The COVID-19 pandemic in children and young people during 2020-2021 : a complex discussion on vaccination

Rudan, Igor and Adeloye, Davies and Katikireddi, Vittal and Murray, Josie and Simpson, Colin and Shah, Syed Ahmar and Robertson, Chris and Sheikh, Aziz, Public Health Scotland and the EAVE II Collaborators (2021) The COVID-19 pandemic in children and young people during 2020-2021 : a complex discussion on vaccination. Journal of Global Health, 11. 01011. ISSN 2047-2978 (

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In this, second of the two editorials on children and young people (CYP) in the COVID-19 pandemic, we focus on the complex discussion on vaccination of minors against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Vaccination of children and young people (CYP) against COVID-19 remains highly debated, with considerable policy divergence internationally. Vaccinating younger age groups was not an initial plan when the original variant of the SARS-CoV-2 virus emerged, because CYP seemed mildly affected by COVID-19 when compared to adults, as discussed in the first editorial. However, new mutations led to increased transmission of SARS-CoV-2. This led to an increase in the population threshold of vaccination coverage required for prevention of viral spread, possibly to levels above 80% vaccine uptake in the whole population. Also, due to the successful roll-out of vaccination to older and at-risk populations, the virus began to circulate in greater numbers amongst younger populations, which became a new concern. An important element was also the issue of broader harms, such as educational disruption, which can also become a determinant of long-term health. A broader perspective weighted the long-term impact across multiple dimensions of human life and shorter-term health concerns. In addition, increasing awareness of the possible rare complications of COVID-19 in CYP, such as Multisystem Inflammatory Syndrome in Children (MIS-C), and the "long COVID" syndrome prompted the scientific study and comparison of the risks of disease vs the safety of vaccination, even among the very young