Katy Balls

The moral debate over Covid jabs for children

The moral debate over Covid jabs for children
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Israel has the world’s attention, becoming the first country to achieve mass vaccination. What it does now may be followed worldwide. The first big development has been the use of immunity ID cards which give vaccinated Israelis access to gyms, indoor restaurants and — soon — holidays in Greece. Britain is preparing to follow suit, with Michael Gove considering UK vaccine certificates ahead of the great unlocking on 21 June. He’s widely expected to come out in favour of IDs in some form.

But the other idea attracting interest in Whitehall is Israel’s plan to vaccinate children. Israel’s deputy health minister Yoav Kisch has said those aged 12 to 16 could start to be vaccinated next month, pending regulatory approval. A few weeks ago, Israel spotted a problem with their plan to hit herd immunity. No one is quite sure what the magic number is, but the general assumption is that if you hit 80 per cent of the population you’re there. But how to get there? If vaccines are 70 per cent effective in stopping all infections and 80 per cent of the people got vaccinated, then just 56 per cent of the population would have immunity from vaccination. Mass vaccination of adults alone may not be enough.

Nachman Ash, Israel’s national vaccine coordinator, raised concerns about this. ‘The fact that children under the age of 16 are not currently getting vaccinated is certainly troubling, in terms of the ability to achieve herd immunity,’ he said in January. Last month, Israel became the first country in the world to vaccinate over-12s who have specific risk factors — but the idea is to extend this to all over-12s in the coming weeks. One of the worries in Israel is that high transmission of Covid among unvaccinated youth could produce new vaccine-resistant variants.

The idea that children should be vaccinated is also catching on in America. The US director of infectious diseases, Dr Anthony Fauci, has suggested that those as young as five could receive the jab by next year (about a quarter of Britons and Americans are under 18). Several studies are under way in America to test vaccines on children. In Britain, the Oxford-AstraZeneca vaccine has been given to 300 children aged six and over in a trial. Results are expected soon; odds are that it will pass.

The bigger question is whether ministers would choose to proceed with a vaccination programme for British children, and if so, how they would make a convincing argument for it. Health Secretary Matt Hancock declared in December that the vaccine would ‘not be used on children’ as ‘the likelihood of children having significant detriment if they catch Covid-19 is very, very low’. The fatality rate for under-20s with Covid-19 is estimated at 0.003 per cent.

But the argument in government is changing. If children are vaccinated against Covid-19, it will help build up herd immunity for the entire population. A vaccine for your son would not primarily be for his sake, but for his country’s. Rather than the grown-ups looking after the kids, the reverse would be true.

Professor Edmunds has said we must start ‘turning to children as fast as we can’ to stop the disruption in schools when a class is sent to self-isolate after one case of Covid. Part of the decision about whether children should be vaccinated will come down to the data on the effectiveness of the vaccines at stopping transmission. Boris Johnson previously warned that schools may act as ‘vectors for transmission’, causing the virus to spread between households. If the vaccine can stop a child from passing Covid on, this form of transmission could be prevented.

‘The more data there is to show the vaccines stop transmission, the more you will hear arguments about giving it to children and young adults,’ says a figure who helped draft government policy at the beginning of the pandemic. With Public Health England’s head of immunisation saying this week that the current Covid vaccines may stop people passing on the virus ‘almost completely’, it’s clear which way the wind is blowing.

Should ministers give the idea the green light, they will need to make new arguments and answer new questions. What is the duty of a family to society? Does a child have a moral obligation to protect an adult? Any vaccination programme among the young would require the government to ask parents to volunteer their children to complete the great national effort for herd immunity. The risk from vaccines is negligible, as worldwide experience shows. But hesitancy is a problem among adults, and may be far greater among parents who must decide whether or not to vaccinate their children.

Israel is already wrestling with these moral dilemmas. The vast majority are willing to take the jab themselves — but a poll found only 41 per cent of parents plan to vaccinate their kids. With vaccine passports now in use there, a parent’s decision not to vaccinate a younger member of the family could end up precluding the child from parts of society.

Tories like ‘nudge’ policies, which gently steer people in the right direction. One example of such a policy could be that vaccinated children would be exempt from lateral flow testing in schools. Or vaccinated children might be given freer access to sports or group facilities, or allowed to accompany parents into restaurants. A recent article in the New England Journal of Medicine suggested appealing to parents’ public spirit, by thanking children and parents for helping to protect others. One idea was that children could be given badges to wear that say ‘Sars stars’ or ‘Corona diplomas’.

These sorts of policies create moral issues. And given that uptake of the vaccine is thought to be lower among some ethnic minority groups, there’s a clear risk of a childhood vaccination programme inadvertently creating segregation in society, if some families choose not to vaccinate their children.

But Britain will soon be facing all of these moral questions because our vaccination programme is progressing so fast. By July, most adults will have been offered a jab — and most will have said yes. The UK is one of the most pro-vaccine nations in the world. Whether this sentiment extends to our children remains to be seen. The battle against Covid may be being won — but the debate on vaccinations is only beginning.

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‘No, you can’t have a note excusing you from PPE.’