Considering Mandatory Vaccination of Children for COVID-19.

Abstract

* Abbreviations: COVID — : coronavirus disease COVID-19 — : coronavirus disease 2019 MIS-C — : multisystem inflammatory syndrome of children SARS-CoV-2 — : severe acute respiratory syndrome coronavirus 2 Herculean efforts are ongoing to develop vaccines against the severe acute respiratory syndrome 2 new coronavirus that causes the disease known as coronavirus disease 2019 (COVID-19). The World Health Organization lists >100 candidate vaccines, with several already in clinical trials and at least 3 receiving Emergency Use Authorization in the United States. We already know that some vaccines can protect against illness caused by the virus (Pfizer, Moderna, and AstraZeneca). However, we do not yet know whether these vaccines induce immune responses at the nasopharyngeal mucosa such that protection against nasopharyngeal infection and carriage of the virus is achieved. The publicly available briefing document for the December 17, 2020, Food and Drug Administration Vaccines and Related Biologic Products Advisory Committee meeting suggested such an effect in the Moderna vaccine study, but much remains to be learned regarding magnitude and durability of any such effect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nevertheless, protection against COVID-19 is evidently feasible if vaccines induce robust neutralizing antibodies and, perhaps, T-cellular responses.1,2 Although immune memory has not yet been extensively studied, vaccines that induce those responses usually induce persistent memory and therefore immunity. Vaccines against COVID-19 are being administered to adult populations. The National Academy of Medicine and the Centers for Disease Control and Prevention recommend that vaccination begin with those at high risk of exposure, such as medical personnel, patients in long-term care facilities, and first responders, followed by those with high risk of severe coronavirus disease (COVID), such as the elderly and those with comorbidities. Vaccination of other adults will follow, with previously healthy adolescents and … Address correspondence to Stanley A. Plotkin, MD, University of Pennsylvania, 4650 Wismer Rd, Doylestown, PA 18902. E-mail: stanley.plotkin{at}vaxconsult.com