Vaccinating Young People Is Unethical; Those Vaccines Should Go to Poor Countries

On September 3rd, the Joint Committee on Vaccination and Immunisation (JCVI) – an independent panel of experts – advised against offering COVID-19 vaccines to healthy children aged 12-15.

The panel concluded that, although “the health benefits from vaccination are marginally greater than the potential known harms”, the margin of benefit is “too small to support universal vaccination”. However, it did recommend expanding the list of underlying health conditions that would qualify someone in the relevant age-group for vaccination.

The panel’s recommendation apparently came “as a blow to the Government”, which for some reason really wants to vaccinate healthy children.

Immediately after the announcement, Health Secretary Sajid Javid wrote to the U.K.’s Chief Medical Officers asking them to “consider the matter from a broader perspective” (which reads like bureaucratese for “ignore the recommendation of the JCVI, and find a new justification for the policy”).

And it’s worth asking: if the Government does decide to ignore the JCVI’s recommendation, and offer the vaccine to healthy children anyway, will it adopt the slogan: “Don’t necessarily follow the science.”

I can understand why children with an underlying health condition would be worried about getting COVID-19, and it seems right that they’re being offered a vaccine. However, for the overwhelming majority of healthy children, the disease poses virtually no serious risk.

The main justification for vaccinating young people is to protect older people. But given evidence that natural immunity provides better protection against infection than the Pfizer vaccine (the only vaccine approved for those aged 12-15), this justification looks increasingly weak.

It’s now abundantly clear that vaccinated people can transmit the virus. Hence the only true safeguard – for a child visiting a vulnerable grandparent, say – is a negative COVID-19 test beforehand.

However, even if the vaccines had no side effects and offered the same level of protection as natural immunity, it would be unethical to vaccinate children at the present time. And that’s because it’s a waste of vaccines that could go to people who actually need them.

Rather than offering vaccines to children and young people, rich countries like the U.K. – which have so far been hogging all the vaccines – should donate them to elderly people in poor countries.

Even though a government must always look to the interests of its own citizens first, the benefit/cost ratio of donating vaccines to poor countries is so vast that this principle is hardly relevant. People forget that the risk of death from COVID-19 is not just higher, but orders of magnitude higher, for elderly people.

I said that Britain should donate its remaining vaccines to poor countries in an article back in July. The same argument has been made by several other commentators, including – mostly recently – two scientists writing in the journal Nature.

Zain Chagla and Madhukar Pai argue against vaccine ‘booster’ programs on the grounds that far more lives could be saved by administering vaccines in poor countries. The global vaccine supply is limited, they note, so “this is a zero-sum game”. Every vaccine given to a healthy British 12 year-old is one that can’t go to a 70 year-old in Africa or Latin America.

Even discounting side effects, it’s unethical to vaccinate 12–15 year-olds in Britain when a such small share of the population in poor countries has been offered a vaccine. COVID-19 is a disease that disproportionately targets older people, while posing almost no risk to children. Our vaccination policy should reflect that.