COVID-19 Vaccines in Children and Adolescents

The coronavirus disease-2019 (COVID-19) pandemic has an effect on children, either directly or indirectly. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) immunization in children and adolescents plays a role in containing the COVID-19 pandemic. As of December 2021, a limited number of COVID-19 vaccines have been approved for use in children and/or adolescents. Both mRNA vaccines (BNT162b and mRNA 1273) were found to be well tolerated and effective in large phase 2 and phase 3 clinical trials. BNT162b2 vaccine was approved for children and adolescents aged 5 to 18, and mRNA-1273 vaccine for children aged 12 to 17. CoronaVac, an inactivated SARSCoV- 2 vaccine, was also found to be safe and immunogenic in a phase 1/2 clinical trial in China, and is presently used for pediatric immunization in some countries as a routine. As COVID-19 is less severe in children than it is in adults, the benefit of its vaccination in children is less than that of adults. Immunization with an effective and safe vaccine in children and adolescents is likely to provide protection against severe COVID-19 infection. Pediatric COVID-19 vaccines may also protect against the long-term effects of COVID-19 (MIS-C and long COVID) and community transmission, as well as mitigate the indirect effects of the pandemic on them. Vaccination should be prioritized for children and adolescents who have an increased risk of severe COVID-19 infection. If vaccines were evenly distributed worldwide, they would be the safest way to return normal life. Otherwise, lowand middle-income countries will crash, resulting in mortality, undermining global recovery, and allowing more virulent variants (such as Omicron) to emerge. If health officials incorporate the COVID-19 vaccine into routine immunization, they should also regularly evaluate their benefits and potential risks.