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As a pediatrician, don't you find it frustrating that everything takes so long?

2021-11-25T11:53:29.552Z

Vaccination for younger children should be formally approved in Europe shortly. But it will take some time before the vaccine is ready in Germany. The pediatrician Jakob Maske sees an obligation on adults.



Enlarge image

So far, children under the age of twelve cannot be vaccinated against the coronavirus in Germany (symbol image)

Photo: Volkan Sezai Suda / Getty Images

SPIEGEL:

Mr. Maske, the European Medicines Agency Ema will most likely recommend vaccinations for children between the ages of five and eleven soon.

Are the pediatricians prepared for a possible rush of child vaccinations?

Mask:

We are prepared to vaccinate the children of this age group, but there will be no rush for the time being.

The approval does not mean that the vaccinations will start right away.

SPIEGEL:

Why?

Mask:

On the one hand, because the Stiko, the Standing Vaccination Commission, does not yet recommend vaccination for five to eleven year olds, and on the other hand because the special vaccine ampoules for this age group are not yet available.

SPIEGEL:

For 12- to 17-year-olds, the Stiko recommendation came months after the Ema. At some point the health ministers decided not to wait for the Stiko any longer, but to offer all children of this age group a vaccination anyway. Are the paediatricians even waiting for the Stiko recommendation this time?

Mask:

Of course there will now be parents who want their children to be vaccinated immediately.

As an association, however, we urge the paediatricians to wait for the Stiko.

Only 3,000 toddlers participated in the pivotal study, 1,500 of whom were in the vaccination group.

I think it is justified when the Stiko says that this data is not enough for it.

She is waiting for more children to be vaccinated to record possible rare side effects as well.

We want a good and safe vaccine for the children.

more on the subject

  • Pandemic failure: Why does Stiko take so long to make decisions? By Imre Balzer, Veronika Hackenbroch and Yasemin Yüksel

  • Corona vaccine: Stiko boss shows understanding for skepticism about child vaccinations

SPIEGEL:

Covid-19 is not as dangerous for the majority of children as it is for older people. But this does not apply to children with chronic diseases, they sometimes have a very high risk of developing serious Covid-19. Your parents should be pretty desperate when Ema finally recommends the children's vaccine, but the doctors still don't vaccinate - especially with the current case numbers.

Mask:

Precisely for this reason, a different consideration applies to high-risk patients: Children who are at high risk of severe Covid-19 courses should also be protected from infection as well as possible.

For children with previous illnesses, Stiko will therefore probably recommend vaccination at the end of the year.

In addition, every doctor is of course free to decide at his own discretion and in consultation with the parents whether to vaccinate a child before this recommendation.

But you should always check whether this also makes medical sense.

SPIEGEL:

So paediatricians can already vaccinate on the basis of the Ema recommendation?

Mask:

The problem is that Ema presumably does not allow the active ingredient in general, but rather the vaccine, which is specially mixed for small children.

This is because children between five and eleven need a different dose than adults.

The manufacturer Biontech has made its own ampoules for this, but these will not be delivered in Germany until December 20th.

SPIEGEL:

That means that even if the Ema allows child vaccinations, they cannot de facto be carried out in Germany.

Mask:

That's right.

Theoretically, the dose for small children can also be obtained from an ampoule for adults by dividing the dose into thirds.

That's 0.1 milliliters of the vaccine.

Due to the small amount, there is, on the one hand, the risk of not mixing exactly the correct dose and, moreover, the method is not approved by the Ema.

However, some doctors already carry out these so-called off-label vaccinations.

But legally that's tricky.

Because when using an unapproved drug, the parents are liable in the event of any damage.

In healthy children who do not have an increased Covid-19 risk, it makes sense to wait for the ampoules approved by Ema and the Stiko recommendation.

SPIEGEL:

When do you expect the recommendation?

Mask:

early 2022, so it won't be until the beginning of the year

really get started with child vaccinations.

SPIEGEL:

So the ampoules will be delivered at the end of December, but initially only two million.

In Germany, however, there are around 4.5 million small children between the ages of five and eleven - around nine million ampoules would be required for complete immunization of this age group.

Are you accusing Mr Spahn of ordering too little vaccine?

Mask:

No, we don't.

The two million cans will be enough for now.

As I said, the majority of doctors and parents will wait for the Stiko recommendation first.

When that comes, there will be vaccine replenishment.

In addition, probably not that many will go to the vaccination before Christmas anyway, for fear of vaccination reactions during the holidays.

SPIEGEL:

As a pediatrician, don't you find it frustrating that it all takes so long?

Mask:

No, I don't think so.

The vast majority of children do not get seriously ill with Covid-19, and from a medical point of view, vaccination is not absolutely necessary for most of them.

But the higher the number of cases, the more children there will be who will become seriously ill.

So the responsibility rests with the adults: in order to protect the children and get the pandemic under control, it is much more important that more adults get vaccinated.

Because it is they who become seriously ill and fill the hospitals and intensive care units - not the children, especially not the five to eleven year olds.

We have therefore spoken out in favor of compulsory vaccination for adults.

Source: spiegel

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