Parents from all over the world took to the streets.

The goal is not to force children to be vaccinated against the coronavirus.

It cannot be said that the majority of parents are against vaccines, but it is clear that vaccinating children and adolescents is different from how they view adult immunizations.

Opinions are sharply divided over the effectiveness and safety of vaccination.

Children and adolescents are mostly asymptomatic or mild even if they contract the coronavirus.

There are no children or adolescents who died of Corona in Korea.

This means that there must be a clear advantage to vaccination.

Health authorities are actively recommending vaccination to children and adolescents with underlying medical conditions.

If you have endocrine diseases such as childhood diabetes, chronic respiratory diseases such as heart disease and severe asthma, chronic nervous system diseases, chronic kidney failure, etc., it is much more beneficial to get vaccinated.

Healthy children and adolescents without underlying diseases are allowed to choose whether or not to vaccinate voluntarily with parental consent as the benefits of vaccination are not overwhelmingly large.

As a result of analyzing the effects of vaccination for 16-18 year-olds in Korea, it was found that the effect of preventing infection was 95.8% and the effect of preventing severe death was 100%.

Children and adolescents with underlying medical conditions are twice as likely to develop severe coronavirus infection as those who are healthy.

Major countries, such as the United States, Europe and Israel, started immunizing children and adolescents over the age of 12 in May.

In Korea, vaccinations are in progress for children and adolescents aged 12 to 17 years (born 2004 to 2009) who are in the sixth grade of elementary school through the second grade of high school.

Vaccination has begun for 16-17 year olds, and 12-15 year-olds will soon be vaccinated.

On the 18th, the Korea Centers for Disease Control and Prevention (KCDC) invited pediatric and adolescent experts to hold an online corona vaccination briefing session for students and parents who are worried about whether they should be vaccinated due to concerns about possible side effects.

Based on the information from the briefing session and the questions left by teenagers on the SBS News TikTok channel, we have compiled a list of questions about vaccination for children and adolescents.

Should children and adolescents be vaccinated?

The advance reservation rate of 16-17 year olds who received advance reservations from October 5th to 29th was 490,000 out of 900,000 people, or 55.1%. (As of 00:00 on the 17th) The reservation rate on the first day of the 12-15 year olds taking reservations from the 18th to the 12th of November was 6.8%. Compared to other age groups, the reservation rate on the first day is low. The reservation rate on the first day of 16-17 year olds was 20.8%, 60-64 years old 18.6%, 65-69 year old 21.4%, 70-74 year old 11.5%, etc. Concerns about the benefits and risks of vaccination seem to have been reflected.

Q. Do I have to be vaccinated?

A. Vaccination is not compulsory. This is done only when both the student and their guardians wish. There is no disadvantage even if you do not vaccinate. The Ministry of Education said, "We will not exclude from the density level or make any difference in attendance-related inequality depending on whether or not they are vaccinated." After the vaccination was over, the policy was communicated to the metropolitan/provincial offices of education and schools to prevent discriminatory measures such as investigating who among the students were vaccinated or providing benefits to the vaccinated students.

Q Can students not get vaccinated if their parents object?

A. Minors must obtain parental consent.

Based on the voluntary consent of the person who inoculates himself and his/her guardian (legal representative), he/she makes a reservation for each individual rather than a group inoculation, and then administers the inoculation at a consigned medical institution nationwide.

Parental consent is not required when making a reservation, but parental consent or parental accompaniment is required for vaccination.

You must decide whether to vaccinate in consultation with your parents about the safety, effectiveness, and adverse reactions of the inoculation.

Q. Do I need to be vaccinated again if I have been confirmed with Corona in the past?

A. Even if you have been infected with Corona in the past, your immunity may decrease over time, and cases of re-infection have been reported.

Health authorities are recommending vaccination for additional protection.

Q. Should I be vaccinated if I have allergies or atopic diseases?

A. Health authorities believe that vaccination is possible with caution unless there has been a severe and severe allergic reaction to a component contained in the vaccine.

Allergic reactions that are not related to the vaccine or its components are not contraindicated in vaccination, so they can be vaccinated like any other non-allergic child.

However, it is necessary to check whether there has been an allergy in the past to any component in the preliminary diagnosis, and it is necessary to observe it after inoculation.

Vaccinations and school life?

Q. Will attendance be accepted if absent after vaccination?

A. In principle, students go to school after vaccination, but if an adverse reaction occurs, attendance is recognized even if they are absent without a separate medical certificate for up to two additional days in addition to the day of vaccination. From the 3rd day, attendance due to illness can be processed through a doctor's certificate.

