The Joint Committee on Vaccination and Immunisation (JCVI) has recommended that children aged five to 11 years in a clinical risk group should be offered a low-dose Covid-19 vaccine.

This includes children with a severe or profound and multiple learning disabilities (PMLD), Down’s syndrome, and those on the learning disability register. It said that further advice regarding Covid-19 vaccination for other five to 11 year olds will be issued in due course following consideration of additional data.

Vaccine dose

For children aged five to 11 years, a 10-microgram dose of Pfizer-BioNTech vaccine for both the first and second doses is considered appropriate. This can be either as a paediatric formulated dose (10-microgram) or a fractional adult dose (one third of the adult 30 microgram dose). Should fractionated adult doses be offered, healthcare providers should have the necessary skills to deliver such fractional doses, with appropriate guidance, training and systems in place to support vaccine delivery.

A dose interval of eight weeks between doses is advised; a longer dose interval improves the immune response to the second dose, and may reduce the risk of myocarditis, compared with a shorter interval.

How safe is the vaccine in this age group?

When formulating advice in relation to childhood immunisations, JCVI said it has consistently held that the main focus of its considerations should be the potential benefits and harms of vaccination to children and young people themselves. The benefits and risks from Covid-19 vaccination in children and young people are finely balanced largely because the risks associated with Covid-19 infection are very low. Of all age groups, children aged five to 11 years are those at lowest risks of serious Covid-19.

JCVI has considered data on:

  • The risk of hospitalisation, paediatric intensive care unit (PICU) admission, mortality and paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) following Covid-19 infection

  • The effectiveness of Covid-19 vaccination in preventing infection, symptomatic disease, hospitalisation, intensive care admission and mortality, and the prevention of PIMS-TS and ‘long Covid’ through protection against infection and disease

  • The incidence and severity of suspected adverse events following vaccination including available data on the risk of myocarditis following vaccination

  • Estimates of the proportion of five to 11 year olds with prior Covid-19 infection in the UK

  • A risk-benefit analysis undertaken by the UK Health Security Agency (UKHSA).

It said that initial safety data from programmatic use of Covid-19 vaccination in five to 11 year olds in the US indicates no new or unexpected concerns. More data is expected to accrue over time as experience with vaccination of this age group of children increases internationally.