India approves two COVID-19 vaccines: Why children can’t get vaccinated yet?

The Central government plans to inoculate nearly 30 crore people in the first phase of the COVID-19 vaccination drive. But kids are not likely to be vaccinated until late 2021.

The Drug Controller General of India (DCGI) on Sunday approved Serum Institute of India's 'Covishield' and Bharat Biotech's 'Covaxin' for emergency use in the country. The vaccination drive is likely to begin soon. Both Covishield and Covaxin COVID-19 vaccines have to be administered in two doses and can be stored at 2-8 degree Celsius.

Union Health Minister Harsh Vardhan on Saturday announced that COVID-19 vaccines will be provided to one crore healthcare workers and two crore frontline workers for free. The Central government plans to inoculate nearly 30 crore people in the first phase of the COVID-19 vaccination drive in the next six to eight months. These include one crore healthcare workers, two crore frontline and essential workers and 27 crore elderly, mostly above the age of 50 years with co-morbidities.

Later, the vaccines may be distributed to younger adults in the second phase, but it could take several more months before a vaccine is available for kids under age 16.

No Covid-19 vaccines for children yet

Here are some reasons why Covid-19 vaccines may not be initially recommended for kids:

• The authorized vaccines are not yet tested on children younger than or equal to 12. Typically, vaccines are tested first in adults. Once they are found safe with adults, the vaccines will be tested on children.
• Covid-19 appears to mostly affect adults than children. Therefore, older people with high-risk health conditions are being vaccinated first.
• Kids aren't typically at high risk for severe illness from COVID-19 and so they will likely be vaccinated in the final phase.
• Although children are great carriers of the novel coronavirus, they do not spread the disease as much as the adults do.

Covaxin the indigenous Covid-19 vaccine developed through a partnership between the Indian Council of Medical Research (ICMR) and Bharat Biotech is one of the two coronavirus vaccines for emergency use in India.

Dr Sanjay Rai, Professor in the Community Medicine Department at AIIMS and principal investigator of the Bharat Biotech Covaxin clinical trial, recently told a new channel that he doesn't think vaccines are required for children. Firstly, they are at lesser risk of Covid-19 infection; and secondly, the long-term health impact of the vaccine is yet to be seen, he said.

Paediatric clinical trials of Covid-19 vaccines

Kids' immune systems are very different from adults. So, even if the COVID-19 vaccines have been found safe and effective for ages 16 and up, the tests need to be repeated in children of younger ages.

While Pfizer's vaccine has been authorized for individuals age 16 and above, the vaccine developed by Moderna is currently approved for ages 18 and up in the US.

Both Pfizer and Moderna have begun new vaccine trials including children as young as age 12. Only when the tests are successful, the data will be sent to the regulators for review and approval. This process can take time, plus the time required for the production and distribution.

The Oxford/ AstraZeneca COVID-19 vaccine (named Covishield in India) were tested on healthy adults age 18 years and older. AstraZeneca had earlier announced to include children above the age of five (with the consent of their parents) in a mid-to-late stage trial of its Covid-19 vaccine in Britain. However, trial data updated on Dec. 10 under the U.S. National Library of Medicine showed that the company has removed children from the trial.