International comparison of the impact of the pandemic and vaccination measures adopted on children and adolescent population

Background

The objectives of this study were to compare the cumulative incidence, hospitalizations and mortality, by country and age group, in child and young people (CYP) from the beginning of the pandemic to January 2022, and to describe the differences and similarities and justification in the measures adopted in relation to CYP vaccination against SARS-CoV-2.

Methods

A descriptive quantitative summary of the available data on the impact of the COVID-19 on children and adolescents (<18y) from 7 countries (Chile, Colombia, Paraguay, Nigeria, Ghana, Spain) or regions (Kocaeli, Turkey), based on official published data was performed. Outcome measures were: available data on incidence, admission to hospital and to intensive care units (ICU), and deaths, by country or region; vaccination plans, including age, type of vaccine and official justification about the proposal.

Results

All countries analyzed data showed variable incidence rate, and relatively low ICU hospitalizations and deaths. Vaccines used and age at starting were also variable, i.e. starting at 3-5y in some Latin American countries, while in other countries proposal starts at 15y old. Almost all justifications were based on the idea to promote collective protection, and that vaccination is important as it -directly and indirectly-protect the rest of the population.

Conclusions

The results reinforce the idea of the urgent need to prioritize globally and equitably distribution of vaccines in the population at greatest risk, and to apply the precautionary principle in CYP before deciding to massively vaccinate it.

What is known

The child population has less severe infections and seems to transmit the infection less than the adult population.

Published data from the Randomized Clinical Trials (RCT) of vaccines in minors presented short follow-up than in the adult population and basically studied the incidence of infection as the main endpoint

What this study adds

Mortality in the child population due to COVID-19 since the start of the pandemic has been low in all the countries analyzed

The vaccines used as well as the vaccination guidelines shows high variability in these countries

The results of the study reinforce the need to establish global and equitable mechanisms for the distribution of vaccines and prioritize the population at greatest risk, such as older people.

In the child population, it is necessary to apply the precautionary principle before establishing massive vaccination plans