What is the JCVI advice on COVID-19 vaccination of children aged 12 to 15?

The JCVI has reviewed the evidence on vaccinating children aged 12 to 15 who do not have underlying health conditions that put them at increased risk from severe COVID-19.

The assessment by the Joint Committee on Vaccination and Immunisation (JCVI) is that the health benefits from vaccination are marginally greater than the potential known harms. However, the margin of benefit is considered too small to support universal vaccination of healthy 12 to 15 year olds at this time.

It is not within the JCVI’s remit to consider the wider societal impacts of vaccination, including educational benefits. The government may wish to seek further views on the wider societal and educational impacts from the Chief Medical Officers of the UK 4 nations.

For the vast majority of children, SARS-CoV-2 infection is asymptomatic or mildly symptomatic and will resolve without treatment. Of the very few children aged 12 to 15 years who require hospitalisation, the majority have underlying health conditions. The committee has recommended the expansion of the list of conditions to which the offer applies for at-risk 12 to 15 year olds.

There is evidence of an association between mRNA COVID-19 vaccines and myocarditis. This is an extremely rare adverse event. The medium- to long-term effects are unknown and long-term follow-up is being conducted.

Given the very low risk of serious COVID-19 disease in otherwise healthy 12 to 15 year olds, considerations on the potential harms and benefits of vaccination are very finely balanced and a precautionary approach was agreed.

Professor Wei Shen Lim, Chair of COVID-19 Immunisation for the JCVI, said:

Children aged 12 to 15 years old with underlying health conditions that put them at higher risk of severe COVID-19 should be offered COVID-19 vaccination. The range of underlying health conditions that apply has recently been expanded.

For otherwise healthy 12 to 15 year old children, their risk of severe COVID-19 disease is small and therefore the potential for benefit from COVID-19 vaccination is also small. The JCVI’s view is that overall, the health benefits from COVID-19 vaccination to healthy children aged 12 to 15 years are marginally greater than the potential harms.

Taking a precautionary approach, this margin of benefit is considered too small to support universal COVID-19 vaccination for this age group at this time. The committee will continue to review safety data as they emerge.

When deciding on childhood immunisations, the JCVI has consistently maintained that the main focus should be the benefits to children themselves, balanced against any potential harms to them from vaccination.

As longer-term data on potential adverse reactions accumulates, greater certainty may allow for a reconsideration of the benefits and harms. This data may not be available for several months.

Previously, the JCVI advised that children with severe neurodisabilities, Down’s syndrome, immunosuppression, profound and multiple learning disabilities, and severe learning disabilities or who are on the learning disability register, should be offered COVID-19 vaccination.

Following consideration of updated data on hospital admissions and deaths, the JCVI advises that this offer should be expanded to include children aged 12 to 15 with the following:

• haematological malignancy
• sickle cell disease
• type 1 diabetes
• congenital heart disease
• other health conditions as described in Annex A

Children with poorly controlled asthma and less common conditions, often due to congenital or metabolic defects where respiratory infections can result in severe illness, should also be offered COVID-19 vaccination.

All young people to be offered vaccine before return to school and college – Possibility of Covid vaccinations for younger teens 

26th Aug 2021: All young people aged 16 to 17 in England have been offered a first dose of a COVID-19 vaccine (by Monday 23 August), to give them protection before returning to school and college.

Children aged 12 to 15 who are clinically vulnerable to COVID-19 or who live with adults who are at increased risk of serious illness from the virus are also being contacted by the NHS and invited for their vaccine by 23 August, ahead of the new school year.

Responding to reports that all younger teens are to be invited for vaccination before schools return, a government spokesperson said:

“No decisions have been made on vaccinating 12-15 year olds and it is inaccurate to suggest otherwise.”

Paul Whiteman, general secretary of school leaders’ union NAHT, said:

“Whether to vaccinate younger children is a decision for medical professionals to take. Schools should not carry any responsibility for vaccination promotion, enforcement or policing.

“The number of cases of Covid in schools is predicted to remain high, so disruption and missed education looks set to continue unless more action is taken to prevent transmission in schools.

“As ever, the government needs to be clear about the rationale and scientific evidence that underpins whatever decision they make, in order to reassure families that they are taking the right course.”

NHS England has launched a new online walk-in site finder to help 16 and 17 year olds locate the nearest available centre. Further sites will come online over the coming days and weeks.

People aged 16 and 17 will be able to get vaccinated at one of more than 800 GP-led local vaccination sites. Thousands have been invited by text and letter to book their appointments through GPs or via walk-in centres to help keep them, their families and friends safe from the virus.

Tens of thousands of people in this age group have already been vaccinated at local vaccination sites and walk-in centres across the country and the drive to offer a first jab by the new date will allow those teenagers in that age bracket the two weeks necessary to build maximum immunity.

