The Times today

[ToomuchHeat]

(Last line ‘mass exposure’)

Or, to out it another way, science should not work in a moral vacuum, but there is even more scope for ethical disagreements than scientific ones.

*What exactly makes you think you have better knowledge and credentials.

Cos wow thats arrogant.*

I never said I did - I said reasonable minds could differ and they do, unless you don’t consider the CDC reasonable? As a US citizen myself why wouldn’t (or shouldn’t) I?

You may not like the fact that people are looking to other countries to inform their beliefs on vaccines but you know as well as I do that the health authorities the world over are doing so. Yes we have population differences that also inform those considerations but there are lots of similarities too.

It is not arrogant to see my 15 year-old niece being vaccinated and wish I could get the same for my 16 year-old and 14 year-old children.

My main intention in my original post was not to whinge about my kids not being vaccinated, or to start a row about it. I apologise if that’s how it came out. My intention was to ask what our course of action should be regarding children who can’t be vaccinated - should they carry on as normal, expecting to be infected, or do everything to avoid it.

Please don’t call me arrogant. I am not stupid and I do not have a political agenda. I am just a parent trying to navigate this and gather information.

[quote Sparklingbrook]@herecomesthsun when a poster uses the expression ‘let it rip’ I just think ‘oh it’s one of those overly dramatic posters’ and lose respect for what they’re trying to do/say. 🤷‍♀️[/quote]
why so? it is a simple and direct way to describe a phenomenon that is happening or could happen

Because if you go around using the language reminiscent of a sensationalist Daily Mail headline people aren't going to take you seriously @herecomesthsun.

@RedToothBrush

So assuming that the JCVi are competent and the American version is also competent, a question remains about how they came to different conclusions.

Levels of health care different in uk and us. Different vaccinated levels (theres a tipping point where its of benefit to children to vaccinate to prevent them being orphaned for example).

The US has a lot of people with unmanaged / treated / diagnosed conditions - especially in vulnerable at risk groups.

We have a thing called the NHS.

We are not the US. Our risk factors and considerations are different.

This seems to be a hard concept for people to understand. People keep comparing countries as if its a like for like comparison.

And how are we so very different from Israel and half of Europe?

Many of them have much better financed and organised state health care systems than we do.

The main difference appears to be the availability of Pfizer vaccine, which is indeed a factor the JCVi would be taking into account.

It is not arrogant or unreasonable to question the JCVi's decision especially when so many similar countries are doing something different and we have had one of the worst outcomes for covid so far.

The "hard concept for people to understand " is a tad patronising by the way.

@Sparklingbrook

Because if you go around using the language reminiscent of a sensationalist Daily Mail headline people aren't going to take you seriously *@herecomesthsun*.

I am very happy to discuss things in medical terms if that gets a better response.

Don't on my account but maybe you should if you're not getting the better responses you need @herecomesthsun. But TBF other posters also use the same dramatic language and expect to be taken seriously there are other 'let it rip' fans out there.

@Sparklingbrook

Don't on my account but maybe you should if you're not getting the better responses you need *@herecomesthsun*. But TBF other posters also use the same dramatic language and expect to be taken seriously there are other 'let it rip' fans out there.

I am very much not a fan of letting it rip, believe me.

Why did you put "you need" in italics?

Because you sound like you need better responses? @herecomesthsun

There are other fans of using the term 'let it rip' but they are oddly silent today, on this thread at least.

I'd like a better quality of scientific discussion, if that's what you mean.

Rather than telling concerned posters they are "arrogant" for trying to discuss why the JCVi won't allow parents to choose vaccinations, when the CDC is encouraging them.

Completely agree Redtoothbrush re.JCVI decision making.
They should be getting maximum credit for their decision making ( against the derision in some cases of the rest of the world, including the US Fauci in particular)

They were right re. Extending the dose gap and going with the maximum first doses strategy. They were also the first to suggest mix and matching vaccines, again to much of the rest of the world mocking ( and yet many countries are doing this when the U.K. isn’t really as we don’t need to)
They were also right to give emergency approval. The first regulator in the world to do so. I think we are very lucky to have a world leading health regulator and I trust their decision making and evaluation.

They also kept calm amid all the EU AZ Macron nonsense back in January and kept to the data and held the line. Again shows their confidence in their own processes and their own decisions making imo.
A less confident regulator would have been more susceptible to the political winds.

@sashagabadon

They also kept calm amid all the EU AZ Macron nonsense back in January and kept to the data and held the line. Again shows their confidence in their own processes and their own decisions making imo. A less confident regulator would have been more susceptible to the political winds.

