Children and COVID-19 Research Library

Immunization is one of the most cost-effective public health interventions to date, saving an estimated 2 to 3 million lives each year. As a direct result of immunization, the world is closer than ever to eradicating polio, and deaths from measles – a major child killer – have declined by 73 per cent worldwide between 2000 and 2018, saving an estimated 23.2 million children’s lives. The emergence of COVID-19, however, threatens to reverse this progress by severely limiting access to life-saving vaccines.

When we have a vaccine against COVID-19, who should be vaccinated first? The question is relevant because, initially, vaccine availability will likely be limited. After healthcare and some other essential workers, it might seem the most obvious candidates are the elderly and other groups that are more vulnerable to the virus. However, we argue that this is not necessarily the case. Protecting the most vulnerable might require prioritizing vaccinating children in order to maximize the benefits of indirect immunity for the elderly and the other vulnerable groups. Whether this will be the best strategy from a public health perspective will depend on characteristics of the vaccine and of the virus, which are currently unknown. Here, we assess this possibility from an ethical point of view, by drawing comparisons and analogies with the case of the flu vaccination and with other examples of health policies and practices. We conclude that there are strong ethical reasons to vaccinate the young to protect the old, provided that the risks imposed on children are reasonable, even if that implies using children as a means to protect the elderly and the vulnerable

As cases of coronavirus disease 2019 (COVID-19) spread globally and across the USA, reaching over 140,000 US cases by March 30, 2020 (a number that is almost certainly an under estimate, given the lack of testing across states), scientists and companies throughout the world are searching for a response, a treatment or vaccine. Multiple companies are currently working on developing vaccines for the disease. A vaccine will, by the most optimistic estimates, not be available for at least 12–18 months; but while there is no certainty, there are good chances one or more of variable efficacy will, eventually, be available. When it is, one potential question states will have to address is whether the vaccine should be mandated for school children and anyone else. This article examines this question; the answer, naturally, is ‘it depends’, but this article offers guidance about the ethical and legal considerations for making the decision. The article will address this in three parts: the ethical considerations that affect whether a COVID-19 vaccine mandate is appropriate, potential legal constraints, and practical and political considerations.