Q. Will there be any changes to the academic calendar due to vaccination?

A. The health authorities set the inoculation period to be 4 weeks in order to minimize the disadvantages of students in evaluations such as midterm and final exams. There is no change in the academic schedule because the vaccination is carried out individually, rather than as a group, like the vaccination for high school seniors. Vaccination dates can be selected based on individual wishes and school academic calendar.

If it is unavoidable to be vaccinated during the test period, it is necessary to confirm the doctor's diagnosis, etc. The Ministry of Education said, "In case of unavoidable overlap, acknowledgment points will be given as a result of attendance up to two days after inoculation in accordance with city/province guidelines for academic performance management or school regulations."

Q. Can I go to group activities such as field trips or experiential learning after completing vaccinations?

A. Vaccination is entirely a personal choice, and since we do not investigate whether or not students are vaccinated, group activities are possible regardless of whether they are vaccinated or not.

There was also a question as to whether unvaccinated persons must undergo PCR testing to be able to participate in group activities, but the health authorities explained, "There is currently no plan to conduct regular PCR testing on children and adolescents."

However, it said that PCR tests can be performed in advance if necessary for subjects living in close communal life, such as dormitory, dormitory living, group training, etc.

Q. Are there any countermeasures against the issue of bullying for non-vaccinated persons?

A. The Ministry of Education announced that it will instruct schools not to create an atmosphere forcing students to vaccinate children and adolescents because it is voluntary, not compulsory.

In particular, he said that he would continue to provide guidance in life so that there would be no division between students.

Q. Can I be accommodated even if I can't make a reservation during the reservation period?

A. Vaccination for non-vaccinated persons continues even after the set inoculation period is over.

Health authorities will provide detailed plans after the vaccination period is over.

The plan is to create opportunities for those wishing to be vaccinated so that they can be vaccinated at any time.

Are vaccines safe for children and adolescents?

Q. What vaccines do children and adolescents receive?

A. Currently, Pfizer vaccine is the only coronavirus vaccine approved for use in Korea for use over 12 years of age. In March, Pfizer announced that the results of a phase 3 clinical trial on 2,260 adolescents aged 12 to 15 in the United States showed 100% effectiveness in preventing the coronavirus. While 18 people in the sham vaccine group were confirmed to have coronavirus, there were no infections in the vaccinated group. Side effects such as pain, fever, chills, and fatigue were confirmed to be similar to those of the 16 to 25-year-old clinical trial. As a result of follow-up of some participants who completed the second dose, the antibody retention rate was similar to that of those aged 16 to 25 after a month.

On May 5, 2021, Health Canada approved the use of the Pfizer vaccine for 12-15 years of age, and on May 10, the U.S. Food and Drug Administration (FDA) also approved the emergency use of the 12-15 year-old Pfizer vaccine. The European Union (EU) Commission also approved its use on 31 May. The World Health Organization (WHO) concluded on July 14 that the Pfizer vaccine is suitable for children 12 years of age and older.

In some countries, the Moderna vaccine is vaccinated to children and adolescents. Canada, the UK and Europe have approved the Moderna vaccine for teenagers. However, the U.S. Food and Drug Administration (FDA) has withheld approval of the Moderna vaccine for use in adolescents. The Wall Street Journal reports that the FDA has delayed its approval decision to review whether the Moderna vaccine causes inflammatory heart disease. The FDA has not yet determined how high the risk is, but said the decision could be delayed for weeks. Moderna applied for approval to vaccinate children between the ages of 12 and 17 in June.

Q There are individual differences in growth level and weight. Can I get the same dose of vaccine?

A. Regardless of weight, growth, or development, children and adolescents aged 12 to 17 years are vaccinated in the same dose and dosage as adults in accordance with the Korean Ministry of Food and Drug Safety's approval. Health authorities have determined that it is safe and effective through clinical trials and medical verification.

Q In what order are the cervical cancer, flu, and corona vaccines correct?

A. There is no limit to the interval between the corona vaccine and other vaccines. Inoculation can be given several days later to observe adverse reactions, but in theory, it is possible to inoculate on the same day. The health authorities recommended giving priority to the two vaccines, corona and flu (since corona is currently in an epidemic and flu season is approaching), and the cervical cancer vaccine is given at a small interval to monitor for adverse reactions. .

Q What should I pay attention to when getting vaccinated?

A. The inoculation should be administered in a healthy state, and after inoculation, stay at the injection site for 15 to 30 minutes and observe if any adverse reactions such as anaphylaxis occur.

In order to be careful of myocarditis or pericarditis, you should refrain from excessive exercise for about a week, and if new symptoms persist or worsen, you should see a doctor.

Vaccine Adverse Reactions?

A total of 329,363 cases (as of 00:00 on October 20) were reported that they had received the vaccine and experienced an adverse reaction in the past 8 months after the start of the corona vaccine.

