From the Guidelines
The COVID-19 vaccine is not routinely recommended for young children in Australia, except in specific circumstances, due to the low risk of severe disease in this age group and the potential risks associated with vaccination. In Australia, COVID-19 vaccines are generally recommended for children aged 5 years and older, but the benefits of vaccination do not clearly outweigh the potential risks for most healthy young children under 5 years 1. The Australian Technical Advisory Group on Immunisation (ATAGI) has determined that younger children typically experience milder COVID-19 symptoms and have lower rates of severe disease compared to older age groups.
Some key factors to consider when evaluating the need for COVID-19 vaccination in young children include:
- Congenital or developmental disorders
- Nutritional status
- Maturational changes
- Immuno-compromised status, which may result in a lower antibody response to Covid‐19 vaccines 1 However, COVID-19 vaccination is recommended for children aged 6 months to 5 years who have severe immunocompromise, disability, or complex or multiple health conditions that increase their risk of severe COVID-19. For these higher-risk children, the Moderna or Pfizer pediatric formulations are used, with dosing adjusted appropriately for their age and weight.
The approach to COVID-19 vaccination in young children in Australia balances the lower disease burden in this age group against the need to protect those most vulnerable to severe outcomes, while continuing to monitor emerging evidence about vaccine safety and efficacy in this age group 1.
From the Research
COVID-19 Vaccine Recommendations for Young Children in Australia
The COVID-19 vaccine is not universally recommended for young children in Australia, with specific guidelines in place for different age groups and health conditions.
- Children aged 5 years and older are recommended to receive either the Comirnaty (Pfizer) or Spikevax (Moderna) mRNA COVID-19 vaccines, as they are efficacious and safe in the general population, including children 2.
- However, for children under 5 years, there is no universal program for COVID-19 vaccination, although vaccines are available for those with serious comorbidities 3.
Safety and Efficacy of COVID-19 Vaccines in Children
Studies have shown that COVID-19 vaccines are safe and effective in children, with most adverse events being mild to moderate 4.
- A study in the United States found that approximately 8.7 million doses of Pfizer-BioNTech COVID-19 vaccine were administered to children aged 5-11 years, with 4,249 reports of adverse events, mostly not serious 4.
- Another study compared parent-reported motivators of non-vaccination for children 5-11 years old in Australia and Canada, finding that information on vaccine safety and effectiveness were common motivators in both countries 5.
Vaccination Recommendations for Children with Underlying Health Conditions
Children and adolescents undergoing treatment for cancer and immunosuppressive therapy for non-malignant haematological conditions are particularly vulnerable to severe or fatal COVID-19, and COVID-19 vaccination is strongly recommended for this at-risk population 2.
- The Australian Technical Advisory Group on Immunisation recommends COVID-19 vaccination for children aged ≥ 5 years, including those with underlying health conditions 2.