Around three million children and their parents are from this week having to choose whether to take up the offer of a COVID-19 jab.
Many will agonise over the decision.
Whether they’ve got all the information they need – and the strength of the evidence for and against – dominated the questioning of the UK’s top medical experts by MPs on the Education Select Committee.
The evidence, briefly, is this.
For every one million first doses you give to 12-to-15-year-olds, you might expect three to 17 cases of myocarditis – inflammation of the heart that can also be caused by coronavirus infection.
But you also prevent 87 children from being admitted to hospital and two ending up in intensive care.
The UK chief medical officers also considered a disruption to education and concluded that the vaccine would prevent 110,000 school days from being lost over a six-month period. On that basis, the rollout went ahead.
One of the committee members, Dr Caroline Johnson MP, who is also a consultant paediatrician, wasn’t satisfied.
She argued that around half of children in that age group have already had COVID-19 and have good immunity against future infection.
So what extra benefit would they get from a vaccine that has this rare side effect on the heart?
England’s chief medical officer, Professor Chris Whitty, agreed the benefit would be smaller in a child who has had coronavirus, though the vaccine would still give a boost to their immune response.
But he said distinguishing between children who have and haven’t been infected would be “practically very difficult”.
And antibody tests to confirm whether children had COVID-19 would just mean they faced having two needles instead of one, he said.
Dr Johnson wasn’t convinced, though. She strongly felt that not all children would benefit equally from vaccination, and the tiny risk of heart inflammation was something that boys, in particular, should be aware of.
That information doesn’t always seem to be clear. She held up an NHS leaflet for children and parents that she said didn’t mention the risk – information they should have before consenting to vaccination.
Prof Whitty said the leaflets he had seen all gave the evidence for and against the jab. Why one version didn’t is unclear.
In truth, doctors aren’t sure of the significance of heart inflammation. Most children seem to completely recover, and they may well go on to have healthy lives.
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But medics can’t exclude the possibility that there is some residual scarring of the heart muscle that may, in some rare cases, lead to cardiac problems much later in life.
In an ideal world, doctors would have wanted a few more months to follow-up cases to really understand what impact, if any, there was on their health.
But we are in a pandemic and parents and their children are having to make a decision on the evidence for themselves.
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