The adverse reaction reporting rate is 0.45% of all vaccinated patients.

Among them, 1,127 deaths occurred and 10,000 cases suffered permanent disability or sequelae.

This number was calculated based on information reported by medical institutions as suspected adverse reactions after vaccination.

This does not imply that there is a causal relationship between the vaccine and the adverse event.

Currently, 7 cases (two deaths) have been recognized as adverse reactions by the government.

The biggest reason for hesitating about vaccines is because of concerns about 'adverse vaccine reactions'.

According to the results of a survey conducted by Korea Research on 1,000 adults over the age of 18, 4% said they would postpone vaccination and monitor the situation, 1% said they would only get vaccinated when absolutely necessary, such as leaving the country, and 1% said they would receive vaccinations. In total, 8% showed a passive attitude toward vaccination, with 3% of the respondents saying they would not receive the vaccine.

As a reason for hesitating about vaccines (duplicate responses), 70% cited 'concern about adverse reactions to vaccination'.

Survey results for children and adolescents did not differ significantly. According to the Korea Centers for Disease Control and Prevention (KCDC) survey of 340,000 parents and 270,000 students, 69.1% of those who said they wanted to be vaccinated, and 17.1% of students who said 'probably will not get vaccinated' or 'will never get vaccinated'. Regarding the safety of vaccines, 57.6% of parents and 50.9% of students answered that they thought it was 'safe'. On the other hand, 26.8% of parents and 24.2% of students thought it was unsafe. The most worrisome thing is the unexpected 'side effects'.

Q What are the adverse reactions that occur after vaccination?

A. Adverse reactions known so far are common symptoms such as pain at the injection site, fever, fatigue, and headache similar to adults, and may occur within a few days after inoculation. As a serious adverse reaction, anaphylactic reactions that can occur with any vaccination as well as the corona vaccine can occur very rarely. Pfizer vaccines can cause myocarditis or pericarditis.

▶ Myocarditis: Inflammation of the heart muscle. Symptoms include chest pain, heart palpitations, and shortness of breath.

Pericarditis: Inflammation of the membrane surrounding the heart. The most common symptom is chest pain. Pain when breathing deeply or coughing.

Q. Are the side effects more severe for male adolescents?

A. In the United States and Canada, there has been a report that the number of cases of acute myocarditis diagnosed by male adolescents receiving mRNA vaccines such as Pfizer and Moderna has increased. According to the British daily The Guardian, a research team led by Dr. Tresh Hog of the University of California, USA, analyzed the side effects of the vaccine and found that male adolescents had a higher risk of getting myocarditis after receiving two doses of the vaccine than the risk of being hospitalized due to corona infection. appeared to be high.

The research team analyzed data on adverse reactions reported by adolescents aged 12 to 17 years who received two doses of Pfizer vaccine in the United States in the first half of this year. There were 94 cases. For women, this probability was 13 cases per million. The risk of myocarditis among male adolescents is higher than that of healthy American adolescents (44 cases per million) being hospitalized in the next 120 days. However, the paper said the study was not peer-reviewed. "It's not clear how reliable the data from the study is, or whether similar figures will appear in the UK under the same conditions," The Guardian reported.

Q. What were the adverse reactions of high school 3rd graders who were vaccinated earlier?

About 880,000 Pfizer vaccines were administered to 430,000 high school students, and 3,979 cases of adverse reactions were reported. The report rate was 0.45% of the total number of vaccinations, and 97.6% of them were common adverse reactions such as fever, headache, and joint pain.

There were 26 cases of myocarditis or pericarditis reported as myocarditis or pericarditis by the 10th day after the high school 3rd vaccination, and as a result of reviewing the accuracy of the diagnosis by October 7th, 16 cases were recognized. Health authorities analyzed that 3.6 cases per 100,000 vaccinations were not many. There were no patients with underlying cardiovascular disease, 14 males and 2 females. Seven cases occurred after the first dose and 9 cases occurred after the second dose. Of these, 5 received outpatient treatment and 11 received inpatient treatment, and all are now discharged.

Q What should I do if an adverse reaction occurs?

A. Health authorities advise you to go to the emergency room immediately if you have symptoms such as shortness of breath or swelling. For mild adverse reactions such as fever, chills, or headache, it is helpful to take adequate rest and take acetaminophen-based antipyretic analgesics. If symptoms are severe or last longer than 48 hours, seek medical attention.

In particular, since myocarditis and pericarditis can develop within a few days after Pfizer vaccination, it is recommended that you seek medical attention immediately if you experience chest pain, pressure, discomfort, palpitations, or fainting.

Q. Can menstrual disorders occur after vaccination?

A. Vaccination and menstrual problems do not yet have any definitive evidence to determine whether they are related. Health officials said they were still being followed.

