BCCA (bcca-uk.org)
On 22 December 2021, in response to the current wave of Omicron infection, the JCVI updated and extended its advice on primary Covid-19 vaccination for 5 to 11-year-olds in high-risk groups, booster vaccination for 12 to 15-year-olds in high-risk groups and booster vaccination for 16 to 17-year-olds (JCVI Covid-19 vaccination advice for children and young people). The Green Book recommendations have been updated (Green Book information on vaccines 24 Dec 21).
Considerations
With regard the primary vaccination of 5 to 11-year-olds, the JCVI has considered the potential benefits and risks of vaccination to the children themselves. These are finely balanced largely because the risks associated with Covid-19 infection are very low in this age group. The JCVI considered data on:
- Risk of hospitalisation, paediatric intensive care unit (PICU) admission, mortality and paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) following Covid-19 infection
- Effectiveness of Covid-19 vaccination in preventing infection, symptomatic disease, hospitalisation, intensive care admission and mortality, and the prevention of PIMS-TS and ‘long COVID’
- Incidence and severity of suspected adverse events following vaccination including available data on the risk of myocarditis following vaccination
- Estimates of the proportion of 5 to 11-year-olds with prior Covid-19 infection in the UK
- Risk-benefit analysis undertaken by the UK Health Security Agency (UKHSA)
Summary of latest JCVI advice
Young adults (16-17 years)
All 16 to 17-year-olds should now be offered a booster vaccination 3 months after completion of their primary course (unless contraindicated).
Children (12-15 years)
12 to 15-year-olds who are:
- In a recognised higher risk group (which includes haemodynamically significant congenital and acquired heart disease, or less severe heart disease with other co-morbidity- see Table 4 in Green Book information on vaccines 24 Dec 21) or
- A household contact of someone who is immunosuppressed should be offered a booster vaccination 3 months after completion of their primary course. Boosters in children aged 12 to 15 years who are not at high risk will be reviewed by the JCVI in due course.
Children (5-11 years)
5 to 11-year-olds who are:
- In a recognised higher risk group (which includes haemodynamically significant congenital and acquired heart disease, or less severe heart disease with other co-morbidity- see Table 4 in Green Book information on vaccines 24 Dec 21) or
- A household contact of someone who is immunosuppressed should be offered two 10 micrograms doses of the Pfizer-BioNTech COVID-19 vaccine (Comirnaty®) with an interval of 8 weeks between the first and second doses.
These haemodynamically significant congenital and acquired heart disease categories in children have been previously considered and published by the BCCA (14/09/21).
Other children aged 5-11 years
A decision on the vaccination of children aged 5 to 11 years who are not in recognised risk groups is pending further consideration by JCVI. Boosters in children aged 5-11 years will be reviewed in due course.
COVID vaccination after COVID-19 infection and PIMS-TS
Advice unchanged. See further detail in BCCA statement 13 Dec 21 and Green Book information on vaccines 24 Dec 21 Page 31
COVID-19 vaccination and cardiac surgery
There is no specific data to guide time interval between COVID-19 vaccination and surgery and vice-versa. The Royal College of Surgeons (Eng) (RCS (Eng) guidance) states that:
- Essential urgent surgery should take place, irrespective of vaccination status.
- Non-urgent elective surgery can also take place soon after vaccination. There is some rationale for separating the date of surgery from vaccination by a few days (at most 1 week) so that any symptoms such as fever might be correctly attributed to the consequences of either vaccination or the operation itself.
