An 11-year-old receives a Pfizer vaccine in Hadera, Israel.
An 11-year-old receives a Pfizer vaccine in Hadera, Israel.
7 min read

Vaccine in Focus

Explainer

How Australia's COVID-19 vaccines for children aged five to 11 will work

With the Pfizer vaccine rollout for five to 11 year olds to begin in January, we asked an epidemiologist how the advice about doses and risks differs compared to adults.

Published Sunday 12 December 2021
By Akash Arora
Source: SBS News

From 10 January Australian children aged five to 11 will be able to receive a Pfizer COVID-19 vaccine following recommendations issued by the Australian Technical Advisory Group (ATAGI), which the government has accepted.

The announcement follows provisional approval by the Therapeutic Goods Administration (TGA) on 5 December, which was based on the results of a clinical trial that showed the vaccine among this age group was effective and the side effects mild and transient.

Health Minister Greg Hunt said the decision on Pfizer would give parents confidence and choice.

"It protects our children, it protects their families, and it protects their schools and so these are really important steps," he said.

ATAGI has said there should be "adequate supply" of the Pfizer shot to vaccinate all five to 11-year-old children in Australia.

When can I get my child vaccinated?

The rollout of the Pfizer (Comirnaty) vaccine - an mRNA vaccine - for children aged five to 11 will begin on 10 January, in time for the beginning of the school year.

Parents, carers and guardians will be able to book appointments from late December, and jabs will be available via GPs, Aboriginal Health Services, community pharmacies, and state and territory clinics.

ATAGI has recommended an eight-week interval between the two vaccine doses, but this can be shortened to three weeks in special circumstances such as outbreak settings.

Children aged five to 11 years with medical risk factors for severe illness, Aboriginal and Torres Strait Islander children, and children living in crowded conditions or outbreak areas are most likely to benefit from COVID-19 vaccination given their increased risk of severe outcomes and/or exposure, ATAGI said.

Children aged five to 11 years who have previously had a COVID-19 infection are able to receive the vaccine after they have recovered from their illness.

A health worker prepares to vaccinate a girl at the Sanford Civic Center in the US, where children as young as five are already being vaccinated.
Source: LightRocket/Getty Images

“Provisional” approval of Pfizer for the age group means it is valid for two years, during which the TGA will continue to assess it based on emerging domestic and international data.

The Moderna vaccine - also an mRNA vaccine - is still being considered by the TGA and ATAGI for use in children aged five to 11, with advice expected over the coming weeks.

What is the recommended dose for children? 

The recommended dosage for children will differ from that given to adults.

For five to 11-years-olds, a dose of 10 micrograms is given. For those aged 12 or older, it's 30 micrograms.

Orange-capped vials will be used to vaccinate five to 11-year-olds, as opposed to grey or purple that are used for the older age groups.

“That will assist providers in knowing which ones they’re grabbing out of the fridge,” Professor Alexandra Martiniuk, a professor of epidemiology at the University of Sydney, said.

Children who turn 12 after their first dose may receive the adolescent/adult formation of the Pfizer COVID-19 vaccine to complete their primary vaccine course.

Why are we vaccinating children?

While the risk of children developing severe cases of COVID-19 is low, a small proportion of children who contract the virus can get severely ill, leading to hospitalisations and death.

Between March and October, more than 1.9 million children aged five to 11 in the US tested positive for COVID-19, according to data from the Centers for Disease Control and Prevention. More than 8,300 were hospitalised, with 94 deaths.

The European Union, Canada and Israel have also approved Pfizer for younger children, while about 10 per cent of 5 to 11-year-olds in the US have already received their first dose.

“In Australia, about one-fifth of the COVID cases have been under 12 - that’s a fair number,” Professor Martiniuk said.

This age group is also susceptible to the sometimes-fatal MIS-C inflammatory syndrome, which COVID-19 can trigger.

“Even though they typically get mild disease or asymptomatic COVID, some of them can get sick, with some of them in hospitals, some of them in ICUs and obviously, overseas, we’re seeing a small number of children die due to COVID,” Professor Martiniuk said.

A recent report by the Murdoch Children’s Research Institute suggests long COVID may not be as prevalent in children as it is among adults, but children aged five to 11 can experience symptoms including headache, fatigue, sleep disturbance, concentration difficulties and abdominal pain for up to three months after contracting the virus. 

“So, given it’s a very safe and effective vaccine, it’s a great opportunity to vaccinate the five to 11-year-olds,” Professor Martiniuk said.

Are there any risks with getting children vaccinated?

Extensive data from clinical trials in countries including the US, Finland, Poland and Spain was carefully examined by the TGA before reaching the regulatory decision.

The most frequent adverse reactions seen in trials were injection-site pain, redness and swelling, fatigue, headache, muscle pain and chills.

“These are similar side effects to that seen among teenagers and adults, usually very mild,” Professor Martiniuk said.

A COVID-19 vaccination centre in Melbourne.
Source: AFP

Professor Fiona Russell from the Murdoch Children’s Research Institute said it was important to note millions of children have had two doses of the vaccine in the US already and safety surveillance has found it to be safe.

“This vaccine has been found to be well-tolerated, produce good immune responses and be highly efficacious against SARS-CoV-2 infection in a clinical trial,” she said in a statement on Monday.

Myocarditis (inflammation of the heart muscle) and pericarditis (swelling and irritation of tissue surrounding the heart) are two extremely rare side effects of the vaccine.

In the US, fewer than 200 males per million and fewer than 30 females per million in the 12-15 age group reported developing myocarditis.

“While there [is] no published data as yet about the rollout in 5 to 11-year-olds, there are no anecdotal reports about the children experiencing any serious side effects. This is very reassuring,” said Sanjaya Senanayake, a specialist in infectious diseases and Associate Professor of Medicine at The Australian National University, in a statement on Monday.

Will the vaccine be effective against Omicron?

Scientists and health experts all over the world are racing against time to figure out the ins and outs of Omicron - designated as a COVID-19 variant of concern by the World Health Organization.

Initial reports in the US have suggested the virus may be more transmissible than other variants such as Delta but is not as dangerous.

“Thus far, it does not look like there’s a great degree of severity to it,” President Joe Biden’s chief medical adviser, Anthony Fauci, told CNN on Monday.

While we don’t have any data yet about the vaccine efficacy, according to Professor Martiniuk, “there is a very good sense that the vaccines will have some efficacy. It’s not an on-off switch”.

“It’s not ‘not effective’ or ‘yes effective’, there’s going to be a degree of effectiveness,” she said. 

Will this be the end of school closures?

More than 270 schools in New South Wales had to close due to COVID-19 outbreaks in October and November. About two-thirds of those were primary schools, where most children didn’t qualify to be vaccinated. About 300 childcare centres were also impacted.

COVID-19 clusters have also led to unplanned school closures in Victoria. Thirty-six of the state’s 51 listed COVID-19 clusters last week were schools.

“[Due to Omicron], too much is up in the air to say for certain how things will pan out,” Professor Martiniuk said.

“[But] we know, having a vaccine reduces your chances of getting COVID and reduces your chances of transferring it to someone else. So having children vaccinated will reduce the chances of a child bringing COVID into the school or catching COVID at school, or giving it to someone else.”

Click here to find a clinic and book a COVID-19 vaccination. If you need help from a translator, call the Translating and Interpreting Service (TIS National) on 13 14 50. 

- With AAP