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The government is keeping tabs on the possibility of rolling out vaccinations for children aged five to 11, with a recommendation from the Expert Committee on Covid-19 Vaccination on the Pfizer-BioNTech Covid-19 vaccine expected in Nov. 2021.

Previously reported on Nov. 3, the U.S. Centers for Disease Control and Prevention (CDC) gave approval for the Pfizer vaccine to be administered to children aged five to 11 years old.

The U.S. Food and Drug Administration (FDA) also gave emergency authorisation of the vaccine for children on Oct. 29.

A 10 microgram dose of Pfizer's vaccine was approved for children, a third of what is given to those aged 12 and above.

Expert Committee noted Pfizer's approval in the U.S.

On Nov. 8, a Ministry of Health press release stated:

"The Expert Committee on Covid-19 Vaccination has noted that the Pfizer BioNTech/ Comirnaty vaccine has been approved by the U.S. for use in those aged five to 11 years.

(The Committee) is assessing the extension of vaccination to children aged five to 11 years in Singapore. This will confer on them protection against infection and severe illness, and better enable the resumption of a richer educational experience for our school children in 2022."

During the Multi-Ministry Task Force (MTF) press conference on the same day, Minister for Health Ong Ye Kung said:

"The incidence of Covid-19 infection in children has been increasing with a local surge in cases.

While children have a lower risk of severe disease, with a large number of cases, a small number can still develop life-threatening disease and severe later complications such as the MIS-C (multi-system inflammatory syndrome) in children.

And so far we have four such cases out of 8,000 children with Covid-19 infections, translates into 0.05 per cent. Vaccination will reduce this risk."

Possible serious effects of multi-system inflammatory syndrome in children with Covid-19

Senior Minister of State for Health Janil Puthucheary also elaborated on the serious effects of MIS-C, which affects organs like the heart, lungs, kidneys and brain.

However, while the disease is serious and potentially requires intensive care treatment, it is treatable with timely access to the right care.

Individual dosage for children is one-third of a dose for adults

Ong added that MOH has been in talks with Pfizer to prepare for the vaccination of children aged five to 11.

According to the health minister,  the talks are likely to stretch until early 2022 before vaccinations can begin.

Ong also noted that a dose for children is one-third of a full adult dosage, as trialled in a U.S clinical study. Two doses are needed for full vaccination.

The U.S. study concluded that vaccination for this group is safe and effective based on this reduced dosage of the adult formulation of the vaccine.

The Expert Committee has studied the data and agreed with conclusions of the review. The Committee assessed that in Singapore, it is overall beneficial for children to receive the vaccines especially in the current setting of community transmission.

Expert Committee to make recommendation later this month

Ong noted that the Committee is expected to make a recommendation of the use of the Pfizer vaccine for children aged five to 11 in Singapore later this month.

At the same time, MOH is embarking on a study involving a few hundred children in this age group who will similarly receive a smaller dosage of the vaccine. This is partly to see results in a local context, but also to work out a smooth vaccination process for children before scaling up.

Ong said:

"Hence, we are pushing ahead with vaccination for children aged five to 11 years as soon as we can, and once the Expert Committee on Covid-19 Vaccination has finalised their recommendation and given the go ahead. This is so that parents have the added assurance and peace of mind that their children can become protected."

He noted that once vaccinations cover children in this age range, only a small proportion of the population will be left unprotected by vaccines, namely very young children (infants to four years old) and people who refuse to get the vaccines.

No cases of myocarditis reported in U.S. paediatric regime study: Kenneth Mak

Director of Medical Services Kenneth Mak said that Singapore is not the only country considering approving vaccines for children.

He also said that the lower dose administered for children has been associated with a "low risk of side affects." He said:

"The side effects were similar to that seen in a vaccination of adults and mainly comprised local reactions like pain, swelling, redness, or more systemic effects like fever, headaches, muscle and joint aches or diarrhoea.

A small proportion of children experienced allergic reactions which were resolved with treatment and the rate was not higher than that seen in the adult population.

In particular, there were no cases of myocarditis reported with the revised paediatric regime in the study. And the data suggests that the paediatric regime is safe, which is why both the U.S. CDC and FDA have approved extending Covid-19 vaccines using the Pfizer-BioNTech vaccine to children between five and 11 years."

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Top image by Rou via Unsplash

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