Couldn’t agree more with these posts

It’s good to see the decisions have held

The US has a lot of people with unmanaged / treated / diagnosed conditions - especially in vulnerable at risk groups

We have a thing called the NHS

We are not the US. Our risk factors and considerations are different

Yet our death rate per capita is even higher & the NHS is apparently heading for a waiting list that is 13m long, we are also a very health and wealth unequaly society.

Yet according to you, we are so very different? Access to Pfizer and the need to administer Pfizer booster doses, is likely the main reason.

Yet according to you, we are so very different? Access to Pfizer and the need to administer Pfizer booster doses, is likely the main reason

And how would you solve that issue? Not do the Pfizer booster doses?

It is possible however to say that the JCVi has made some decent decisions in the past, and still have a conversation about vaccines for children.

The JCVi may be good but they are not infallible.

Other countries have also done as well, or better in some respects with vaccines, and are still vaccinating 12-15 year olds, for example.

The thing about scientific method and process is that of its nature it is open to debate.

@Ifitquacks

Yet according to you, we are so very different? Access to Pfizer and the need to administer Pfizer booster doses, is likely the main reason

And how would you solve that issue? Not do the Pfizer booster doses?

One possibility - If healthy 18-30 year olds are not taking up their doses, could we offer some of those doses to CV/ CEV 12-17 year olds to get them done in time to be vaccinated before the September return to school.

@herecomesthsun

It is possible however to say that the JCVi has made some decent decisions in the past, and still have a conversation about vaccines for children.

The JCVi may be good but they are not infallible.

Other countries have also done as well, or better in some respects with vaccines, and are still vaccinating 12-15 year olds, for example.

The thing about scientific method and process is that of its nature it is open to debate.

Yes I think you can. And I would bet my mortgage they are watching countries that are vaccinating their teens closely. If the risk benefit therefore changes then I’m sure their advice will change too.

@Walkaround

Or, to out it another way, science should not work in a moral vacuum, but there is even more scope for ethical disagreements than scientific ones.

Well we could talk about the ethics of medicine in the US and why the US might make decisions different to us at this point, but we might be here quite a while. The UK has had its share of questionable decisions but our track record is somewhat better than the US.

'Safe' in scientific useage as a term could mean a lot of things too. It means the risks are low. That does't mean 'without risk' though and thats important to understand. And we are talking about an emergency approval rather than a normal process of approval.

As a default though, unless there is more than a marginal benefit, or there is a concern that one of the unknowns is the risk of side effects (and there is a worry that incoming data might not be so favourable and might undermine other vaccine programmes if not handled well) then we should air on the side of doing nothing as thats the basis of ethical medicine as a general rule. We shouldn't intervene unless the benefits to the individual are significant and worthwhile to them personallu and the question that the JVCI has openly said there is the biggest problem with: should we vaccinate one group, if there is little to no benefit to that group and its only marginal to society as a whole - as that is ethically questionable because the problem is that it carries only risk to that group and is therefore potentially at their expense.

This is one expert reaction to the JCVi decision, setting out some of the benefits to children of a vaccine that were possibly not considered:

Dr Peter English, Retired Consultant in Communicable Disease Control, Former Editor of Vaccines in Practice, Immediate past Chair of the BMA Public Health Medicine Committee, said:

“It seems clear, from the statement, and in particular the line “The primary aim of the vaccination programme has always been to prevent hospitalisations and deaths…”, that the JCVI had been instructed ONLY to take into account the impact of vaccinating children and young people on hospitalisations and deaths.

“Knowing how JCVI, and the people on the committee, work, I am sure that they know that the impact of Covid-19 on children and young people amounts to far more than just hospitalisations and deaths. Children also stand to benefit directly from:

“- Ending the pandemic and inevitable restrictions sooner;

“- Avoiding the harms relating to the secondary cases (people infected by the children), especially if teachers, parents or carers are infected;

“- Reducing the effects of Covid-19 (directly or through self-isolation etc) on loss of school;

“- And, crucially, given the growing evidence of its severity and frequency, by preventing the long term consequences on the children and adolescents of “Long Covid”. As Dr Tom Frieden in the USA tweeted: “The most certain way not to get long Covid is not to get Covid. The most certain way to not get Covid is to get vaccinated.”

“It would appear that none of these issues have been considered in this guidance; and I strongly suspect that it because the government told them not to consider them.”

