Abstract
ObjectiveTo offer a quantitative risk–benefit analysis of two doses of SARS-CoV-2 vaccination among adolescents in England.SettingEngland.DesignFollowing the risk–benefit analysis methodology carried out by the US Centers for Disease Control, we calculated historical rates of hospital admission, Intensive Care Unit admission and death for ascertained SARS-CoV-2 cases in children aged 12–17 in England. We then used these rates alongside a range of estimates for incidence of long COVID, vaccine efficacy and vaccine-induced myocarditis, to estimate hospital and Intensive Care Unit admissions, deaths and cases of long COVID over a period of 16 weeks under assumptions of high and low case incidence.ParticipantsAll 12–17 year olds with a record of confirmed SARS-CoV-2 infection in England between 1 July 2020 and 31 March 2021 using national linked electronic health records, accessed through the British Heart Foundation Data Science Centre.Main outcome measuresHospitalisations, Intensive Care Unit admissions, deaths and cases of long COVID averted by vaccinating all 12–17 year olds in England over a 16-week period under different estimates of future case incidence.ResultsAt high future case incidence of 1000/100,000 population/week over 16 weeks, vaccination could avert 4430 hospital admissions and 36 deaths over 16 weeks. At the low incidence of 50/100,000/week, vaccination could avert 70 hospital admissions and two deaths over 16 weeks. The benefit of vaccination in terms of hospitalisations in adolescents outweighs risks unless case rates are sustainably very low (below 30/100,000 teenagers/week). Benefit of vaccination exists at any case rate for the outcomes of death and long COVID, since neither have been associated with vaccination to date.ConclusionsGiven the current (as at 15 September 2021) high case rates (680/100,000 population/week in 10–19 year olds) in England, our findings support vaccination of adolescents against SARS-CoV2.
Highlights
On 19 July 2021, the Joint Committee on Vaccination and Immunisation, which advises on vaccine policy in England and Wales, recommended that COVID-19 vaccines should not be offered to all 12–17 yearolds, judging that any health benefits relative to potential risks were marginal.[1]
We examined how many COVID-19-related outcomes would be averted by vaccination of all 12–17 year olds, assuming conservative estimates of vaccine effectiveness in reducing severe outcomes (90% with the Delta variant among the fully vaccinated) and infections (64% among the fully vaccinated),[37,38,39] assuming no additional protection against long COVID once infected
The risk of hospitalisation with vaccination only exceeds the risk of hospitalisation with COVID-19 when the case incidence is below 30 per 100,000 per week; a level that has not been seen in adolescents in the UK in 2021 (Figure 3(a))
Summary
On 19 July 2021, the Joint Committee on Vaccination and Immunisation, which advises on vaccine policy in England and Wales, recommended that COVID-19 vaccines should not be offered to all 12–17 yearolds, judging that any health benefits relative to potential risks were marginal.[1]. On 13 September,[11] based on the assessment by the Joint Committee on Vaccination and Immunisation, and additional consideration of direct benefits to children from reduced educational disruption, the four UK Chief Medical Officers recommended a single dose of vaccine Intensive Care Unit for all 12–15 year olds, pending further assessment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
