The new Covid-19 vaccine for under-5s at risk of severe disease should be considered for all children in the age group given their high infection rate, a epidemiologist says.
From today, a version of the paediatric Pfizer Covid-19 vaccine is available for children aged 6 months to 4 years at higher risk of severe illness if they were to catch Covid-19.
National Immunisation Programme director Astrid Koornneef said the vaccine contained a lower dose of mRNA that had been formulated for this age group and approved by Medsafe.
It is a three-dose course, with the second dose given three weeks after the first, followed by a third dose at least eight weeks after the second.
Following Medsafe approval, the Covid-19 Vaccine Technical Advisory Group recommended the vaccine be approved for use in children who are severely immunocompromised, or who have complex and/or multiple health conditions which increase the risk of severe disease, Koornneef said.
University of Otago epidemiologist Dr Amanda Kvalsvig said this would better protect children with underlying conditions, but it was worth questioning why the choice was not being offered to all families, as was the case in the United States.
During the Omicron waves last year, children under the age of 5 were the highest infected age group, Kvalsvig said.
Between February and October 2022, three in four children aged 1-4 years (75.4 percent) tested positive for Covid-19, she said, citing the WellKiwis study of respiratory infections.
"Serious outcomes from Covid-19 are fortunately rare in this age group, but because the disease spreads so easily in young children, the impacts can be high.
"US figures show that Covid-19 infection is the seventh-highest cause of death in the 1-4 year age group, ahead of many other conditions that children are vaccinated against."
The vaccine is available for children aged 6 months to 4 years who have the following health conditions:
- chronic lung disease including bronchiectasis, cystic fibrosis, BiPAP for OSA (excluding mild, controlled asthma)
- complex congenital heart disease, acquired heart disease or congestive heart failure
- diabetes (insulin-dependent)
- chronic kidney disease
- severe cerebral palsy (or severe neurodisability including neuromuscular disorders)
- complex genetic, metabolic disease or multiple congenital anomalies for example trisomy 21/Downs Syndrome
- primary or acquired immunodeficiency
- haematologic malignancy and/or post-transplant (solid organ or HSCT in last 24 months)
- on immunosuppressive treatment including chemotherapy, high-dose corticosteroids, biologics or DMARDS.
Koornneef said children who were not in any of the high-risk categories had a low likelihood of severe illness from Covid-19, so they would not need or be eligible for the vaccine.