Vaccination of children and young people against COVID-19 remains highly debated, with considerable policy divergence internationally. Vaccinating younger age groups was not an initial plan when the original variant of the SARS-CoV-2 virus emerged, because children and young people (CYP) seemed very mildly affected by COVID-19. However, new mutations led to increased virulence of the SARS-CoV-2. This led to an increase in the population threshold of vaccination coverage required for prevention of viral spread, possibly to levels above 80% vaccine uptake in the whole population. Also, due to the successful roll-out of vaccination to older and at-risk populations, the virus began to circulate in greater numbers amongst younger populations, which became a new concern. An important element was also the issue of harms unrelated to health, such as educational disruption. A broader perspective weighted the long-term educational benefits and shorter-term health issues. In addition, increasing awareness of the possible rare complications of COVID-19 in CYP and the “long COVID” syndrome prompted the scientific study and comparison of the risks of disease vs the safety of vaccination, even among the very young.

As a result, pharmaceutical and biotechnological companies started testing the efficacy and safety of vaccines in adolescents and children. In parallel, an increasing number of countries started to roll out vaccines in under-18-year-olds to protect themselves from the new and ever-more-virulent variants. The first studies on the uptake, effectiveness and safety of the vaccines in children at the population level were conducted in 2021. This editorial aims to review the development of research on vaccinating CYP: the circumstances, rationale and evidence that was used to extend the vaccine programme to CYP during the COVID-19 pandemic in some countries. The paper is based on the information available until December 1, 2021.

Cite as

Rudan, I., Adeloye, D., Katikireddi, S., Murray, J., Simpson, C., Shah, S., Robertson, C., Sheikh, A. & EAVE II Collaboration 2021, 'The COVID-19 pandemic in children and young people during 2020-2021: A complex discussion on vaccination', Journal of Global Health, 11, article no: 01011. https://doi.org/10.7189/jogh.11.01011

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Last updated: 21 June 2023
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