Coronavirus vaccination from the age of 12: Which children should be getting vaccinated

School closures, contact restrictions and a ban on sports and leisure activities –
children and young people had to forgo many things during the pandemic.  The reason being that they, too, can get ill with COVID-19 and spread the coronavirus. Thanks to the vaccine rollout's progress, several million adults have already been protected effectively against severe COVID-19 symptoms. On 28 May 2021, the European Commission authorised the first coronavirus vaccine also suitable for children and adolescents from the age of 12. Read on to learn how safe and effective the coronavirus vaccination is in
this age group and why no blanket recommendation to vaccinate all children is being issued by the Standing Vaccination Committee (STIKO) just yet: 

How ill can children with COVID-19 get?

COVID-19 is a potentially life-threatening disease. However, children
and adolescents between the ages of 12 and 17 without underlying conditions are
very unlikely to develop severe symptoms. Studies suggest that they are
less likely to get infected with coronavirus and also seem to be less likely to
infect others. Only one percent of children and adolescents ages 12 to 17 who
get COVID-19 need to be hospitalised. Cases of death have been sporadic, too,
and only in children and young people with underlying conditions.

For which children does the STIKO recommend coronavirus vaccination?

Since children and adolescents have a relatively low risk of getting seriously ill with COVID-19, the risk-benefit assessment of illness or vaccination is different than for adults. Therefore, the STIKO has not issued a general recommendation to vaccinate all children from the age of 12, but recommends that children and adolescents with certain underlying conditions who are particularly at risk get the coronavirus vaccination. According to the STIKO’s recommendation, these conditions include:

• Currently: obesity (> 97th percentile of body mass index (BMI))
• congenital or acquired immunodeficiency or relevant immunosuppression
• congenital cyanotic heart defects (resting O2 saturation <80%)
• severe cardiac insufficiency
• severe pulmonary hypertension
• chronic pulmonary disease with chronic lung function impairment
• chronic renal insufficiency
• chronic neurological or neuromuscular disease
• malignant tumour disease
• Down’s syndrome
• syndrome diseases with severe impairments
• insufficiently controlled diabetes mellitus

The STIKO also recommends that children who have close contact with vulnerable
persons (e.g. younger siblings, pregnant women or persons with allergies to certain ingredients of the coronavirus vaccines) get the COVID-19 vaccination. The same goes for adolescents who are training for or working in an occupation that involves an increased risk of infection.

Which COVID-19 vaccine is authorised for use in children and adolescents?

BioNTech/Pfizer’s Cominarty® was the first vaccine to be globally authorised for use against COVID-19. It was also the first to recently receive a conditional marketing authorisation from the European Union for use in children and adolescents aged 12 to 15 years.  This means that now prioritisation has been lifted, younger persons, too, can book a vaccine appointment. Currently, the coronavirus vaccination is recommended primarily for children with certain underlying conditions. However, BioNTech/Pfizer’s Comirnaty® vaccine can also be given to children and adolescents without underlying conditions, after being informed by a doctor and given the child's or adolescent's individual preferences and risk acceptance, or their custodians'.

How effective is the coronavirus vaccination for children?

The results of a study with approx. 2,000 children and adolescents between the ages
of 12 and 15 years show: BioNTech/Pfizer’s vaccine Comirnaty® is also safe for this age group and its effectiveness comparable to or even better than in the 16 to 25 age group. None of the approx. 1,000 children and adolescents vaccinated fell ill with COVID-19. All of the other study participants were injected with a placebo in the form of saline solution - 16 of them fell ill. This means that, in mathematical terms, the vaccine offers 100 percent protection from COVID-19 and has also been reported to prevent long-term health effects such as Long Covid or Paediatric Inflammatory Multisystem Syndrome
(PIMS).

For more on BioNTech/Pfizer’s vaccine and its mode of action, please click here.

What vaccine reactions have been observed in children?

The vaccinated children in the study also developed typical vaccine reactions that
completely resolved after one to three days. These include pain at the injection site, fever, shivering and headaches. Overall, such complaints were observed somewhat more often in the 12- to 15-year group than in older persons, especially after the second vaccine dose. These vaccine reactions are known from other clinical studies in adults and are usually no cause for concern. Serious side effects after vaccination were not observed in children or were not associated with the vaccination.

In consultation with your physician, you may give pain or fever-reducing medication in the recommended dosage to mitigate possible complaints.

Guidance on what to do in the case of suspected side effects can be found in this article.

In what cases should I have my child vaccinated

The coronavirus vaccination affords children from age 12 with certain underlying
conditions and special life situations safe and effective protection from severe COVID-19 disease. Moreover, vaccination not only protects the health of the child, but also that of their community. Because the more younger age groups - those with many social contacts - are vaccinated, the less easily the virus can spread. And this, in turn, also protects persons who cannot get vaccinated, such as babies who are too young to get the vaccine. This concept is known as community protection or herd immunity. This is why the STIKO recommends that children who have close contact with vulnerable persons (e.g. younger siblings, pregnant women or people with allergies to certain
ingredients of the coronavirus vaccines) also get the COVID-19 vaccine. The same goes for adolescents who are training for or working in an occupation that involves an increased risk of infection

Where can I get advised?

Prior to vaccination, you should get in-depth information about vaccination opportunities and ask your treating paediatrician for a face-to-face consultation and information. If your child is older and no longer has a paediatrician, you can also consult a family doctor you trust.  You can also find important information on the coronavirus vaccination in the information sheet and the consent form. 

How can I book a vaccination appointment?

We recommend that you get in touch with your treating paediatrician directly to
check whether their practice carries out COVID-19 vaccinations and how vaccination is organised at that location. Some practices offer special vaccination hours, while others check for open slots or directly reach out to you. In any case, there is likely to be great demand with extended waits – so as not to unnecessarily burden the system, you should only contact your doctor’s practice if your child is in the group that the STIKO has recommended get the vaccine.

You should bring the following to the vaccination appointment: 

• Your child’s identity card  
• Your child’s vaccination booklet (if they have none, you will receive a substitute certificate)
• A protective mask to comply with the hygiene measures
• A medical certificate, if your child is to be vaccinated on account of an underlying condition (only applies to vaccination at vaccination centres)

You might wish to take a moment to recollect your child’s medical history (e.g. allergies, fainting spells) in advance, so that you can discuss it with the vaccinating physician and gauge potential risks. Also allow some time for post-vaccination observation (about 15 minutes, for certain underlying conditions it can be somewhat longer).

Good to know: The vaccine is administered twice by injection into the muscle of the upper arm three to six weeks apart. The vaccine develops its full protective effect approx. 14 days after the second jab. The coronavirus vaccination is voluntary and free of charge.