In the last week emerging data appears to suggest that people who are fully vaccinated can catch and pass on Covid-19 — the vaccine, in other words, appears not to stop transmission.  This news is significant in the context of the JVCI’s decision, announced last week, to extend the roll out of the vaccine to 16 and 17-year-olds.

To say that the issue is divisive is an understatement.  However, wherever one sits on the “should they/shouldn’t they” question, it’s especially crucial, in the context of an irreversible clinical treatment on children that parents — or in some cases the young people themselves — can make free and informed decisions.  A proper appreciation of benefits versus risks is the pillar of informed consent; plus, any treatment must be offered — not forced.

There are many parents — myself included — who would feel altogether more comfortable if, firstly, we could see a genuine benefit to those children (or — perhaps — though many would disagree — a proven and evidence based benefit to society at large); and secondly, if we could be assured of the ability of parents and children to give free, informed consent. 

That consent should be voluntary is a bedrock of medical ethics

Currently I struggle to see how either of these conditions are met.

The news about transmission strikes at the heart of the benefit side of this equation.  Children are themselves at very low risk of getting seriously ill from Covid — and whilst long Covid is a genuine issue for those struck by its aftereffects, a recent report — and indeed the JCVI themselves — acknowledge it to be rare.

One reason commonly used to justify vaccinating children, then, has been that this will limit community transmission. The JCVI had themselves acknowledged this benefit to be “highly uncertain”; but in light of this week’s reports it now looks more tenuous still. We should not be making a decision of this significance on the basis of anything other than certain and evidence-based benefits.

The other upside to vaccination — majored on repeatedly by Ministers over the last few months — is the idea that vaccination of children is necessary to keep schools open. The JCVI allude to this when they refer to the “mental health and educational impacts of COVID-19 on children and young people”. Again, though, this is an entirely artificial inflation of “benefits”.  After the year and a half they’ve just endured we do kids no favours by painting school closures and isolation of healthy children as a clinical inevitability rather than a political choice; and a disastrous one at that. Especially in the context of a population where 9 in 10 adults have antibodies, many would say that school closures should now simply be taken off the table as a failed public health response.

I was put in touch with an 18 year old boy who has recently suffered a 1 in 100,000 adverse reaction

That accurate information about risks is almost impossible to come by is deeply problematic for anyone trying to reach an informed conclusion — the JCVI have yet to produce any evidence to explain their change of heart and the various adverse reaction databases, scattered across the MHRA yellow card reporting system, the EU database and the US VAERS system, are impenetrable to any normal human being let alone to a parent juggling three kids, a school run and a conference call on a Tuesday morning.  Parents are being urged, by the Prime Minister no less, to just trust the JCVI: “they know what’s safe and I think we should listen to them and take our lead from them”.  Perhaps — but parent’s first and most important duty is to protect their children and after this last year of government riding roughshod over children’s interests many will feel they need to see the underlying data for themselves rather than being led to a decision which may — or may not — be in their child’s interests. This is especially so given that this latest decision came a mere 17 days after JCVI’s original finding that “…the health benefits of universal vaccination in children and young people below the age of 18 years do not outweigh the potential risks.”

That consent should be voluntary is a bedrock of medical ethics which, in truth, has been under attack for some weeks now; ordinances such as “well done, good luck…and get a jab!”, from the PM on A-level results day fall short of coercion but are nonetheless a heavy handed approach to adolescents indicative of the last year of “nudge”. Dubious incentives and “junk food for jabs” bribes are an ethical minefield, and jabbing dizzy youngsters as they tumble out from Thorpe Park rollercoasters is just plain bonkers.  Offers that come with threats of exclusion from social and educational settings — as happened with young people in the last few weeks — are not offers, but coercion — admittedly we aren’t there (yet) with kids, but that this was threatened for university students does not augur well; likewise Grant Shapps’ statement-cum-threat: “it’s important to understand there are simply going to be things that you will not be able to do unless you’re double-vaccinated”, chips away still further at any remnants of faith left in this government’s respect for medical ethics.  

Yesterday evening I was put in touch with a teenage boy who has recently suffered what he and his doctor believe may be a rare adverse reaction from the Pfizer vaccine. He has been left with a rare neurological disorder leaving his dominant arm paralysed and in ‘excruciating pain’. He ends a hauntingly moving account by observing “knowledge is key when making decisions about our health and I only wish the information had been out there when I took the decision.”

That these severe events are rare is true, but that does not absolve us — as custodians of our youngsters’ bodies and health — from being honest about the stakes.  A society that pushes or worse still forces a medical intervention carrying risk on its children for no or unclear benefit to those children is one in which a great many parents and grandparents would want absolutely no part.