In Sweden, healthy children will no longer be vaccinated against the coronavirus in the future. A sensible decision? FOCUS Online asked three German experts for an assessment – the result is clear.
In Sweden, healthy children under the age of 18 will no longer be recommended by COVID 19. In the future, minors should only be vaccinated against Sars-Cov-2 if they belong to certain risk groups.
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But how should this decision be assessed? Act Sweden and Denmark carelessly? Oder wäre es sinnvoll, wenn die Ständige Impfkommission (Stiko) auch hierzulande die Covid-19-Impfempfehlung für Minderjährige überarbeitete?
The epidemiologist and virologist Alexander Kekulé considers this step overdue. FOCUS online he said:
“Yes, the STIKO should check your recommendation again. This still dates from May, and even then the decision for the vaccination recommendation was very scarce. The basis was mainly the experience with the previous variants. I would think it makes sense to now make a new evaluation for Omikron and to incorporate that a lot of children have already gone through an infection. ”
The epidemiologist Klaus Stöhr also considers a reassessment of the vaccination recommendation to be necessary. In response to a FOCUS online request, he writes:
“Ultimately, a recommendation for vaccination is always a benefit-risk assessment. The risk of severe illness from Sars-CoV-2 for children has changed significantly as the virus has adapted to humans. It is therefore right and important that it is also re-evaluated whether the risk of vaccination for children (which is also very low) is still exceeded by the risk of a serious illness.
The answer for Sweden is to lift the vaccination recommendation for healthy children. By the way: in Denmark, the government has apologized to the children for ever having recommended vaccination at all. Therefore, a re-evaluation of the vaccination recommendation for children in Germany is overdue.”
Andreas Radbruch, immunologist and scientific director at the German Rheumatism Research Center Berlin, also comments on the Swedish decision. He goes on to say that the cases of narcolepsy following vaccination against influenza in 2009 made Sweden particularly sensitive to unforeseen serious side effects – even from vaccinations that are actually established.
“It is obvious that children would be more severely affected by long-term and irreversible side effects than adults, but on the other hand much less by the disease itself (Covid-19), at least as far as serious illness and death are concerned,” explains Radbruch.
In addition, there is already a high level of basic immunization due to infections in the vast majority of minors. The immunologist adds: “Here, Stiko’s recommendation to vaccinate recovered children is a bit puzzling to me. In fact, vaccination is only trying to imitate the natural immunization by the virus and thereby avoid the actual disease, but still build up immunity and thus protect against serious illnesses in subsequent contacts with the virus.
Alexander Kekulé also has doubts that the vaccination of children and adolescents who have already survived a corona infection brings an additional benefit: “The infection, like the vaccination, only protects against further infections for a very short time. But all the data that we have shows that a vaccination or a previous infection protects adults and especially the very old from serious and fatal courses. However, the latter cannot be proven statistically in children, because there are so few severe and fatal courses. Whether the very low risk for children can be further reduced with a vaccination is totally in the stars.”
In fact, recent studies also show that natural immunization through infection is even superior to immunity acquired through vaccination. From Radbruch’s point of view, it is therefore incomprehensible why immunization through infection is so underestimated in Germany: “In fact, we have known for more than a year from the work of Ali Ellebedy’s research group at Washington University in which it was published in the journal ‘Nature’ St. Louis that after an infection in most people who have recovered, there are many Sars-CoV-2-specific “plasma cells” in the bone marrow, about as many as tetanus-specific ones. These plasma cells are the immune system’s memory cells, constantly secreting the specific, protective antibodies into the blood for decades, if not a lifetime. And these bone marrow plasma cells are a dead giveaway that these individuals have acquired solid immunity and also have other protective immune cells.”
In the meantime, the same working group has also carried out this study on vaccinated people and found that after two vaccinations with mRNA vaccines there are also such plasma cells in the bone marrow – albeit somewhat fewer than after infection. “This means that a survived infection protects better than two vaccinations,” sums up the immunologist.
At the same time, his colleague, the immunologist Carsten Watzl, pointed out in an interview with FOCUS online some time ago that he would always prefer vaccination to infection. Because it is safer, emphasized the Secretary General of the German Society for Immunology.
Since, according to many experts, children are at little risk from the disease Covid-19 and natural immunization may even bring them advantages, a look at the other side of the scale must be taken in order to assess the risk-benefit ratio for this age group the risk of vaccination should never outweigh its benefit. So how do the experts assess the risk of side effects from the Covid-19 vaccines in children?
“The side effects that are observed are extremely rare,” says Alexander Kekulé. “For example, myocarditis occurs at 1 in 50,000, or if you consult very pessimistic data, in younger age groups at 1 in 10,000. But it is clear that children and young people are affected more often than adults. So it has to be said that the side effects are more serious in younger people. The subject of immunological imprinting, the “original antigenic sin”, probably plays a greater role in children than in adults.”
The epidemiologist adds: “It’s all a little bit of reading coffee grounds at the moment. But reading tea leaves for side effects says you should take them especially seriously in children. And reading the coffee grounds for a possible protective effect in children says that a general vaccination recommendation is not worth it.”
Radbruch points out that the benefit-risk profile has shifted further to the disadvantage of vaccination for healthy children due to the spread of the disease in the population and also in children.
“This also includes the fact that we naturally have no information about side effects of vaccination with the new mRNA vaccines, which are rare and only appear late after vaccination, for example the consequences of a possible reactivation of herpes viruses through vaccination. There is still an unknown risk here,” says the doctor. And the fact that vaccination protects against infection and infecting others does not work. So that is not an argument for vaccinating children.
The immunologist therefore considers the reaction of the Scandinavians to be very reasonable and prudent. “We should take this as an example.”
Alexander Kekulé came to the same conclusion: “Of course, concerned parents should have their children vaccinated,” says the epidemiologist. “The only question is whether to issue a general public recommendation. I don’t see enough data for that at the moment. I could imagine that the Stiko would come to a similar conclusion if they revised the recommendation now.”
That currently seems unlikely. Only recently, in an interview with “Zeit Online”, pediatrician and Stiko member Martin Terhardt advocated that parents have their children vaccinated – even if they were already infected in the omicron wave and have already gone through Corona. “We continue to assume that a single infection with omicron does not leave any lasting and broad immunity against other variants,” explained Terhardt. An additional vaccination could broaden and prolong this immunity. That makes sense right now, before fall.
Stiko boss Thomas Mertens has so far not commented on the request from FOCUS online.
