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Israeli Health Establishment Backs Vaccinating Children, but Not All Experts Agree
An Israeli health worker administers a dose of the Pfizer COVID-19 vaccine to a 6-year-old child at Clalit Health Services in Jerusalem on November 23, 2021. (Menachem Kahana/AFP via Getty Images)

Israeli Health Establishment Backs Vaccinating Children, but Not All Experts Agree

Only 3.6% of Israeli children ages 5-11 have so far been vaccinated.

Israel began vaccinating its young children, ages 5-11, following overwhelming support for the decision by the Health Ministry’s professional bodies. Some 73 of 75 leading health professionals, part of the ministry’s coronavirus vaccine committee and its team charged with managing epidemics, voted in favor of launching a campaign to vaccinate children.

The campaign took off last week as worrying signs of a possible fifth wave appeared. Since the height of the fourth wave in Israel in late August and early September, which saw some 10,000 cases diagnosed daily, Israel has experienced a steady decrease in new COVID-19 patients. In recent weeks, however, this trend has shown signs of reversing. The R value, which indicates the number of people infected by each COVID-19 patient, rose above 1 in the beginning of November. The decrease in new cases also stopped.

Adding to the worry are Hanukkah celebrations, which began on Sunday, November 28. It is possible that the holiday events, which bring families and crowds together, will give the spread of the pandemic a push, as holidays have in the past. The new omicron variant, whose effects on the pandemic are still unclear, is also a cause of sleepless nights for Israeli decision-makers. Already, the country has changed the rules governing entrance from abroad, closing its borders to foreign travelers for the next two weeks.

In a statement released November 22, at the start of the inoculation campaign, Israel’s Health Ministry said, “The vaccination of children against the coronavirus is recommended by the Israeli Pediatric Association and received the approval of the FDA, the CDC and the Israeli Health Ministry, having shown efficacy of 91% against symptomatic coronavirus in this age group and found to be effective and safe for them in clinical trials.”

“More than 3 million children have already been vaccinated in the United States, and now also in Israel we can protect them and spare them infection with the coronavirus, a potentially serious disease for children, as well,” the statement also said.

“In light of increased infection rates among the younger age groups, the Health Ministry encourages people to consult their pediatricians, to make decisions based on facts and data, to schedule an appointment with their HMOs, to vaccinate and protect their children and to prevent the next infection wave,” it concluded.

This is a matter of managing the risks. The vaccine is a new vaccine, it’s been around for approximately a year and no one knows what its long-term effects are.

While the Israeli health establishment mostly unified behind the decision to vaccinate young children with the special Pfizer vaccine doses created specifically for them, not all health professionals agree with the government’s policy.

The Israeli Public Emergency Council for the COVID-19 Crisis (PECC), an organization of doctors and researchers in relevant fields that has generated some controversy, released a position paper advising against the Health Ministry’s decision to recommend the vaccine for young children.

Professor Zvika Granot, an expert in immunology at The Hebrew University of Jerusalem, is a member of PECC. In a conversation with The Media Line, he explained the council’s stance, as well as his own, vis-à-vis the ongoing campaign to vaccinate children. “We support [the policy] that you vaccinate … to protect from a dangerous disease, and when we examine children’s reaction to contracting COVID-19, [we recognize that] the disease isn’t dangerous to children and so we don’t see an urgent need to vaccinate children,” Granot told The Media Line.

Granot stresses that PECC members are not opposed to the vaccine, but do not see the urgency of vaccinating healthy young children at present. Children who are at higher risk, because of preexisting health conditions should definitely be vaccinated, he said.

The professor further notes that the US Food and Drug Administration, upon whose endorsement the Israeli government relies, gave the vaccination of children its stamp of approval, but did not recommend its use. “We don’t know if it is harmful or not,” Granot said of the vaccine. “This is a matter of managing the risks. The vaccine is a new vaccine, it’s been around for approximately a year and no one knows what its long-term effects are,” he also said.

In a statement released after its advisory committee’s recommendation to vaccinate children ages 5-11, the Center for Disease Control (CDC) noted, “COVID-19 cases in children can result in hospitalizations, deaths, MIS-C (inflammatory syndromes) and long-term complications, such as ‘long COVID,’ in which symptoms can linger for months. The spread of the delta variant resulted in a surge of COVID-19 cases in children throughout the summer. During a six-week period in late June to mid-August, COVID-19 hospitalizations among children and adolescents increased fivefold. Vaccination, along with other preventative measures, can protect children from COVID-19 using the safe and effective vaccines already recommended for use in adolescents and adults in the United States.”

Granot said, “In principle, it’s supposed to be very, very safe. But ‘it’s supposed to be very, very safe in principle’ does not mean that it is very, very safe.”

“What I want is that the Health Ministry will not be so certain in saying that it’s safe,” he said. “There’s a degree of hubris here, something unfair. No one can say what are the side effects of a vaccine that has existed for a year. It simply isn’t possible.” He called on the ministry “to supply the facts as they are, even if the price is that some parents choose not to vaccinate their children.”

Professor Amnon Lahad, Granot’s colleague at Hebrew University who practices family medicine, is also a member of the PECC. While noting that symptoms of the coronavirus in healthy children are relatively light, Lahad turns to the virus’s long-term effects. “The long-term symptoms of the virus are an unknown,” Lahad told The Media Line, “and the side effects of the vaccine are an unknown, so we in fact have an equation with … four variables, so it doesn’t have a clear right answer.”

There’s a degree of hubris here, something unfair. No one can say what are the side effects of a vaccine that has existed for a year. It simply isn’t possible.

The uncertainty is strengthened by the limited scope of Pfizer’s study of vaccinated children, which included 1,500 patients who were supervised for two months, he says.

With this in mind, Lahad says, “Children in very high risk, that have prior illnesses or, you know what, not them but they have a sick sibling receiving treatment, or a sick parent, or even sometimes if they’re living with their grandparents who can become seriously ill, they should receive the vaccine. Contrarily, for the rest, it’s good to have it at hand, and if there will be a huge wave of the pandemic … it would be good to have it within reach.” But, he adds, “I wouldn’t rush to vaccinate.”

While the CDC identified the rise in the hospitalization of children during the latest wave, which cast its shadow over the previous belief in children’s relative safety from the virus, Lahad points out that in Israel: “Until now, here, we haven’t seen that big spike in serious illness among children as a result of the delta [variant], and certainly not children’s mortality rates.”

At present, it appears that Israeli parents share in the experts’ hesitance. Only 3.6% of children ages 5-11 have so far been vaccinated, according to Health Ministry data, and the Israeli news website Ynet reported that the new variant is driving parents to wait to vaccinate their children until things are further clarified.

 

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