The committee looked at the data for a long time, and now the decision has been made: Stiko recommends that parents in Germany also have healthy children between the ages of five and eleven vaccinated against Covid-19. The decision was not easy and will probably draw criticism. Some will consider the recommended single dose to be insufficient, while others will question the point of vaccination at all. In fact, the decision is a wise compromise. The slowness of the Stiko, which is sometimes criticized, proves to be a strength and a bulwark against the sometimes polemical escalation of the debate.
At first glance, there is much to be said against child vaccination at this point in time. According to estimates, more than 80 percent of the children have already been in contact with the virus. Most were infected during the omicron wave, the consequences were manageable. No age group copes with the virus as well as this one: only one in 10,000 previously healthy children had to be treated in hospital for a corona infection. Of the eight children who died in Germany in this age group, all had previous illnesses. Long-Covid symptoms do occur in children, but it is difficult to prove whether they were really caused by infections or other stress factors.
So why should a healthy child be vaccinated now? Two reasons. First of all, no one knows what will happen next. A winter wave among children is considered likely. If we could assume further omicron waves, a general vaccination could not be justified. But you also have to reckon with new variants or a return of Delta. Secondly, we now know better than a few months ago that children between the ages of five and eleven cope remarkably well not only with corona infections, but also with vaccinations; the risk of vaccine damage is negligible in this age group.
So the Stiko had to weigh up: On the one hand, the not exactly known risk of future variants plus the uncertainty of how well the current vaccine will work against them at all; on others the extremely small but existent risk of vaccine damage in the children. She made a compromise. Since immunization through a one-time infection is just as unreliable as a one-time vaccine dose, both should be combined, and the incomplete immunization should be supplemented by a vaccine dose.
In this way, you will most likely increase the basic protection and at the same time keep options for action open. Then you can wait for further developments. Which variants will appear in winter? What vaccines will then be available? In the race between the human immune system and the virus, time works to the advantage of the children: the long interval between the first and a possible second vaccination has a positive effect on the development of a good immune response.
The lengthy examination of the study situation and the compromise that is now available makes it clear that the Stiko’s decision was a close one. Clear, large effects are generally easier to detect, for the subtleties, science needs a lot of data. It would therefore be neither completely irresponsible not to have your child vaccinated despite the recommendation, nor would the vaccination expose your child to irrational risks. It would be totally out of place to get excited about the decision.
In the course of the pandemic, the Stiko was sometimes subjected to severe allegations, especially on the sensitive issue of child vaccinations. Some complained about the slow work, the hesitant decisions of the commission. Others suspected that politicians were putting pressure on a decision. It is feared that children could ultimately be vaccinated for the benefit of the elderly and not for their own benefit. The 18 honorary commission members no longer have to put up with this accusation.
Stiko has professionalized its work, with the help of full-time employees, mountains of specialist literature have been viewed. It is credible that the long-considered decision was primarily about individual protection and the well-being of the child.
One inconsistency should be noted: double vaccination is recommended for children in close contact with patients who may be at risk. This could come as a surprise to some, since – as is now known – the protection against pure infection with omicron, i.e. protection from others, disappears within a few months. Here the provisional character of the decision becomes clear. As the situation changes, you have to reckon with new, adjusted decisions by the Commission.