The vaccines have already saved around 84,600 lives and prevented 23.4 million infections and 66,900 hospitalisations in England up to 6 August, according to the latest data from Public Health England and Cambridge University.

Health and Social Care Secretary Sajid Javid said:

It is brilliant to see tens of thousands of young people have already received their vaccine – thank you for helping to further build our wall of defence against COVID-19 across the country.

I have asked the NHS in England to ensure they offer a first dose of the vaccine to everyone aged 16 and 17 by next Monday 23 August, this will make sure everybody has the opportunity to get vital protection before returning to college or sixth form.

Please don’t delay – get your jabs as soon as you can so we can continue to safely live with this virus and enjoy our freedoms by giving yourself, your family and your community the protection they need.

Teenagers within three months of turning 18 can book their vaccine appointment online through the National Booking Service or by calling 119. Around 100,000 texts are being sent to those eligible inviting them to book their jabs.

Vaccines Minister Nadhim Zahawi said:

Young people have shown great enthusiasm to get their vaccines and this has allowed us to safely enjoy the things we have missed, such as going to the pub or seeing family and friends.

Thank you to the NHS and volunteers for your continued dedication to protect people from this virus. I urge everybody else to get their vaccines as soon as possible.

Data from Public Health England (PHE) shows COVID-19 vaccines are highly effective against hospitalisation from the Delta (B.1.617.2) variant, the dominant strain in the UK. The analysis shows the Pfizer-BioNTech vaccine is 96% effective and the Oxford-AstraZeneca vaccine is 92% effective against hospitalisation after two doses.

A total of 87,421,381 doses have been administered in the UK, with 47,215,352 people receiving a first dose (89.3%) and 40,206,029 people receiving both doses (76%). More than 70% of people aged 18-29 have already received their first dose.

The government is working closely with the NHS to make it as easy as possible to get a vaccine, including through ‘grab a jab’ pop-up vaccine sites across the country, such as London-based nightclub Heaven, as well as football stadiums and festivals up and down the country.

Advice and information on the benefits of vaccination have been shared at every opportunity, including through a range of partnerships with industries catering for predominantly younger audiences.

This work has included partnerships with high-profile entertainment and sports personalities on short films encouraging people to get the jab, such as film stars Jim Broadbent and Thandiwe Newton, and football figures Harry Redknapp and Chris Kamara.

The government has also partnered with dating apps, social media platforms and large companies, such as Uber and Deliveroo, on adverts and incentives to get the vaccine.

NHS medical director of primary care and deputy lead for vaccination programme in England, Dr Nikki Kanani, said:

Thanks to the dedication and hard work of NHS staff, well over 39 million people in England have already had their first, including more than a quarter of a million young people under the age of 18.

Now as teenagers prepare to head back to school or college or into their first full-time jobs, once again NHS staff are doing everything they can to offer young people the lifesaving vaccine as quickly as possible to protect themselves and others. Those who are eligible should check their nearest walk-in centre on the site finder today or book through their GP team once invited to do so.

YouGov polling also shows the UK continues to be one of the top nations where people are willing to have a COVID-19 vaccine or have already been vaccinated. ONS data published on 9 August shows that more than 9 in 10 (96%) adults reported positive sentiment towards the vaccine, and vaccine hesitancy for those aged 18 to 21 has almost halved from 9% to 5%. The statistics also showed hesitancy has decreased for those aged 16 and 17 from 14% to 11%.

Vaccines are available free of charge and from thousands of vaccine centres, GP practices and pharmacies. Around 98% of people live within 10 miles of a vaccination centre in England and vaccinations are taking place at sites including mosques, community centres and football stadiums.

• People aged 16 and 17 can find their nearest walk-in vaccination centre one the NHS website.
• People with three months of their 18th birthday and all over-18s can book an appointment on the NHS website.
• The latest UK-wide vaccination statistics are published here and NHS England publishes vaccine statistics for England here.
• The latest PHE analysis on the efficacy of COVID-19 vaccines is available here. Their latest study on the number of cases prevented and lives saved by vaccines is here.
• The ONS survey on ‘Barriers to COVID-19 vaccination’ can be found here.
• Further ONS stats on vaccine hesitancy can be found here.
• The YouGov data comparing uptake rates in countries around the world is available here

All 16 and 17-year-olds will be offered the covid vaccine within weeks 

4th Aug 2021: All 16-17 year-olds will be offered their first covid vaccine within weeks at the recommendation of the Joint Committee on Vaccination and Immunisation (JCVI)

Chief Executive of AoC, David Hughes said:

“Today’s announcement is a welcome step as these young people should be able to access their first jab early in the autumn term. Vaccines are a sure way to help reduce transmission and subsequently lessen the likelihood of severe disruption to students’ learning when the new academic year begins. The scientific advice to government is that this is the right thing to do for 16 and 17 year olds, for their parents/carers, for college staff and the communities they live within. As part of a wider strategy that colleges already have in place, including testing and all of the measures on campuses, this expansion of the vaccine rollout will be a key part of learning to live with this virus and keep disruption in education to a minimum.”

