Why are children not recommended for herd immunity through intentional exposure to diseases like COVID-19 (Coronavirus Disease 2019), influenza, or pertussis?

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Last updated: June 22, 2025View editorial policy

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From the Guidelines

Children should never be intentionally exposed to diseases like COVID-19, influenza, or pertussis to achieve herd immunity, as this approach poses significant risks to their health and safety. The potential complications of these diseases in children can be severe, including long-term health problems or even death. For example, COVID-19 can cause multisystem inflammatory syndrome in children (MIS-C), a serious condition affecting multiple organ systems, as noted in a study from 1. Influenza can lead to pneumonia or encephalitis in children, while pertussis (whooping cough) can cause dangerous breathing difficulties, particularly in infants.

The American Academy of Pediatrics recommends annual influenza vaccination for everyone 6 months and older, including children and adolescents, during the influenza season, as stated in 1 and 1. This recommendation is based on the review of current available data on vaccine efficacy and the potential risks of influenza infection in children. Vaccination is a safer alternative to achieve herd immunity, providing protection without exposing children to the full disease and its potential complications.

Key points to consider include:

  • The risks of intentional exposure to diseases like COVID-19, influenza, or pertussis in children, including the potential for severe complications and long-term health problems.
  • The importance of vaccination in preventing the spread of these diseases and protecting vulnerable populations, such as elderly family members, immunocompromised individuals, and infants too young for vaccination.
  • The recommendation for annual influenza vaccination for all children 6 months and older, as stated in 1 and 1.
  • The potential benefits of vaccination in achieving herd immunity and reducing the transmission of infectious diseases in the community, as discussed in 1 and 1.

Overall, the safest and most effective way to achieve herd immunity is through vaccination, which provides individual protection and contributes to community immunity when enough people are vaccinated, as noted in 1, 1, and 1.

From the Research

Herd Immunity and Children

  • Herd immunity is a concept where a sufficient proportion of a population is immune to a disease, thereby preventing its spread and protecting those who are not immune, such as children 2.
  • However, children are not recommended for herd immunity through intentional exposure to diseases like COVID-19, influenza, or pertussis, as this approach can be harmful and even life-threatening 3, 4.
  • The idea of achieving herd immunity through natural infection is problematic, especially for children, as it can lead to serious health complications and even death 4, 5.

Risks and Challenges

  • Intentional exposure of children to diseases can lead to outbreaks and undermine the progress made in controlling and eliminating vaccine-preventable diseases 3, 6.
  • Moreover, the concept of herd immunity is often misunderstood, and its application can be complex, depending on the disease, vaccine, and population characteristics 5, 2.
  • The rise of anti-vaccination sentiment and vaccine hesitancy has also contributed to the challenges in achieving and maintaining herd immunity, putting vulnerable populations, including children, at risk 3, 4.

Vaccination and Herd Immunity

  • Vaccination remains the most effective way to achieve herd immunity and protect children and other vulnerable populations from infectious diseases 6, 4.
  • However, the strength of the moral obligation to contribute to herd immunity through vaccination depends on various factors, including the disease, vaccine, and population characteristics 5.
  • Educating the public and policymakers about the benefits and importance of vaccination is crucial to addressing vaccine hesitancy and maintaining herd immunity 4, 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Herd immunity.

Current biology : CB, 2021

Research

Vanishing vaccinations: why are so many Americans opting out of vaccinating their children?

University of Michigan journal of law reform. University of Michigan. Law School, 2004

Research

Herd immunity, vaccination and moral obligation.

Journal of medical ethics, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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