 to 11 years old
On September 20, Pfizer, a major American pharmaceutical company, and Biontech, a German pharmaceutical company, announced the results of clinical trials conducted in the United States and other countries on the vaccine for the new coronavirus.
In clinical trials, 2268 people between the ages of 5 and 11 were vaccinated twice with one-third the usual amount of the ingredient.
One month later, when the value of the neutralizing antibody that suppresses the action of the virus was examined, a strong immune response was confirmed.
Neutralizing antibody levels were the same as when 16 to 25 years old received a vaccine containing normal amounts of ingredients, and side reactions were generally similar, so the target of inoculation was this age. We are planning to apply to the FDA = Food and Drug Administration soon to expand to.
Inoculation age History so far Will it be discussed in Japan in the future?
Pfizer's vaccine was initially targeted at ages 16 and older, but has been expanded to ages 12 and older in May.
At that time, Pfizer announced on March 31 that it had confirmed the safety and efficacy of clinical trials for 12 to 15 years old.
On April 9, I applied to the FDA to increase the age of vaccination.
And on May 10th, the FDA expanded the scope of emergency use permits, and on May 13th, vaccinations of this age began in the United States.
Pfizer also submitted data from overseas clinical trials to the Ministry of Health, Labor and Welfare in Japan.
On May 28, the Ministry of Health, Labor and Welfare decided to add 12 to 15 years old to the age at which vaccination is possible.
Then, on May 31, it became the target of public inoculation and the inoculation started.
At this time, about three weeks after the target of inoculation was expanded in the United States, inoculation in Japan began in this age group.
With the announcement that the safety and efficacy have been confirmed between the ages of 5 and 11, and the application, it is expected that discussions will begin in Japan as to whether this age group will be the target of inoculation.
Expansion of inoculation age Expert "meaningful"
How should we accept the movement to expand the scope of inoculation even in the age of elementary school students?
Tetsuo Nakayama, a pediatrician and professor at Kitasato University who is familiar with vaccines, says that lowering the age of vaccination is significant.
(Specially Appointed Professor Tetsuo Nakayama, Kitasato University)
"Until now, there was no vaccine that children could inoculate. In reality, there are infections at school, in childcare, and in lessons. It is meaningful to be able to do one means. "
There are few cases where children become seriously ill
On the other hand, it is also known that most children who are infected with the new corona are mild and rarely become severe.
According to data from the Ministry of Health, Labor and Welfare, as of September 15, 2021, the cumulative number of infected people in Japan was about 1,625,000, the number of people who died was 14,229, and the mortality rate was about 0.9%. I am.
Of these, about 84,000 were infected under the age of 10 and about 163,000 were teenagers.
Among them, the person who died is one of the teenagers.
According to another Ministry of Health, Labor and Welfare data, 0.09% of those diagnosed between June and August last year were under 10 years old and 0% were teenagers.
There are cases in which children with underlying illness become more severe, but the current situation is that few children become more severe.
Infection is "adult → child" rather than "child → adult"
According to an analysis by an expert meeting of the Ministry of Health, Labor and Welfare, most domestic infections are transmitted from adults to children, and infections from children to adults are relatively small.
It is said that children are infected at school and the like, and it is not like the flu that spreads to families at home.
After an expert meeting on August 25, Chairman Takaji Wakita was asked about childhood infections. We believe that this has led to an increase in infections among children. For now, we do not predict that the situation will be like influenza, where the infections are increasing among children. "
The benefits of vaccination for children
Given this situation and the fact that vaccines have some side reactions, the benefits of vaccines may be less than those hit by adults.
What are the benefits?
▽ Preventing the onset and aggravation The
vaccine currently being inoculated is known to be highly effective in preventing the onset and aggravation of Delta strains.
▽ Reducing clusters in schools and lessons In
the fifth wave of infection spread
, clusters
centered on children occurred through lessons such as schools and cram schools, and it is thought that the occurrence of such clusters can be reduced.
▽ Reduce the risk of infection in the home?
It is believed that vaccination by children can reduce the risk of spreading the infection to people who are not or cannot be vaccinated at home.
Fever as a side reaction should be considered a balance between efficacy and safety
What do you think about vaccine side reactions?
For ages 5 to 11, Pfizer's press release on September 20 only states that it was no different from ages 16 to 25, who were vaccinated with the usual doses of ingredients.
(Professor Nakayama)
"It's not a dangerous vaccine for children, but it's likely that there will be some side reactions. The side reactions of the vaccine may cause fever, and some of them are prone to convulsions. Some children. parents are firmly understand, it is necessary to receive the vaccination to convince, when the inoculation it is important to carry out in the family doctor who knows well the usual physical condition. "
in addition, Japan vaccine Society Professor Kenji Okada of Fukuoka Nursing University, who is the chairman of the university, said that it would be necessary for children with underlying diseases and students who wish to receive the vaccine, and that vaccination of children under the age of 12 is a top priority. He points out that this is not an issue.
(Professor Kenji Okada, Fukuoka Nursing College)
"When a big side reaction occurs in children, it leaves a stigma. Especially, inoculation to healthy children is based on the severity of illness and the effectiveness of the vaccine. , Safety should be considered. "
Differences in circumstances from the United States
In the United States, data from the American Academy of Pediatrics show that the number of children infected with the new coronavirus in the week leading up to the 9th of this month remains at least 243,000, the highest level ever.
In addition, the CDC = Centers for Disease Control and Prevention has reported data that the number of children hospitalized is increasing with the expansion of Delta strains.
Professor Nakayama says that the tendency is different from that of Japan, which should be considered in the future discussion of inoculation.
"In the United States, the vaccination rate is sluggish in society as a whole, and the number of clusters at schools is increasing, so it may be necessary for elementary school students to be able to inoculate. In Japan, people in their 20s and 30s will be required. The vaccination rate of the younger generation and the generation of parents and mothers of children may increase, so it may be okay to take a closer look. "
Identifying Benefits and Risks Whether Children and Parents Want
A vaccine that is a great weapon in the absence of the convergence of corona.
Increasing the target age for vaccination is of great interest as a countermeasure against infection in children.
It is important to carefully assess the benefits such as effectiveness and the risks such as side reactions and consider the balance, and it is necessary to make a judgment including whether the child or the guardian desires it.