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Children and COVID-19 Research Library

UNDER DEVELOPMENT UNICEF Innocenti's curated library of COVID-19 + Children research

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Global ethical considerations regarding mandatory vaccination in children

AUTHOR(S)
Julian Savulescu; Alberto Giubilini; Margie Danchin

Published: January 2021   Journal: The Jpurnal of Pediatrics
Whether children should be vaccinated against COVID-19 (or other infectious diseases such as influenza) and whether some degree of coercion should be exercised by the state to ensure high uptake depends, among other things, on the safety and efficacy of the vaccine. For COVID-19 these are currently unknown for children, with unanswered questions also on children’s role in transmission of the virus, the extent to which the vaccine will reduce transmission, and the expected benefit (if any) to the child. Ultimately, deciding whether to recommend that children receive a novel vaccine for a disease which is not a major threat to them, or to mandate the vaccine, requires precise information on risks, including disease severity and vaccine safety and effectiveness, and comparative evaluation of the alternatives, and of the levels of coercion associated with each. But the decision also requires balancing self-interest with duty to others, and liberty with utility. Separate to ensuring vaccine supply and access, we outline three requirements for mandatory vaccination from an ethical perspective: (1) whether the disease is a grave threat to the health of children and to public health; (2) positive comparative expected utility of mandatory vaccination and (3) proportionate coercion. We also suggest that the case for mandatory vaccine in children may be strong in the case of influenza vaccination during the COVID-19 pandemic.
Cite this research | Open access | No. of pages: 21 | Language: English | Topics: Health | Tags: child health, COVID-19, ethical research, vaccination
Integrating public health ethics into shared decision-making for children during the COVID-19 pandemic

AUTHOR(S)
Angira Patel; Dalia M. Feltman; Erin Talati Paquette

Published: December 2020   Journal: The Journal of Pediatrics
This commentary examines how values typically prioritized in public health ethics such as solidarity and justice can be integrated into SDM, where the individual child's best interest and caregiver preferences are often paramount. Additionally, it suggests a framework to integrate public health ethics into the traditional shared decision-making continuum using 4 scenarios that are examined for risks, benefits, settings, and appropriate levels of directiveness.
Impacts of the COVID-19 pandemic on children: an ethical analysis with a global-child lens

AUTHOR(S)
Sydney Campbell; Carlo Cicero Oneto; Manav Preet Singh Saini (et al.)

Published: November 2020   Journal: Global Studies of Childhood
During the COVID-19 pandemic, the lives of children and adolescents in resource-limited countries have been significantly impacted in complex ways, while largely having their interests overlooked. The purpose of this colloquium is to examine these impacts across seven resource-limited nations and apply an ethical lens to examine the ways in which children and adolescents have been treated impermissibly.
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Research on violence against children during the COVID-19 pandemic
Institution: *UNICEF
Published: October 2020 UNICEF Publication
Research and data are important to draw attention to the experiences of children during the COVID-19 pandemic, to advocate for a range of protection services to be available during the crisis and beyond, and to inform the design of violence against children (VAC) prevention and response programmes. That said, the need for evidence must be balanced against the substantial risks to children, families and even researchers participating in violence-related research and data collection efforts. These risks are always present, but are likely to be amplified in the context of COVID-19, which may require rapid research, often via remote methods such as mobile phones or the Internet. This new UNICEF publication, Research on Violence against Children during the COVID-19 Pandemic: Guidance to inform ethical data collection and evidence generation, addresses key questions on generating VAC evidence that may arise during the pandemic and includes a decision tree (below) to guide those considering conducting research and data collection on VAC during COVID-19.

 
Digital Contact Tracing and Surveillance During COVID-19. General and child-specific ethical issues

Balancing the need to collect data to support good decision-making versus the need to protect children from harm created through the collection of the data has never been more challenging than in the context of the global COVID-19 pandemic. The response to the pandemic has seen an unprecedented rapid scaling up of technologies to support digital contact tracing and surveillance. As the pandemic progresses, we are also likely to see the emergence of more applications that link datasets as we seek to better understand the secondary impacts of the pandemic on children and their families.

This working paper explores the implications for privacy as the linking of datasets increases the likelihood that children will be identifiable and consequently, the opportunities for (sensitive) data profiling. It also frequently involves making data available to a broader set of users or data managers.

While it is recognized that reuse of unidentifiable data could potentially serve future public health responses and research, the nature of, access to and use of the data now and in future necessitate accountability, transparency and clear governance processes. It requires that these be in place from the outset. These are needed to ensure that data privacy is protected to the greatest degree possible and that the limitations to the use of these data are clearly articulated.

Digital Contact Tracing and Surveillance During COVID-19. General and child-specific ethical issues
The response to COVID-19 has seen an unprecedented rapid scaling up of technologies to support digital contact tracing and surveillance. The consequent collation and use of personally identifiable data may however pose significant risks to children’s rights. This is compounded by the greater number and more varied players making decisions about how data, including children’s data, are used and how related risks are assessed and handled. This means that we need to establish clear governance processes for these tools and the data collection process and engage with a broader set of government and industry partners to ensure that children’s rights are not overlooked.
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UNICEF Innocenti's Children and COVID-19 Library is a database collecting research from around the world on COVID-19 and its impacts on children and adolescents.

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COVID-19 & Children: Rapid Research Response

UNICEF Innocenti is mobilizing a rapid research response in line with UNICEF’s global response to the COVID-19 crisis. The initiatives we’ve begun will provide the broad range of evidence needed to inform our work to scale up rapid assessment, develop urgent mitigating strategies in programming and advocacy, and preparation of interventions to respond to the medium and longer-term consequences of the COVID-19 crisis. The research projects cover a rapid review of evidence, education analysis, and social and economic policies.