In a sane era, no ethics review board would allow doctors to bribe young children to undergo a treatment with unknown dangers and minuscule benefits. But medical ethics are just one more casualty of the Covid pandemic, as Bill de Blasio cheerfully demonstrated at a recent press conference. New York’s mayor announced that children aged five and older would get $100 for being vaccinated against Covid—and then he made a direct pitch to those too young to appreciate the size of the city’s bribe.
“It buys a whole lot of candy,” the mayor explained.
Norms of science and medicine have been flouted throughout the pandemic, but the campaign to vaccinate schoolchildren represents a new low. It’s being led by the Centers for Disease Control with the help of politicians, journalists, and Sesame Street’s Big Bird (who appeared in a CNN special proselytizing children). Ninety-five percent of people in low-income countries haven’t yet received one dose, but officials supposedly dedicated to public health want to deplete the world’s still-limited supply by vaccinating more than 50 million young Americans at minimal risk from the disease. While some children with underlying medical conditions could benefit, no compelling case can be made for mandating universal vaccination in schools, which is under consideration in some states and has already been decreed by California’s governor.
Based on seroprevalence surveys, it appears that close to half of American schoolchildren have already had Covid. (The estimate was about 40 percent as of June and has undoubtedly risen during the spread of the Delta variant.) Children who’ve already had measles or chickenpox aren’t required to be vaccinated against those diseases. Why should tens of millions of kids with natural immunity against Covid be pressured to get a vaccine with known side effects? Federal officials have offered various answers, none convincing. The CDC continues to insist that infection is not proved to confer strong immunity and even published a study purporting to show that vaccinations offer better immunity. But as Martin Kulldorff of Harvard Medical School showed, that study was badly flawed and is contradicted by more rigorous research demonstrating that natural immunity is much stronger and longer-lasting than vaccine immunity.
For children without immunity, a vaccine would lessen the risk of being hospitalized or dying—but that risk for most children is already tiny, particularly for younger kids. (So is the risk of severe “long Covid,” and it’s questionable that vaccination would offer additional protection.) Among the 28 million Americans aged five to 11, the CDC counted just 66 Covid fatalities in the year ending in October, less than the number who died from the flu in 2019. And the Covid tally is surely an overcount that includes children who happened to test positive but actually died from other causes. (Two-thirds of them had at least one other underlying condition.) In studies analyzing the hospital records of children classified as Covid cases, researchers found that nearly half of the children showed no symptoms of the disease and were being treated for other problems.
In its risk-benefit analysis of vaccines for young children, the Food and Drug Administration estimates that, under most scenarios, only one death would be averted for every 1 million children vaccinated. That’s probably too optimistic, because the calculation is based on overestimates of past Covid mortality (those overcounted deaths by the CDC) and doesn’t account for the reductions in future mortality due to improved treatments. But even assuming that vaccination did prevent that one Covid death in a million, it would take only a small number of deaths from unforeseen side effects from the shot to result in a net loss of life.
Researchers have already identified several rare but worrisome side effects, including blood clots and myocarditis, which have not been adequately investigated. No one knows what else might turn up. When the FDA’s advisory committee approved the vaccine for young children on the basis of a clinical trial, one of its members, Eric Rubin of the New England Journal of Medicine, acknowledged that the trial was too small and too brief to identify rare and potentially severe side effects. “We’re never going to learn about how safe the vaccine is unless we start giving it,” Rubin said. “That’s just the way it goes.”
But that’s not how it has to go for otherwise healthy children. Many experts, including the United Kingdom’s advisory committee on vaccines, have recommended against vaccinating them. “The benefits to children from this vaccine are so low that almost any risk of side effects would mean it’s not a good idea to vaccinate,” says Jay Bhattacharya, a professor of medicine at Stanford. “The vaccine may be good for some kids with chronic conditions, but this should be left up to parents and pediatricians, not forced on everyone. Mandating this vaccine in all kids will undermine trust in other childhood vaccines.”
It has been argued that even if children themselves don’t benefit, vaccinating them will increase herd immunity and slow the spread of the virus to adults. But the risk of adults dying has already plummeted now that 80 percent of older Americans have received at least one dose of the vaccine, so vaccinating children would carry limited benefits. And now that we’ve learned what happens a few months after vaccination—people become vulnerable to breakthrough infections that can be transmitted to others—it makes more sense to build herd immunity by letting low-risk children acquire the stronger and more durable natural immunity.
Even if mass childhood vaccination did significantly slow the spread of the virus, it would still be unethical, as an international group of researchers argued in the British Medical Journal. “Should society be considering vaccinating children, subjecting them to any risk, not for the purpose of benefiting them but in order to protect adults?” they wrote. “We believe the onus is on adults to protect themselves.” If adults choose to take the risk of not being vaccinated, they have no right to ask children to take risks on their behalf.
The creepiest justification for vaccinating children is that it would “help schools safely return to in-person learning as well as extracurricular activities and sports,” in the CDC’s words. The United States has been singularly cruel to children throughout the pandemic, closing schools and masking students for extended periods despite extensive evidence that these measures were unnecessary and harmful. Sweden showed that keeping schools open throughout the pandemic—without masks, social distancing, smaller classes or strict quarantines—did little to endanger students, teachers, or the community. Other European countries have also kept schools open without forcing young students to wear masks. Today, with most American adults vaccinated, there’s less reason than ever to close schools. Yet instead of apologizing for their previous child abuse, officials are placating neurotic adults—and teachers’ unions—by threatening still more punishment unless students submit to vaccination.
The threat is a version of the mob’s old protection racket—Nice school you got here, be a shame if anything happened to it—but at least the mob’s extortionists didn’t target children. Mobsters were content with cash payoffs, which would be preferable to today’s demands for mass vaccination. The children would be better off if de Blasio and the other adult bullies settled for taking their candy money.
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