As rituals of summer return to America, the national goal of herd immunity against the coronavirus has been largely abandoned. States are instead focusing on at least partially immunizing a minimum of 70 percent of adults. There’s a problem with this strategy, though: It leaves out children. In fact, some parents and doctors have recently suggested that there should be no urgency to vaccinate U.S. children, given the risk of rare heart complications, the fact that covid-19 is typically mild in young people and the concern that vulnerable people in other countries still lack the vaccine.
But teens and young children, if the vaccine is approved for them, must be part of our approach if we are to end this pandemic — and not just because anyone, irrespective of age, can be infected with and transmit the SARS-CoV-2 virus. Sustainable control of the coronavirus will certainly require vaccinating children. And kids have the right to live free of the threat of the virus, too.
The Food and Drug Administration has authorized the coronavirus vaccines for adolescents 12 and older, and manufacturers are testing lower doses to use on even younger kids, possibly as early as this fall. Although covid-19 tends to be milder or asymptomatic in children, new variants of concern continue to emerge, including the delta variant, which is substantially more infectious than the original virus and many other variants.
So far, vaccines used in the United States seem to be holding up against these variants, but the risk of the virus to unvaccinated individuals remains significant. At this point, most covid-19 deaths and hospitalizations are among the unvaccinated.
Barely 48 percent of the U.S. population has been fully vaccinated. While many states have reached the goal of 70 percent of adults receiving at least one dose of a coronavirus vaccine, more states (particularly in the South) are well below this target. County-level variability in immunization rates is even starker. It is hard to imagine gaining sufficient ground against the virus without vaccinating a large share of teens and children.
Vaccinating children would eliminate the need to choose between keeping them safe and restoring a sense of normalcy for them. After all, children will be going back to indoor classrooms this fall; children are subject to testing every time they get the sniffles; children often wear masks, even in hot weather; and many children are missing out on the swim lessons and birthday parties that still haven’t resumed in parts of the United States. Even when kids do engage in these activities, parents worry about the looming risk of the variant du jour.
The Centers for Disease Control and Prevention issued guidance this month saying that vaccinated children and teachers can go maskless in school buildings this fall — a recommendation that could open new risks to unvaccinated young children if there is no way to ensure that those shedding their masks have truly had their shots.
Given the substantially higher risk of covid deaths and hospitalizations in older people, it was appropriate to focus on adults — particularly older adults — in the early part of the outbreak. The World Health Organization continues to appropriately recommend prioritizing various adult groups, such as health care workers and the elderly, for the first 50 percent of the vaccine supply. However, for the past several months, the United States has had sufficient supply for vaccinating its population.
What about global vaccine equity? Should young people in the United States be considered for the shots when many older adults in low- and middle-income countries remain unvaccinated? This view treats vaccine equity as a zero-sum game — which it is not.
Increasing global vaccine access will require ramping up production and distribution manyfold both in the United States and through global technology transfer, with donations of doses from high-income countries as a short-term strategy. The United States must redouble its efforts to increase global access to vaccines and do so with fierce urgency.
Taking away vaccines from young people in America would yield only a small fraction of the doses the rest of the world needs. And if there is a substantial increase in cases and hospitalizations in the United States — already a country with one of the highest death tolls from covid-19 — domestic pressure on the government is likely to decrease the willingness to prioritize global vaccine access.
Like many policy choices in this pandemic, vaccinating young people is a challenging one. Even though young people have a lower risk of severe covid-19 effects, vaccination is the rational choice for their own benefit, and for society’s. Returning to normalcy and resuming school, sports and social interaction without fear of the virus are the least we can do for those responsible for our future.