Paul Whiteman, general secretary of school leaders’ union NAHT, said:

“The debate about whether or not to vaccinate older children has been raging for many weeks. NAHT has always said that UK policy on child vaccination should be led by clinicians. To the extent that any such policy is controversial it is clear that schools should not carry any responsibility for vaccination promotion, enforcement or policing.

“Regardless of the extent that young people might suffer directly from the virus, the large numbers of pupils absent from school at the end of last term showed that COVID still has the power to affect the quality and continuity of the education they receive. That is a continuing worry for school leaders.

“Pupils will return to schools next month, and the government needs to take every possible step to prevent transmission of the virus amongst people in school communities, no matter their age. As ever, it will be a matter of public confidence in whatever these measures are deemed to be, so the government also has a duty to communicate carefully and clearly in order to avoid any more unnecessary disruption and missed education for pupils.”

Professor Wei Shen Lim, COVID-19 Chair for JCVI, said:

“After carefully considering the latest data, we advise that healthy 16 to 17 year olds are offered a first dose of Pfizer-BioNTech vaccine. Advice on when to offer the second vaccine dose will come later.

“While COVID-19 is typically mild or asymptomatic in most young people, it can be very unpleasant for some and for this particular age group, we expect one dose of the vaccine to provide good protection against severe illness and hospitalisation.”

In the last few weeks, there have been large changes in the way COVID-19 has been spreading in the UK, particularly in younger age groups.

The adult vaccine programme has progressed very successfully and more safety data has become available, so it was important to review the advice for the vaccination of children and young people.

This updated advice means we can be confident that young people will be afforded around 80% protection against hospitalisation, following receipt of their first dose.

It is expected that protection will probably be even higher as younger people respond better to vaccines and some will have already had the COVID-19 infection, meaning this first dose should act as a ‘booster’ to their immunity.

The JCVI has looked at the very latest safety data from the UK and other countries as we know that some serious side effects have been reported in this younger age group. This includes myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the membrane around the heart). These are extremely rare and usually occur within a few days of the second dose, typically more in young men.

Data from the USA suggests that, in males aged 12 to 17 years, 9.8 cases of myocarditis were reported per million first doses given. This rises to 67 per million after the second dose. Most people recovered quickly.

We know that COVID-19 is usually mild in younger people and so it is important to weigh up the benefits of any vaccine against the possible, although extremely rare, side effects.

In the current UK situation, where there is good uptake of the vaccine amongst adults, we can take a more precautionary approach to vaccine rollout in younger people, who are at lower risk of serious harm from COVID-19. Prioritising the first dose and delaying the recommendation on the second, allows the JCVI to provide the best available advice with the latest available information for the second dose, whilst providing some immediate protection from severe disease.

The second dose can be given later and will extend protection for a longer period, for example when those young people start work or go to university, or if we begin to get another wave of cases in winter. It is important to keep young people well and in school in the autumn term and to minimise disruption to education as far as possible. For now we recommend prioritising the first dose in younger age groups.

It is likely that, when the second dose is offered, this will be from 12 weeks after the first dose. The benefit of having an 8 to 12 week gap between the first and second doses is becoming increasingly clear, as it offers more protection for a longer period of time.

If younger people experience any of the following symptoms after receiving their vaccination, they should call 111 or see their GP:

• a stabbing pain and/or tightness in the chest which may spread across the body
• pain in the neck that may spread across the shoulders and/or arms
• shortness of breath when lightly exercising or walking
• difficulty breathing when resting or feeling light-headed
• flu-like symptoms such as a high temperature, tiredness and fatigue
• palpitations or an abnormal heart rhythm
• feeling like you need to be sick

As previously advised by the JCVI, children aged 12 to 15 with specific underlying health conditions that put them at risk of severe COVID-19 should be offered 2 doses of Pfizer-BioNTech vaccination with an interval of 8 weeks between doses.

This includes children with severe neurodisabilities, Down’s Syndrome, immunosuppression, profound and multiple learning disabilities, and severe learning disabilities or who are on the learning disability register. Children with additional underlying health conditions to be offered vaccination will be updated in the Green Book.

Children and young people aged 12 years and over who are household contacts of an immunosuppressed person should also be offered 2 doses of the Pfizer-BioNTech vaccine.