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“We don’t know yet what will be the burden of co-infections in children when we have a massive circulation of routine viruses and COVID,” he says. A handful of vaccines have been tested in young people over the age of 12, including mRNA vaccines made by Moderna and Pfizer–BioNTech, and two Chinese vaccines made by Sinovac and Sinopharm. And several countries, including the United States, Israel and China, are now offering vaccines to this age group. Other studies are expected to report results in young people over the age of 12 soon, including studies on the Zydus Cadila vaccine and the Covaxin inactivated coronavirus vaccine, both made in India. Thus far, the vaccines seem to be safe in adolescents 1 , and some companies have moved on to carrying out clinical trials in children as young as six months old. In the United States, vaccines for those under 12 might be available later this year, says paediatrician Andrea Shane at Emory University in Atlanta, Georgia. A potential link between the Pfizer vaccine and heart inflammation — conditions called myocarditis and pericarditis — has emerged since Israel and the United States began vaccinating young people. However, researchers have yet to establish that the vaccine caused the inflammation. Most of those affected have recovered, and the data suggest that the risk of these conditions is “extremely low”, says paediatrician David Pace at the University of Malta in Msida — about 67 cases per million second doses in adolescent males aged 12–17, and 9 per million in adolescent females in the same age group. How will vaccinating children and young people affect the pandemic? Malta has fully vaccinated 80% of its population — one of the highest vaccination rates in the world — and is now also vaccinating adolescents over the age of 12. There, the decision to vaccinate young people was shaped, among other factors, by the close-knit family structures in a country where adolescents often have frequent contact with their grandparents, says Pace. “On a population level, vaccinated adolescents may result in a reduction in transmission to vulnerable older people,” he says. Young people in Malta also often travel abroad for school, potentially importing coronavirus infections and variants from abroad, he adds. Data show that children and particularly adolescents can play a significant part in coronavirus transmission, says Catherine Bennett, an epidemiologist at Deakin University in Melbourne, Australia. And concerns about transmission by children and adolescents are growing as new coronavirus variants emerge. It’s possible that more-transmissible variants will develop a way to push through whatever it is in a young person’s immune response that makes them more resistant to infection, says Bennett, making it all the more important that they are vaccinated. Hopes of killer deal achieving herd immunity through immunization have waned, so countries need to do the best that they can to keep transmission low, she adds: “You only need one poorly vaccinated population to generate global variants.” Chile, another country with one of the highest COVID-19 vaccination rates in the world, is also rolling out vaccines to those aged 12 and older.

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