Vaccinating children against COVID is important. But only 11% of 5- to 11-year-olds in England have received the first dose of COVID vaccine. Where we have safe and effective vaccines, there’s no sense in not rolling them out.

First published: Sept 2022.

Several countries, including the US and Australia, recommend vaccinating children aged five to 11 against COVID.

The UK was much slower to approve this compared with some other countries and labelled it a non-urgent offer when COVID vaccines were made available to this age group in April this year. Children under five in the UK are not yet eligible for COVID vaccination.

The NHS has promoted COVID vaccines for primary school aged children alongside older kids; however, uptake has been low. Only 11% of 5- to 11-year-olds in England have received the first dose.

But parents in England wanting to have their children vaccinated once they turn five may no longer be able to. It’s come to light that any child who turns five after August 2022 won’t be eligible to receive a COVID vaccine until they are 12, unless they are in a higher-risk group. The relevant policy from the UK Health Security Agency states:

“This one-off programme applies to those aged 5 to 11 years, including those who turn five years of age before the end of August 2022.”

Wales will continue to offer COVID vaccination to children who turn five after August 31, and it’s not yet clear what Scotland and Northern Ireland are doing.

But this move in England makes little sense. Vaccinating children against COVID is important, despite some of the arguments you might hear to the contrary.

COVID can be serious for kids

One popular idea is that COVID is a less serious infection in young children than it is in adults. Indeed, data has suggested that children generally fare better with COVID compared with adults. But this doesn’t mean that all children have the same experience. Some children can experience severe infections.

And, of course, the risk of this happening is higher the more COVID cases there are. It’s no secret we’ve seen high levels of COVID infections in the UK in recent times.

Hospitalisations for COVID in adults have been falling due in a large part to the successful vaccination campaigns. But this is sadly not the case for children. In 2020 in England, there were 3,259 hospitalisations in under 18s for COVID. This has risen to 16,412 so far in 2022. Sadly, there have been more deaths in children due to COVID too – 37 by the end of July this year, compared with 51 in 2021 and 12 in 2020.

Children can also develop long COVID, and the more children that are infected, the higher the number of long COVID cases we’ll see. Long COVID is a condition where symptoms continue for more than 12 weeks after the initial infection, and can’t be explained by an alternative diagnosis. These symptoms can include breathlessness, fatigue and gastrointestinal problems, for example, and can be life-changing.

At least 105,000 children and young people currently have long COVID in the UK, of which 22,000 have had symptoms for more than a year. A staggering 18,000 children and young adults report their activities are “limited a lot”. This is an appalling figure and again emphasises that COVID is not a trivial infection.

The benefits of vaccination are clear

Some might suggest that natural immunity is better than a vaccine. While we do have incredible immune systems, it takes time for the immune system to act if exposed to a new threat. Vaccines teach your immune system what to do, so it can react quickly and appropriately when it encounters the virus.

A related argument is that young children may well already have been infected with COVID by the time they can be vaccinated, possibly reducing the benefit.

While it’s certainly true that many young children have been infected, it’s now clear that a prior COVID infection doesn’t necessarily protect against reinfection. Notably, the risk of reinfection with omicron is much greater than with previous variants – around five times higher than the risk with delta – and younger people are more likely to be reinfected.

Also, hybrid immunity (immunity conferred by both vaccination and infection) seems to offer better protection than that from infection alone, an argument in favour of vaccinating children.

Certain risks of vaccination have circulated on social media, in particular, that the vaccine can cause myocarditis (inflammation of the heart muscle). However, the risk of myocarditis is much higher from a COVID infection itself. COVID vaccines have been used successfully and safely billions of times around the world.

Weighing up the risks and benefits illuminates the real harms and costs of COVID in children, and the clear impetus to have them vaccinated. This analysis has led most developed countries to recommend that children are vaccinated against COVID.

With schools and buildings not necessarily protected by adequate ventilation, and mask-wearing no longer mandated, vaccine protection is even more urgent. England is now an outlier in the world and it’s not clear why this decision has been made.

PMP Magazine


  • COVID-19: the green book, chapter 14a | UK Health Security Agency

  • — AUTHOR —

    Professor Sheena Cruickshank, Professor in Biomedical Sciences, University of Manchester.

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