The Stiko no longer recommends vaccination against Corona for healthy children. But there are situations in which the spade can still make sense for them. © Fabian Sommer/dpa/dpa-tmn
The Standing Committee on Vaccination no longer recommends that healthy children be vaccinated against Covid-19. How can parents weigh up whether a spade could still be useful for their offspring?
Dresden/Berlin - The Covid-19 vaccination recommendation for healthy children has been dropped. Some families are now faced with the question: Do we still want the spade for the child?
There is no general answer to the question of how useful it can be for a healthy child. It is a balancing question, in which the conversation with the pediatrician in particular can provide more clarity.
"If you deviate from the general vaccination recommendation of the Stiko, which you can certainly do in individual cases - then this will always be an individual decision based on many different factors," says Prof. Reinhard Berner. He is Director of the Clinic and Polyclinic for Pediatrics and Adolescent Medicine at the University Hospital Dresden.
Courses under Omicron are almost always mild
But let's start at the beginning: The Stiko's vaccination recommendations focus on one consideration: How great is the benefit of the prick? Avoiding severe courses, hospitalizations, intensive care and death - that's what the vaccination was made for, according to Berner.
However, since the Omicron variants became established, the benefits of vaccination for healthy children have decreased significantly.
The reason: "Children rarely become seriously ill under Omicron variants - even rarer than under the previous variants," says Prof. Tobias Tenenbaum, Chief Physician of the Clinic for Pediatrics and Adolescent Medicine at Sana Klinikum Berlin-Lichtenberg and Chairman of the German Society for Pediatric Infectiology.
This can be seen, for example, when it comes to the inflammatory syndrome PIMS. According to Tenenbaum's observations, Omicron is virtually non-existent in children - unlike the Delta variant. What's more, many children have already had contact with the coronavirus and built up a certain immunity.
By the way: The fact that the Stiko no longer recommends vaccination to healthy children does not mean that it actively advises against the injection. There are "no safety concerns in the vaccination of healthy children and adolescents," writes the Commission.
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Vaccination recommendation for children with serious pre-existing conditions
But what is the new recommendation of the Stiko when it comes to children? The Stiko recommends a Covid-19 vaccination for children from six months of age who have an increased risk of severe Covid-19 courses.
This includes a child with a severe neurological or neuromuscular disease who is in a wheelchair. Or a child with a chronic disease of the lungs or kidneys. Or with an immune deficiency, a congenital heart defect or trisomy 21. In the current vaccination recommendation, the Stiko lists the diseases for which vaccination is recommended.
"We know from such children that they have a high risk of having to go to hospital - or even to intensive care - with Covid-19, but also with influenza or other viral infections," says Berner. Covid-19 vaccination can significantly reduce this risk.
According to the recommendation of the Stiko, children with such serious illnesses should receive a basic immunization. It can consist of either three vaccinations or two vaccinations and one corona infection.
Subsequently, the Stiko advises an annual booster vaccination. It should take place at least 12 months after the last infection or vaccination, ideally in autumn.
Parents should also check vaccination protection
For children with serious underlying diseases, vaccination is therefore still important. And in such families, according to Tenenbaum, it can make sense for parents to check their vaccination protection again. By the way, not only against Corona, but also, for example, against measles.
"In the case of a child with a severe immune deficiency in the context of a bone marrow transplant, for example, vaccinations do not work well," says Tenenbaum. This is because their immune system responds worse to the vaccination, so if the environment protects itself as well as possible, this will ultimately also protect the sick child.
This is also how the Stiko assesses it: The vaccination recommendation also includes family members and close contacts of people for whom a Covid 19 vaccination "probably cannot achieve a protective immune response". The Stiko also advises them to get a basic immunization and an annual booster prick.
What applies to milder diseases
But what about the child who has mild asthma or atopic dermatitis? For the Stiko, according to Berner's assessment, they are among the healthy children.
"A child who has a normal participation in life, who can put himself or herself under normal physical strain during physical education classes or in a sports club - such a child is not at risk of suffering a severe Covid-19 infection," he says. This means that it does not fall under the indication of the Stiko.
The hope of sparing an infection
Even if summer is approaching, some parents are already expecting that numerous pathogens will be circulating in daycare centers and schools again in autumn and winter. Wouldn't vaccination be a way to spare the child at least one infection?
"That's an understandable thought," says Berner. But he doesn't look at it without skepticism. Because there are many, many viruses that the offspring could pick up in the daycare center. "The question is: Would it make sense at all to specifically try to prevent a single infection that does not even have a severe course?" he says. "Or doesn't it make much more sense that - as with many other respiratory infections - natural immunity can build up?"
In his estimation, the coronavirus is now part of the "infinite variety of different respiratory viruses that exist every winter".
In addition, the fact that the child contracts a corona infection with cough, runny nose and fever and has to stay at home for a few days - according to Berner, the vaccination does not reliably protect against this. Parents should therefore not attach the hope to the spades that they can spare their child an infection.
Third-party protection may be a consideration
However, the consideration of whether parents vaccinate their healthy child may not only be about the offspring. Perhaps the grandfather will soon undergo cancer therapy, which will weaken the immune system enormously. Here, too, the Stiko's recommendation that close relatives of immunosuppressed people should have sufficient vaccination protection applies. These can also be children or adolescents.
According to Tenenbaum, however, parents should know that even a vaccinated child as well as the vaccinated parents can become infected and thus infect others. Although the risk can be reduced by vaccination, it cannot be avoided.
Vaccination in autumn or at the beginning of winter
If families opt for the Piks for the child - when should it take place? The Stiko recommends the Piks preferably in autumn.
If you vaccinate at the beginning of winter, "then a certain protection over the first winter months would be expected," says Berner. However, he qualifies: "But maybe it's just next winter that Corona won't peak until March or April? In principle, however, the following applies: Similar to the influenza vaccination, one would recommend vaccinating at the beginning of the winter season." dpa