The authors suggest that the risk-benefit ratio of vaccination is not as clear in the case of minors, as the disease is usually mild or asymptomatic in this group of the population
The difficulty in establishing a suitable risk-benefit balance regarding the vaccination of children and teenagers against COVID-19 poses ethical dilemmas that must be taken into account in decision-making. This was the focus of research carried out by Laura García Garcés, Marta Lluesma Vidal and Raquel Carcelén, lecturers at the Faculty of Health Sciences at the CEU Cardenal Herrera University (CEU UCH) of Valencia, together with Ángel Gerónimo, from the EFI Foundation’s Purísima Franciscanas School. Their work was presented as a poster at the 13thI International Congress of the Spanish Association of Bioethics and Medical Ethics (AEBI), held in Logroño, and was awarded the top prize in that section. The lack of data on the medium and long-term effects of the vaccines, coupled with the fact that COVID-19 does not represent a significant threat for the health of minors, led the authors to conclude that “we need to consider carefully both the benefits that minors could obtain from the vaccination as well as the risks to which they could be exposed in our decision-making”.
For this award-winning study, named “Consideraciones éticas de la vacunación de niños y adolescentes contra la COVID-19” (ethical considerations of vaccinating children and teenagers against COVID-19), the professors conducted an exhaustive analysis of the most recent scientific publications on the ethical aspects of vaccinating minors against COVID-19 from the Cochrane, Pubmed, Web of Science and EBSCO host databases. They extracted the main ethical dilemmas linked to vaccinating minors against COVID-19 from this analysis.
According to the authors, “in the case of adults it is easier to establish a suitable risk-benefit balance for vaccination, taking into account the high morbidity and mortality from this disease among this population. However, COVID-19 does not represent such an important threat for the health of children and teenagers, as the disease is usually mild or asymptomatic in this group of the population.”
In this sense, they recall that only a small part of minors affected by the disease have to be taken to ICUs and require ventilatory support. Mortality is also very rare, occurring in just 0.48% of the considered population. In addition to the direct benefit of vaccination not being as clear in this group of population, the authors also include as a risk the fact that the scientific community still does not know the medium and long-term secondary effects of these vaccines.
Collective immunity and the minor’s interests
In their analysis, the authors also consider both sides of the issue of collective immunity with regard to minors. “On the one hand, achieving collective immunity could accelerate the return to normality, which would have a positive impact on the life and full personal development of children, who have been affected by situations of social isolation and distance learning. Vaccinating minors to protect the most vulnerable people could be justified from a utilitarian point of view, according to which the minor’s interests could be contingent upon society’s interests,” the researchers say. They conclude that establishing a suitable risk-benefit balance is essential for decision-making regarding vaccinating children and teenagers against COVID-19. This study was recognized as the best poster presented at the international conference on bioethics recently held in Logroño.