According to data released in the UK on October 14, more than 40,000 menstrual-related adverse events were reported after 48.8 million vaccines were administered.

There were many cases where the amount of bleeding was higher than usual, the cycle was delayed, or vaginal bleeding occurred suddenly, and most of them were temporary symptoms and it is known that they recovered within a range that did not harm health.

In Korea, as of October 3, there were 949 reports of adverse reactions related to irregular bleeding.

Health authorities recommend seeing a pediatrician or obstetrician if the bleeding is excessive or the cycle is very irregular.

Vaccination of children and adolescents, what is the situation in other countries?

Opinions on the efficacy and safety of vaccines for children and adolescents are still divided.

However, considering the necessity, effectiveness, and safety of vaccination, the judgment prevails that it is advisable for children aged 12 to 17 years to be vaccinated.

In many countries, such as the United States and Canada, vaccination is recommended for all adolescents 12 years of age and older.

The Centers for Disease Control and Prevention (CDC) found that unvaccinated adolescents were 10 times more likely to be hospitalized.

As a result of analyzing data from 14 state hospitals from June to July, the vaccine was effective in preventing severe cases of Corona in 12-17 year-olds.

The CDC recommends that everyone over the age of 12 get vaccinated to prevent the spread of coronavirus.

Although most states in the United States are voluntarily vaccinated, Los Angeles recently announced that it will be mandatory for children 12 years of age and older.

Students who exercise the right to veto are excluded from face-to-face classes and can only take remote classes, which is strongly opposed by parents.

The Joint Committee on Vaccination and Immunization (JCVI), an advisory body to the UK Ministry of Health, announced on 3 September that it would not recommend a coronavirus vaccine for healthy 12-15 year-olds. This is because the benefits of vaccination are not great. Most children and adolescents showed no symptoms or mild symptoms even if they were infected with Corona, and they recovered spontaneously. For healthy adolescents, it was difficult to see that the benefits of vaccination outweigh the risks of vaccine side effects. However, after controversy, UK health authorities have decided to vaccinate children aged 12 to 15 years old, considering children's right to education, mental health and public health. You only get one dose of Pfizer vaccine. High-risk individuals may receive two doses of the vaccine.

In June, Germany issued a recommendation to vaccinate only those 12 to 15 years of age with underlying medical conditions. However, as the spread of the delta-mutant virus accelerated in August, the number of recipients to be vaccinated was expanded to all age groups aged 12 and over. According to the German Vaccine Council (STIKO), nearly 10 million children and adolescents in the United States have been vaccinated against the coronavirus, and judging from this, the benefits of vaccination outweigh the risk of very rare side effects.

In Sweden, children aged 12 to 15 can only be vaccinated if they have lung disease, severe asthma or other high-risk conditions.

Q Many children and adolescents have been vaccinated abroad. What are the adverse reactions?

A. In the United States, after receiving 8.9 million Pfizer vaccines for 12-17 year olds by mid-July this year, there were 9,246 adverse reaction reports. Of the 9,000 cases, general adverse reactions such as pain at the injection site, fever, and fatigue accounted for 90.7%. Serious adverse reactions were reported in 863 cases, or 0.01% of the total number of vaccinations. There were no deaths from myocarditis or pericarditis, and all recovered.

Q In the UK, adolescents are vaccinated once, so why do we get 2 doses?

A The reason why the UK reduced the dose to a single dose is because side effects such as myocarditis and pericarditis mainly occurred after the second dose. However, our health authorities have determined that a single dose of vaccination may reduce the effectiveness of prevention. Health officials said they had determined that a sufficient number of vaccinations based on a medical review was better given the growing number of confirmed cases in children and adolescents.

Q. Can children under the age of 12 be vaccinated?

A. In June, China approved the Shinovac vaccine for the 3-17 year olds. It became the first country to approve a vaccine for children of the age group. Currently, countries such as South Africa, Chile and Indonesia have started synovac vaccine for children. Israel recommends vaccination against the coronavirus for children aged 5 to 11 years with underlying medical conditions, and several Latin American countries, such as Chile and Cuba, are also vaccinating children aged 6 years and older.

The U.S. is expected to start vaccinating children between the ages of 5 and 11 from next month.

The White House coronavirus response team said delivery of the vaccine and syringes for children will begin as soon as the emergency approval of Pfizer vaccine for children is granted.

The vaccine for children is one-third the dose for adults.

If the health authorities approve, vaccination will start immediately at pediatric hospitals, pharmacies and schools across the country.

If the US FDA holds an advisory committee meeting on the 26th to review the efficacy and safety of the vaccine, the Centers for Disease Control and Prevention is expected to urgently approve the vaccination early next month.  

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