A new CDC study reports that the first updated Covid-19 vaccine—the bivalent vaccine approved in fall 2022—was about 50 percent effective in blocking infection over a two-month post-vaccination period in children and adolescents aged five to 17. But this limited and transitory benefit does not justify the agency’s official recommendation that everyone in this low-risk age group be vaccinated against Covid-19.
The CDC recommended the bivalent mRNA Covid-19 vaccine—containing the original virus and a later Omicron strain—for persons aged 12 or older on September 1, 2022, and for children aged five to 11 on October 12, 2022. The bivalent vaccine was superseded last fall by a univalent vaccine against a subsequent Omicron variant. Yet limited data are available on the bivalent vaccine and subsequent univalent vaccine’s protection against infection for children and adolescents.
The new study prospectively followed and administered weekly tests to 2,959 participants between the ages of five and 17. It found that the bivalent vaccine was 54.0 percent effective against infection and 49.4 percent effective against symptomatic Covid-19 when comparing those who received it with those who were unvaccinated or received only the original Covid-19 vaccine. The proctors didn’t monitor the participants for long; among participants who received a bivalent Covid-19 vaccine dose, the median post-vaccination observation time was only 50 days.
There is little reason to believe, however, that the bivalent vaccine’s limited protection against disease transmission was durable or that the newer univalent vaccine will be any better. Early last year, Anthony Fauci acknowledged in a coauthored medical article that good scientific basis existed to believe that vaccines against respiratory viruses like the one that causes Covid-19 would provide only “incomplete and short-lived” protection against infection. As time passed and new viral variants emerged, it became clear that while Covid vaccines continued to protect against severe illness and death, their incomplete ability to stop viral transmission quickly faded over a few months.
That did not stop public-health officials like Fauci from recommending Covid vaccines for schoolchildren. Fauci defended vaccine mandates as protection against transmission, even though, as his January 2023 article makes clear, he has long understood that the effectiveness against infection of these types of vaccines (for viral respiratory diseases such as influenza and Covid) “is decidedly suboptimal” and “is measured only in months.” And the CDC continues to recommend that everyone, aged five and older, be vaccinated.
But protecting a low-risk group like schoolchildren from viral transmission has never made much sense. It was clear in the pandemic’s early days that children had little risk of severe outcomes from the virus. Over nearly four years (from January 2020 to December 2023), children aged five to 17 accounted for less than one-tenth of 1 percent of total Covid-19 deaths in the U.S. (911 deaths out of 1.17 million). In contrast, the most vulnerable group—people aged 65 and older—accounted for more than three-quarters of deaths. Similarly, those aged five to 17 have consistently had one-tenth the Covid-19 hospitalization rate of the population at large, while those aged 65 and older had rates 25 times as high.
Covid-19 vaccines, like any medicine, are not risk-free. They pose a documented risk of serious heart inflammation (myocarditis and pericarditis) most frequently seen in adolescent and young adult males. Such risks warrant caution in recommending the vaccines to a group with such an extraordinarily low risk of severe disease.
If the CDC is going to recommend vaccination for those aged 18 or younger, it should focus its guidance on the subpopulation within this age group that is most at risk of severe disease and death. Children with certain chronic medical conditions, for example—such as Type 1 diabetes, obesity, and cardiac and circulatory congenital anomalies—are much more likely than their peers to experience severe Covid-19 illness and hospitalization. As pediatric vaccine expert Paul Offit wrote in The New England Journal of Medicine, new Covid vaccines are “best reserved for the people most likely to need protection against severe disease—specifically, older adults, people with multiple coexisting conditions that put them at high risk for serious illness, and those who are immunocompromised. . . . We should stop trying to prevent all symptomatic infections in healthy, young people by boosting them with vaccines containing mRNA from strains that might disappear a few months later.”
Most of the world’s major nations have concluded that healthy children do not need Covid-19 vaccinations. The time has come for the United States to change its recommendation that all schoolkids be vaccinated, which does little to protect them, exposes them to unnecessary risk, and further erodes trust in our public-health authorities.
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