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All you need to know as government confirms single dose of Covid-19 vaccine will be offered in school to 12 to 15-year-olds

Youngsters aged 12 to 15 in England will be offered a first dose of a Covid-19 vaccine in schools from next week, the government has confirmed this evening.

It follows unanimous advice to ministers from the four UK chief medical officers.

Children aged 12-15 will be offered one dose of the Pfizer vaccine
Children aged 12-15 will be offered one dose of the Pfizer vaccine

Consent from a parent, guardian or carer will be sought prior to the Pfizer/BioNTech vaccine being administered, as it is in with the current in-school vaccination programmes for HPV and diphtheria, tetanus and polio (DTP).

But if a child and parent do not agree and the child is considered competent to decide, the final say will rest with the child.

Alternative provision will be offered for those who are home schooled, in secure services or specialist mental health settings.

Health and Social Care Secretary Sajid Javid said: “I have accepted the recommendation from the Chief Medical Officers to expand vaccination to those aged 12 to 15 - protecting young people from catching Covid-19, reducing transmission in schools and keeping pupils in the classroom.

“I am very grateful for the expert advice I have received from the Joint Committee on Vaccination and Immunisation and UK Chief Medical Officers.

“Our outstanding NHS stands ready to move forward with rolling out the vaccine to this group with the same sense of urgency we've had at every point in our vaccination programme.”

Children aged 12 and over who are vulnerable to Covid-19, or who live with an at-risk person, have already been eligible for vaccination.

In many countries around the world, all over-12s have already been eligible for vaccination.

People aged 16 & over who have received Covid-19 vaccine. Graph: PA (51197793)
People aged 16 & over who have received Covid-19 vaccine. Graph: PA (51197793)

What did the JVCI say?

Earlier this month, the independent Joint Committee on Vaccination and Immunisation (JCVI) had been unable to recommend expanding the vaccination programme to the entire age-group on health grounds alone, despite acknowledging that “the benefits from vaccination are marginally greater than the potential known harms”.

It noted that the risk of Covid-19 to healthy children was small, and took into account the small number of cases of post-vaccination myocarditis, or inflammation of the heart muscle.

Total population unvaccinated in UK nations. Graph: PA (51197795)
Total population unvaccinated in UK nations. Graph: PA (51197795)

The condition, which affects more boys than girls, can cause chest pain and heart palpitations, although cases of it are usually mild and children normally recover quickly with treatment. The JVCI report suggests three to 17 cases per million are seen after one dose of the Pfizer/BioNTech vaccine, with 12 to 34 cases seen for every one million second doses.

In its report, the JVCI noted: “The potential risks from vaccination are also small, with reports of post-vaccination myocarditis being very rare, but potentially serious and still in the process of being described.”

Myocarditis can also be caused by Covid-19 and resolves itself in most cases.

Why was the chief medical officers’ recommendation different?

The chief medical officers (CMOs), who had a wider remit to consider, advised the health secretary that the “additional likely benefits of reducing educational disruption, and the consequent reduction in public health harm from educational disruption” provided sufficient reason to recommend vaccinating the group.

This disruption, they noted, had been particularly acute in areas of “relative deprivation”.

Modelling assessed by the CMOs suggests 30,000 infections could be prevented in England between October and March, preventing 110,000 days of missed schooling, the equivalent of one day for every 20 pupils.

The CMOs sought advice from a range of experts, including the Royal College of GPs and the Royal College of Paediatrics, and said they consider education “one of the most important drivers of improved public health and mental health”.

They added: “The effects of disrupted education, or uncertainty, on mental health are well recognised.

“There can be lifelong effects on health if extended disruption to education leads to reduced life chances.

“Whilst full closures of schools due to lockdowns is much less likely to be necessary in the next stages of the Covid-19 epidemic, UK CMOs expect the epidemic to continue to be prolonged and unpredictable.

“Local surges of infection, including in schools, should be anticipated for some time. Where they occur, they are likely to be disruptive.”

During a Downing Street briefing today, England’s chief medical officer Professor Chris Whitty said that vaccination “will reduce education disruption” but added: “We do not think this is a panacea, it is not a silver bullet”.

Covid-19 vaccine doses in the UK. Graph: PA (51197797)
Covid-19 vaccine doses in the UK. Graph: PA (51197797)

Prof Wei Shen Lim, from the JCVI, said there was “no conflict” between the advice provided by the JCVI and that from the CMOs, stressing that the JCVI had looked at jabs from a health perspective.

Dr June Raine, from the Medicines and Healthcare products Regulatory Agency (MHRA), said the side effects for 12 to 15-year-olds being vaccinated are “mild”.

On myocarditis and heart issues, she said: “We’ve undertaken a very thorough review, both of the UK and the international reports, there is a consistent pattern, slightly more often frequently do we see cases in young males and after the second dose.

“But, overall, the conclusion of our expert advisers is these are mild cases, individuals usually recover within a short period of time with standard treatment.

“Our advice remains that the benefits outweigh the risks of getting vaccinated, and this includes those aged 12 to 15.”

Why did the CMOs recommend only one dose?

The fact that most cases of myocarditis are seen after a second dose, while most of the benefits would be seen after the first, prompted the CMOs to recommend a single shot at this stage, although they have indicated they would revisit that decision in the spring.

A million doses of the vaccine would prevent 87 hospital admissions and two intensive care admissions among those aged 12 to 15, data suggests.

A million second doses would prevent only a further six hospital admissions and 0.16 intensive care admissions.

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