Don’t rush. Do not rob associations of pediatricians. Above all, make sure that all precautions have been taken. Five days after the green light given by the European Medicines Agency for the immunization of 5-11 year olds with the Pfizer vaccine, the High Authority for Health (HAS) chose caution. In an opinion delivered on Tuesday, November 30, it recommends that the government“Expand now” the campaign to children at risk of serious form. On the other hand, it conditions the generalization of vaccination on a series of“Stakeholder hearings” and the results of studies expected in the coming weeks. Then, and only then, will it be possible to“Assess relevance” of this new phase.
As since the start of the pandemic, the HAS is therefore pursuing its strategy in stages, starting, once again, with the subjects ” at risk “. Of the 5.77 million children aged 5-11 living in France, 1,284 were hospitalized after Covid-19, 226 had to be placed in critical care and three died. Very low figures, compared to the tribute paid by adults, but above all unevenly distributed. Based on specialized literature, the HAS has identified a group of particularly sensitive pathologies. They affect a total of 364,000 children, or 6.3% of the total, but accumulate 21% of severe forms of the disease.
The opinion lists them in detail: congenital heart disease, chronic liver disease, chronic heart or respiratory disease (including severe asthma), neurological disease, pathological or drug-induced immunodeficiency, obesity, diabetes, hematologic malignancy, sickle cell anemia, trisomy 21 For these children, the “Direct individual benefit” vaccination appears established. The HAS does not stop there, however. She considers it prudent to vaccinate children “Carriers of one of the comorbidities previously identified in adults as at risk of developing a severe form of the disease” : recent cancer, chronic kidney disease or neurological disability.
One third of the adult dose
“Finally, we wanted to leave specialist practitioners the possibility of recommending, on a case-by-case basis, the vaccination of children who seem particularly vulnerable to them”, underlines Lise Alter, director of evaluation and access to innovation at HAS. Last category retained: children living in the entourage of immunocompromised people. Some of these children had sometimes already been immunized, under specific protocols. Everyone will now receive the dosage recommended by Pfizer: two injections of 10 micrograms, three weeks apart, or one-third of the adult dose.
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