JCVI discussed herd immunity among children before not endorsing jab rollout

The UK’s vaccine watchdog discussed allowing immunity against Covid-19 to be built up among children via infection before declining to endorse the universal rollout of the jab to 12 to 15-year-olds.

Minutes published by the Joint Committee on Vaccination and Immunisation (JCVI) have sparked debate among the scientific community after it emerged the body discussed the policy, amongst others.

The documents, released on Friday after lengthy delays, have been met with a mixture of outrage and indifference by scientists.

Some have accused the JCVI of downplaying the risk posed by Covid to children, while others have said it is within the remit of body to discuss building up immunity among the young through natural infection.

After months of discussions over the summer, the JCVI ultimately chose not to recommend Covid jabs for healthy 12 to 15-year-olds, concluding in September that the “margin of benefit is considered too small to support” vaccinating this cohort.

Instead, the watchdog deferred responsibility to the UK’s chief medical officers, who gave approval for the universal vaccination of all young children.

Critics have highlighted a number of lines from the JCVI minutes, including discussions around “allowing the virus to circulate amongst children which could provide broader immunity to the children”.

This approach was considered given the perceived low risk posed by Covid to children, the documents suggest.

Dr Stephen Griffin, a virologist at Leeds University, said this line of discussion shows that there is “very much a bias towards the idea that infection is of no consequence in kids”.

Although Covid is far less likely to lead to serious disease in children than adults, the current high prevalence of the virus among the young means that some will fall ill while others will go on to develop long Covid, Dr Griffin said.

More than 10,000 children have been hospitalised with Covid throughout the pandemic, while an estimated 54,000 are suffering from long Covid, according to the Office for National Statistics (ONS).

Some 21 percent of 12 to 15-year-olds are now vaccinated in England, compared with 80 percent of adults. This comes at a time of soaring case rates among the young. More than 9 per cent of children in school years 7 to 11 were infected in the week ending 22 October, according to figures from the ONS. Over this same period, 248,000 children were out of school due to Covid-related reasons.

Some have also criticised the JCVI for appearing to consider a policy which advocated using children as a “vehicle” of transmission to booster adult immunity

During a meeting held on 20 May, members of the watchdog “considered in the absence of vaccination, future generations would be exposed to Covid-19 in childhood, with a relatively mild disease”.

“This early infection would then provide protection against severe disease throughout life,” the minutes read. “Circulation of Covid-19 in childhood could therefore periodically boost immunity in adults through exposure.”

However, one member of the JCVI said they were not discussing whether to use children as vectors.

“JCVI considered the cumulative beneficial Covid immunity to individual children and young people on the assumption that Covid will eventually become endemic in the same way as many other viruses,” the source said. “This should not be interpreted as using children to infect and naturally boost adults in the current pandemic.”

But some said the criticism was unfair, and that scientists are only right to consider all options.

Professor Francois Balloux, director of the Genetics Institute at University College London, said critics of the JCVI had “picked out a handful of paragraphs” from the minutes and lost sight of the wider context around discussions on child vaccinations.

He said he was “not shocked” that the JCVI addressed theories on allowing Covid-19 to circulate among children and, by extension, re-exposing protected adults to the virus.

Regardless, Prof Balloux said, these types of discussions wouldn’t have been taken into consideration too much as the eventual JCVI decision was based on the “immediate benefit” of vaccinating children, and not the wider benefit to adults and the rest of the society.

“Not everyone seems to grasp the remit of a vaccine regulatory agency such as the JCVI,” Prof Balloux said. “In short, it is to advise whether the benefits of vaccinating a specific demographic group (eg. healthy 12 to 15-year-olds) significantly exceed the risks for this group alone.”

However, Dr Griffin said the time it took for the JCVI to reach its decision – when other countries, like the US and Israel, had already pushed ahead with child vaccination – had proven costly.

“It’s right to be cautious, but it shouldn’t have really taken that long,” he said. “Maybe our caution has been counterproductive in this instance, because it really isn’t right that that we missed the opportunity of summer to vaccinate children when they were off from school.

“We’re now seeing the consequence of that delay with soaring cases in children and classrooms where there aren’t any mitigations in place.”

The JCVI member said recent criticism raised against the watchdog failed to “consider the timelines and state of knowledge when each meeting took place over the summer”.

Prof Balloux said the attacks were eroding trust and creating a narrative that suggested the watchdog was acting as a conduit for the government’s Covid policies.

“If people think they do the bidding of the government, that’s not ideal because it undermines trust,” he added. “It could have an impact on other immunisation programmes that the JCVI advises on in the UK, which would not be good.”