New JCVI advice for high risk 0-4s

Will parents trust the ‘experts’?

HART has spent the last two years explaining why it never made sense to vaccinate young people. We have been horrified as the vaccine has been extended to ever younger age groups even as covid has become significantly milder. We have repeatedly written to the JCVI asking for their justifications. No satisfactory or comprehensive response has ever been received. 

Unstoppable as they appear to be, earlier this month an extraordinary document was published by the JCVI entitled 

Independent report COVID-19 vaccination of children aged 6 months to 4 years: JCVI advice, 9 December 2022’. 

The December date in the title is extremely confusing as the document has a publication date of 6th April 2023 with a recommendation for the programme to start in June. Where has this report (based on a two-day JCVI meeting 31st October – 1st November 2022) been hiding for the intervening 4 months? Where are the reports from more recent monthly meetings?

Logic would say that if this vaccine was really likely to be beneficial to this group of children, then offering it in December 2022 would have given some protection during the last winter season. Waiting until spring to protect against a winter virus seems utterly bizarre. But of course the JCVI have form. They did the same in February 2022 when they announced a ‘non-urgent offer’ of vaccination for 5-11-year-olds to start in April, acknowledging that it would do nothing for the current wave but ‘might’ be helpful in the autumn! This was despite substantive evidence that even any hypothetical protection would not last that long. 

On the other hand, if, as the evidence suggests, these vaccines turn out to cause more harm than good, then the more delays there are in the system the better. In general however, it seems parents are going to have to learn to use their own common sense and critical thinking in the absence of any trustworthy regulatory process. 

HART published yet another open letter to the JCVI on 6th December, the date when the MHRA first gave a conditional marketing authorisation for 0-4s. As has been the norm, no reply was received. The concerns remain the same:

  • SARS-CoV-2 infections in young children were extremely mild in the first wave and are now even milder with the predominant omicron variant; 
  • The vast majority of children have already been exposed;  
  • This age group has the most efficient innate immunity
  • There are increasing concerns over safety and possible adverse effects on the immune system; 
  • There is still no long-term safety data in adults let alone children. 

There is only one sane conclusion: this product should under no circumstances be recommended for children. 

The matter of efficacy is also rather important. The Phase 2/3 Pfizer trial on which approval was based could kindly be described as a dog’s dinner. They originally planned a 2 dose schedule as for older children and adults, but using a baby dose of 3 mcg. They then recruited a total of 4526 0-4s, with 3013 active and 1513 controls. As with the adult trials, after 6 months they were unblinded and the placebo children offered the vaccine. But late in the day, they realised that their ‘immuno-bridging’ target (where antibody levels are used to define success) was not met, since the 2-4-year-olds didn’t make enough antibodies with the low dose used. They introduced a protocol amendment to give a 3rd dose of vaccine or placebo but this only went to less than a third of the children in the trial.  

JCVI, in their infinite wisdom, are recommending the two dose schedule that was shown to be inadequate in Pfizer’s own trial. They base this on the estimate that the vast majority of children will already have been exposed to the virus and have some immunity. Why in that case do they need a novel vaccine with poor to non-existent safety data at all? The logic – or lack thereof – really does beggar belief. 

The only ‘positive’ (if one can call it that) to date for healthy under 5s is that JCVI have not recommended Covid-19 vaccination for them. They only deem it necessary for those with specific high risk conditions. The conditions they deem relevant are listed in the Green Book (the UKHSA guide to immunisation against infectious disease). Ones marked out for this ‘bonus’ vaccination comprise many serious but rare childhood conditions and it would be difficult to quantify the covid risk. They certainly don’t elucidate their thinking in any meaningful scientific way in this publication, just stating ‘from first principles’. 

In the first year of the pandemic, (a period that included two winter waves) there were only 2 deaths in infancy and not a single death in the 1-4 age group. That includes children with major comorbidities as well as their healthy counterparts. It has been demonstrated that young children have better T-cell immunity against SARS-CoV-2 than adults including cross-immunity from other coronaviruses and there are other mechanisms which may contribute to the mild nature of Covid-19 in childhood. Except for children with severe immune deficiencies, there is absolutely no reason to suppose that children with the various comorbidities listed would not have mounted a normal immune response when exposed to SARS-CoV-2, as indeed implied by the JCVI decision to only recommend two doses. And recommending a product to the immunocompromised that has immunosuppression of lymphocytes as a short-term side effect is what one might call reckless in the extreme. 

Two conditions included that raise very troubling questions, are autism and ‘all those on the learning disability register’. These are not in any way conditions linked to immune or cardiorespiratory dysfunction and there is no clear evidence that such children are at increased risk. Why are they being offered? The original suggestion was that because of their learning disability or neurodiversity, they might be less able to comply with mitigations such as social distancing and masking. Over time, these mitigations have been shown to be completely useless and indeed were one of the very aspects of pandemic policy to have had a likely detrimental effect on children’s mental health and wellbeing. Foisting experimental drugs on this cohort because they can’t comply with pointless NPIs is a breath-taking feat of illogical and immoral policy making. Seeing the pressure to force vaccination on young adults with learning disabilities via the Court of Protection, has been an abhorrent aspect of the ‘State Knows Best’. It is heartening to hear that a doctor has recently refused to implement a court order for vaccination of a 22-year-old in good health but with profound learning difficulties, on grounds that it would be ‘unethical’. Perhaps humanity is re-entering the room. 

The only moderately good news on this topic is that Switzerland have stopped vaccinating high risk children and indeed “only recommend vaccination for persons at particularly high risk .. from the age of 16 if the attending physician considers it to be medically indicated in the respective epidemiological situation in the individual case and a temporarily increased protection against serious illness can be expected.” Hopefully, if doctors are doing their job, this last category will be N = 0.

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