Many parents are unsettled by the different statements about children and vaccinations. Is the recommendation of the Standing Vaccination Commission (STIKO) a clear rejection of everyone who would like to protect their otherwise healthy children, or how should parents understand the recommendation?
Von Kries: At STIKO, we are not fundamentally against vaccinating children against Covid-19. And of course it’s better to prevent disease if you can. But one has to ask, for what price? And the only reason we haven’t made a general vaccination recommendation is because we don’t know how safe the vaccine is in children. The data on the safety of the Covid-19 vaccination for children and adolescents are still limited. On the one hand, the number of those in the controlled approval study was too small to be able to safely rule out vaccination complications that occur less than one in 100. On the other hand, the average follow-up time of around two months was too short to reveal any vaccination complications that could only be identified later.
Other countries see it differently. In the United States, for example, the youth vaccination campaign is largely running smoothly.
The fact that vaccinations are used in America does not mean for us that all side effects are actually covered after a few weeks. If we have more data there that can stand up to a critical assessment, we will reassess the situation. But we have to exercise the necessary care. Experience has shown that side effects are not always recorded in the American system as we would and would expect in Germany.
Let’s go away from Canada and the USA. The European Medicines Agency (EMA) has also approved the vaccine. Why does the STIKO have a different view than this?
It makes sense, of course, for us to have a European authority; that makes coordinated work in Europe a lot easier. But STIKO and EMA are not identical and have different tasks. We look at the national situation and requirements in Germany. Other vaccines are also approved by the EMA, but not – yet – recommended by the STIKO. The EMA looks primarily at the global benefit-harm ratio of a vaccine. The STIKO must also ask itself, is a vaccination recommendation the right measure to tackle problems in the country in a meaningful way?
Unvaccinated children have to live with further restrictions and the danger of being particularly vulnerable to new mutations. Isn’t that problem enough to recommend vaccination?
The STIKO is not responsible for these restrictions. And one has to ask, what else is appropriate now? The STIKO does not currently see a viable argument for vaccinating all healthy children in the fight against pandemics, especially because endangered groups among adults as well as teachers and educators can now be vaccinated and thus protected. And certainly if the epidemiological situation changes due to mutations, the STIKO will also reassess this question. But at the moment the delta variant does not play a major role in this country.
Is waiting good advice to parents? Do you expect that the data situation will change with quantitatively more vaccinations for children and that there will be uniform statements from politics, EMA and STIKO?
Each family can and should discuss the individual vaccination decision for the young person in question with the pediatrician in charge. Just because there is no general vaccination recommendation does not mean that individual decisions cannot be made. As STIKO, we have to be sure that the benefit of the vaccination for the children is greater than the possible damage caused by any serious vaccination complications that can only be recognized later, especially in the case of a disease that is much milder in children than in adults. Only then can we possibly give a general vaccination recommendation.