And here is a Professor who is likewise "confused" as to why the risk benefit is in favour of children 12-15 being vaccinated in the US but not the UK

Dr Penny Ward, Faculty of Pharmaceutical Medicine, Visiting Professor in Pharmaceutical Medicine, Kings College London, said:

“I confess to being a tad confused by the JCVI recommendations, as the broad range of underlying conditions which increase risk for severe outcomes from COVID, and for which vaccination is recommended for 16-18 year olds, seem to have been omitted from the list of conditions for which vaccination of 12-15 year olds are recommended. No clear explanation is given for this and as a consequence one might imagine lengthy discussions in GP surgeries between parents of children with brittle diabetes and renal disease and their GP advisor.

Perhaps JCVI might consider a fuller – preferably completely referenced – document for use by the folks at the sharp end of patient care.

The JCVI has emphasized hospitalisation and death as benefits overlooking the, apparently less serious but potentially significantly disabling, potential for post covid syndrome which, as the disease is now more prevalent in the young, may soon affect almost as many covid affected children as adults.

Given the impact on ability to concentrate associated with this illness the relative impact on schooling might be greater than days lost only to the acute illness. JCVI has stated that it may revise these recommendations in future.

It is interesting to note the (completely referenced) recommendations of the US Advisory Committee on Immunisation Practices published in the MMWR last week which recommended continued universal vaccination of 12-15 year olds, based on the same considerations. I don’t myself follow why there is a positive risk benefit position for this age group in the US but a negative one in the UK, particularly as the US has been vaccinating 12-15 year olds for some time now and are therefore in a better position to have directly observed experience.”

TBH i do think there are a hell of a lot of people who are so wedded to the idea that vaccines are a miracle beyond question that they won't stop to think.

I am not anti-vax. Quite the opposite. I think vaccines are brilliant but should be used appropriately like any other medicine.

The problem is after being conditioned about the importance and value of vaccines to adults its hard to get your head around the idea of different risk profiles for children.

And risk - both on a population and individual level - is something that the vast majority of people (even educated ones) struggle to get their heads around full stop without the emotive stuff floating around.

Even if there was compelling data on there being risks I don't think some would want to listen to that as an argument because 'won't someone think of the children'.

At the moment we are simply not seeing enough to reasonably make a water tight case for vaccines. Its marginal - at best - and thats why there is a fundamental problem here and those who want it, just aren't going to be satisfied whatever simply because the MHRA say its safe. Without putting this into context of what safe means or what the ramifications would be for a number of deaths resulting from a child death or serious side effects from a vaccine - in the absence of a substantial benefit from vaccines.

The indirect consequences of this could have a huge impact on public health in the long run which would be far more damaging and cost more lives in non-covid related areas.

It is not a zero sum game to give vaccines to children even under the MHRA approval as safe.

We need trust in vaccines to be as high as possible across the board. Children will die in far greater numbers from other illnesses if we lose that public trust.

Thats where I come from. A place thinking about the health of children in relation to vaccines but from a different angle. I worry about the risk of things like measles far more than covid, because thats the reality of a world without vaccines and public trust in vaccines is absoluetely crucial in that equation.

It would only take a handful of cases in the press to trigger it. And the converse is not true in a 'do nothing' scenario. Not at this point (where we could only have started vaccinating most children now based on their risk profile). There's already been enough exposure.

This might change if we see the emergence of a new variant - but this would be picked up pretty damned quick if this were to arise and the JVCI probably think this likelihood is small at this stage in the panademic cycle.... (especially as many children will have some level of immunity through exposure anyway).

Very positive news OP, thanks for posting. Yesterday was the fifth consecutive day that numbers have decreased - whatever happens next (and nobody knows that that is), at the moment things feel quite positive.

Agree that N&J should be banned. The inflammatory falsehoods she posts are disgraceful @mnhq

That post on only hospitalisation and deaths doesn’t seem right.

Scanning JCVI document both Long Covid and isolation are mentioned

Concerns have been raised regarding post-acute COVID-19 syndrome (long COVID) in children. Emerging large-scale epidemiological studies indicate that this risk is very low in children, especially in comparison with adults, and similar to the sequelae of other respiratory viral infections in children.

As disruption of education is likely to have medium to long term impacts on public health, JCVI has also considered the potential for vaccination to prevent outbreaks in educational facilities. These potential benefits have been considered against the potential risks from vaccination.

Plus secondary infection consideration

Persons who are immunosuppressed are at higher risk of serious disease from COVID-19 and may not generate a full immune response to vaccination. Given the potential for indirectly protecting persons who are immunosuppressed, JCVI advises an extension of the current offer of vaccination to persons aged 12 to 17 years who are household contacts of those who are immunosuppressed.