As the start of the school year approaches, the issue of contamination at school and the protection of children is coming back to the fore. Is vaccination the solution? For experts, it must be intensified and the protocol for children who cannot be vaccinated must be strengthened.
One week before the start of the school year, the fear of an outbreak of Covid-19 in schools is mounting and the question of the vaccination of the youngest comes back to the fore. Injections have been possible for 12-17 year olds since mid-June. To date, nearly 58% of 12-17 year olds have received at least one dose of vaccine and 35% are fully vaccinated, according to data from Public Health France. To intensify this vaccination, the Minister of National Education announced that a campaign would take place in September via schools for students who wish.
But should the youngest be vaccinated as well? It is the fear of some who march under the slogan “#TouchezPasAuxEnfants” in the demonstrations against the health pass. Jean-Michel Blanquer recalled last week that the vaccination of under 12s “is not topical” in France.
What have we learned about immunizing children and adolescents in the past 18 months? What data has changed? Overview with specialists interviewed by Agence France Presse (AFP).
A rebound in the epidemic in the lower age groups is considered inevitable by experts. “There will be a mix, we will put in contact individuals who have not seen each other, coming from different places”, in particular from tourist areas where the virus has circulated a lot, underlines to AFP, epidemiologist Mircea Sofonea. Even if the vaccination rate in France is now high (more than 70% of first-time vaccinated), “there remains a vulnerable population”, explains to AFP the epidemiologist Antoine Flahault, citing the under 12s and the small half of 12-17 year olds not yet vaccinated. “Once infected, they will easily find in their relatives the 5% of the population (at risk) which is enough to make a wave,” he notes. According to Arnaud Fontanet of the Institut Pasteur, the models of his research center predict that “half of new infections will occur in children from the fall”.
We must, according to experts, stop believing that children transmit Covid-19 less than adults: “with a variant two to three times more transmissible, children are now as contagious as adults were with previous strains “, emphasizes pediatrician and infectious disease specialist Robert Cohen. CO2 sensors in the classrooms, increased ventilation and air filtering, self-tests for intensified virus screening, wearing a mask from 6 years old, all these experts are calling for an ultra-reinforced protocol for children who cannot be vaccinated. And the vaccination of a maximum of teachers, parents and school staff in contact with children.
The vaccination figure among 12-17 year-olds is “very encouraging”, believes Robert Cohen, president of the National Professional Pediatric Council, which these days receives “a lot of calls from parents who have decided to vaccinate their children” before the back to school. “We must amplify the campaign. It is a real health issue, they must be vaccinated to limit the circulation of the virus,” we told the Ministry of Health on Tuesday during the weekly briefing on vaccination. From September, campaigns are scheduled in schools. With the objective also, according to the Ministry of Health, to bring to the vaccine “the children of reluctant or hesitant families”, in particular in working-class circles. For Antoine Flahault, we could have “made the vaccination of adolescents compulsory” because it is “the period when we have the most social interactions” with the risk of forming a “very large source of contamination”.
In mid-June, pediatricians were not recommending vaccination of the youngest. “We were very mixed and advocated focusing on adults, but Delta has changed the game,” said Robert Cohen, saying he fears that Covid-19 will turn into “a pediatric disease” if the virus only circulates in the unvaccinated, therefore especially children. “Mathematically, there will be more infected children, with the risk of being hospitalized or of serious forms”, estimates the infectious disease specialist, while since the start of the epidemic, France has deplored less than one ten child deaths for 5,000 hospitalizations and 700 intensive care.
Also judging that “the severity of Covid-19 is not to be neglected” in children, Mircea Sofonea cited estimates speaking of “5 to 20%” of long Covid, likely to also affect children, with symptoms ” that may affect their quality of life or even cognitive repercussions “. The expert also mentioned the risk of “reactivation of the Epstein-Barr virus, the mononucleosis virus which can remain in a latent state, and of interactions with other viral infections”. “A British study estimates the proportion of children who have developed a long Covid at 4 to 8%,” adds Antoine Flahault. For Mircea Sofonea, with a stronger contagiousness of Delta and a higher virulence according to Canadian and Scottish studies, there are clearly more benefits than before to also vaccinate the youngest.
The “only known side effect” which mainly affects young boys (one chance in 15 to 20,000) is the risk of myocarditis (inflammation of the membrane surrounding the heart), a “rare, closely watched” effect which is easily treated. according to Robert Cohen. As for the supposed lack of hindsight, Mircea Sofonea recalled that “more than 2.5 billion people have been vaccinated” in the first dose on the planet since December 2020, “with all possible physiologies, the most degraded lands. he had toxic potential, he would have already spoken “. “We have a very good vaccine, particularly well tolerated and effective, already injected into millions of adolescents, we do not have such extensive experience with other vaccines,” says Antoine Flahault.
To say that messenger RNA vaccines would be dangerous for the youngest is also a falsehood, underlines the infectious disease specialist Robert Cohen. “This messenger RNA story is almost medieval: in any viral infection, the virus enters the cell, expresses its messenger RNA – its genetic material – which produces proteins, exactly like a vaccine”, explains- he does. “We vaccinate with a very small part of the genome of the virus which ends up disappearing very quickly”, adds Mircea Sofonea, unlike, for example, the rubella vaccine, based on a live attenuated virus.
According to the pediatrician Robert Cohen, the bar had been set at this age not for fear of a lack of maturity of the organism of the children but because “we had realized that even if the teenagers made less serious forms , they transmitted the disease more than the smaller ones “. With the emergence of Delta, the American laboratories Pfizer and Moderna have launched clinical studies for children under 12, currently in phase 2 and 3 (dosage and tolerance). The first results are expected at the end of the year at the earliest and the authorizations for use, not before 2022. For the little ones, “we will necessarily be more demanding because the Covid infection is less dangerous than for the adult “, underlined Antoine Flahault who is favorable there while judging that the most urgent is to reinforce the prevention in the schools.
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