Ensuring the protection of a group that makes up a quarter of the world's population seems essential as we move toward control of the pandemic. Protection is urgently needed when the risk of disease is high.
However, for children, there is a relatively low risk of disease. According to WHO data, children account for 1 in 9 SARS-CoV-2 infections, which constitutes only 2% of all hospitalizations. Most infections in children are mild and they recover completely. Severe disease is rare, but well described; this includes the inflammatory and life-threatening condition Multisystemic Inflammatory Syndrome in Children (MIS-C). About 1 in 3500 cases in children results in death, compared with a figure of 1 in 60 for adults.
While children are known to transmit the virus to others, recent evidence from Iceland and South Korea suggests that children may be less efficient transmitters of SARS-CoV-2 than previously thought. To put this in perspective, it is important to remember that the risk of children spreading the virus is not zero, and an increase in cases in the community will also be reflected in children.
While keeping schools open for face-to-face classes is critical to children's education and development, having a large cohort of unvaccinated and susceptible children, despite their lower risk of infection and transmission, can become important if cases in the community begin to increase.
Finally, evoking the ethical principle of distributive justice that benefits and burdens should be distributed among members of society fairly, the specialists argue that children should be included in COVID-19 vaccine trials so that they can benefit from immunization.