After more than four hours of exposure, discussion and voting, yesterday the National Vaccination Advisory Commission (CNAV) approved the administration of dose against COVID-19 for the kids under 12 years. The go-ahead was not imminent, according to all the experts consulted by El País, and it came after an intense week of comings and goings within the Uruguayan Pediatric Society (SUP) and demonstrations of anti-vaccine groups.
The statement issued by the Ministry of Public Health (SMEs) after the meeting indicates that the CNAV resolved “to advance in the extension of vaccination against COVID-19 in girls and boys from 5 to 11 years old, not mandatory, in a phased manner.” Besides, the vaccination of minors “It will begin in risk groups, on a date to be defined,” according to the text of the health portfolio.
These risk groups, as El País learned through sources in the portfolio, will be the same ones that were already prioritized in the rest of the vaccination campaign against COVID-19.
“It is emphasized that vaccination should not be a limitation in this age group for their access to any activity that involves them, guaranteeing their rights,” says the MSP in the statement. As El País learned, the point of non-obligatory nature was the one that CNAV scientists insisted the most on.
Because although vaccination against COVID-19 is not mandatory in Uruguay for any age, pediatricians emphasized the need for there to be no discrimination among children. That not only includes the possibility of going to school or a camp, but also attending baby football, a stadium, the cinema or any other activity.
Part of what tipped the balance in favor of the extension of vaccines to children was that access to a pharmacological measure that prevents the development of a disease is a right.
“Children cannot be deprived of this right,” the head professor of Pediatrics, María Catalina Pírez, told El País.
Along the same lines, the MSP Epidemiology authorities taught the part of the CNAV how the Pfizer vaccine prevented infections among vaccinated teens by more than 90%. And how desirable that would be in the population under 12 years of age who represent almost a third of the newly infected.
The right to be vaccinated, added the professor, “does not mean that you have to discriminate between peers and that there are activities for some and not for others.” Hence the emphasis on “non-mandatory”.
The COVID-19 vaccines in children they will be administered during the year 2022 and the intention of pediatricians is that it is before the start of classes in March, according to sources consulted by El País.
“The emerging evidence review process will continue and the recommendation and its strength will be updated as the evidence evolves. Likewise, according to the best current evidence available, this technical group, by majority, recommends the messenger RNA vaccine from Pfizer / BioNtech, ”the MSP statement reads.
Unanimous or not.
Although the statement from the health portfolio mentions that the recommendation of vaccinate children in a non-obligatory and staggered manner, it was approved “unanimously”, there was another part of the discussion among the experts that was not voted unanimously, but rather by majority.
Specifically, the point about the possible use of the Pfizer vaccine for that age group was in which not all the scientists agreed, according to El País.
For some pediatricians, studies of this vaccine have not yet been tested in a sufficient number of people to determine that it should be used, despite the fact that several international organizations have already approved it. At that time of the discussion, the members of the commission representing the chairs of immunology and vaccines alleged that the messenger RNA vaccine platform used by Pfizer has been the main protagonist of vaccination against COVID-19 and, in fact, It has been shown that it is more effective than the rest for the Delta variant, which is the one that circulates in 100% of cases in Uruguay today.
The resolution and the SUP.
El País reported yesterday that, despite the fact that last Wednesday the Uruguayan Society of Pediatrics (SUP) issued a statement in which it positioned itself as an institution in favor of the vaccination of children under 12 years of age, there was a document submitted to the board of directors that did not recommend the inoculation of the age group.
“Currently Uruguay has a successful situation in controlling it, characterized by high vaccination coverage, low viral circulation, with the appearance of viral variants that must be adequately monitored and without overloading the health system due to this disease. Therefore, it is not considered appropriate to offer a vaccine approved for emergency use universally in children under 12 years of age ”, the text indicates.
However, in that same document, written by the SUP Pharmacology Committee, it is stated that in the event of approval it was important that it be done in a staggered and not mandatory manner, as happened yesterday. Some pediatricians who wrote that letter are also part of the CNAV and are part of the unanimous vote in favor of the inoculation of children.
Anti-vaccine demonstration at the MSP after expert approval
While part of the group of scientists who advises the health authorities met inside the headquarters of the portfolio, outside a group of anti-vaccine protesters met who expressed their rejection of the decision. Among the leaders of yesterday’s mobilization was the lawyer Gustavo Salle and doctor Javier Sciuto, who expressed their criticism of the government’s policy regarding COVID-19, which they considered “Nazi”. “Salinas genocida” was one of the songs that they sang at the demonstration, in addition to “children don’t touch each other”. Then they set out for the Executive Tower on July 18.
As part of the call, the anti-vaccine leaders published a video referring to Mónica Pujadas, professor of pediatrics and adviser to the MSP, and accused of having a “conflict of interest” for being part of the Uruguayan Society of Pediatrics and also from the portfolio.
The data that was the key to the green light
The Ministry of Public Health (MSP) confirmed that a third of active cases in Uruguay today are under 12 years of age.
Children are no longer “the last link in the chain,” as the portfolio initially stated, and the MSP confirmed that they do not necessarily get the virus from being in contact with adults, because index cases have been detected in that age group.
Uruguay measured the effectiveness of vaccination in adolescents between 12 and 18 years of age and this exceeded 90%, according to data prepared by the portfolio.
In the studies of the German biopharmaceutical BioNTech and the American Pfizer, not even a single serious case of the disease was reported.
The Pfizer studies were proven to be 90.7% effective in preventing symptomatic disease of COVID-19 in the population aged 5 to 11 years.
In Chile, although with another vaccine technology, the serious effects were 0.0006% of the total doses administered (less than a complication due to suffering from the disease itself).