Decision of the STIKO: The vaccination for children remains voluntary

It is not surprising how much disappointment and uncertainty, sometimes even confusion, the decision of the Standing Vaccination Commission (STIKO) caused not to give a general vaccination recommendation for children from the age of twelve. However, this is not due to the decision itself. It is more due to the fact that the Federal Minister of Health, the government and many doctors did not want to wait for the decision and have clearly spoken out in favor of the widest possible use of child vaccination. The signals from the European approval authority were green, other countries are aggressively promoting child vaccination.

For many, the contradiction can hardly be resolved: Does vaccinating children make sense or not?

And above all: is it safe?

As far as that is concerned, the answer was already given at the end of May with the formal approval by the European approval authority.

The data presented by the manufacturer in its registration study with more than a thousand vaccinated children and on the basis of the large clinical study for adults were unambiguous.

The active ingredient performed even better in the children than in those over eighteen.

Decision not accepted

In its recommendation, however, the STIKO has to evaluate much more than effectiveness and safety. Based on the currently available evidence, it assesses the value of a vaccination with a view to the vaccination protection for the vaccinee himself and the protection against infection as a whole. That does not mean that it makes cost-benefit considerations. It decides neither according to economic nor political criteria. Rather, it looks at as much as possible all available and verifiable data that can be used to say something about the risks, complications and benefits for the individual and society. Real-world data from other countries are also included, provided they are meaningful.

In principle, the vaccination recommendation is a complex big data project that must be completed as quickly as possible by the independent and voluntary scientists on the committee.

It goes without saying that this does not necessarily have to end with a thumbs up or thumbs down, as is the case with vaccine approval.

Some parents may have hoped that the scientists would make the decision for or against the vaccination easier for them, or that they would lose weight entirely.

But vaccination is and remains voluntary, it is a personal decision between children, parents and doctors, like any other medical treatment.

More harmless than the flu

For almost half a million children with previous illnesses, and there are quite a few, the matter is clear: the risk of developing severe Covid-19 infection is statistically greater than the risk of the known side effects of the vaccine. Vaccination makes perfect sense for them.

For everyone else, things are a little more complicated because they are very fortunate not to get sick if they contract the virus. Of the approximately 188,000 children between the ages of twelve and seventeen who have been shown to have become infected in the country since the first wave, a small proportion - less than one percent - have been treated in clinics. Another hundredth of it had to be treated or ventilated in an intensive care unit. This means that Covid-19 is more harmless in this age group than seasonal flu. And there is no STIKO vaccination recommendation for the flu.

Of course, you could now name the almost four hundred children who have so far suffered from the multisystemic inflammatory disease PIMS caused by the coronavirus.

This overreaction of the immune system can be stressful for weeks.

But even of these children, like most of the other young Covid 19 patients and despite the two documented deaths, many would be protected in the future - simply because the vast majority of these children have a previous illness and should therefore be vaccinated according to the recommendation of the STIKO and the doctors .

Nobody wants a compulsory vaccination

But what about the long-term consequences of an infection, called long-covid? The previous data from children on this, as the STIKO has also made clear, is too meager. The evidence is an important goal, but that is flexible and can change over the next few months. The same also applies to the question of whether vaccination helps students to get a better grip on the overall infection process, keyword community protection or herd immunity. Anyone who massively promotes child vaccination, especially with this argument, as can be seen in the United States, runs the risk as a society of jeopardizing the will of many to vaccinate. Nobody wants a disguised vaccination obligation.

The core of the STIKO recommendation is therefore: voluntariness and security are paramount, and that is not a small amount. Anyone who is willing to accept the known, previously low vaccination risks can and can have their children vaccinated.