How has the UK’s Covid vaccination rollout come to this? We started the year with a jabs programme that was the envy of much of the world. We successfully fought off a wave of infections with a rapid, careful and systematic rollout to those most vulnerable to the virus. But the ongoing row over whether to vaccinate healthy teenagers has led to another tetchy stand-off between politicians and scientists, parents and schools. And to what end?
The UK’s Joint Committee on Vaccination and Immunisation (JCVI) has issued its latest advice on the question of jabs for children. It says that ‘the health benefits from vaccination are marginally greater than the potential known harms’, but ‘the margin of benefit is considered too small to support universal vaccination of healthy 12- to 15-year-olds at this time’.
This is sensible and balanced advice. The committee maintains that ‘the main focus should be the benefits to children themselves, balanced against any potential harms to them from vaccination’. This is an important ethical consideration, which guards against using children as mere means to the end of infection control. Given the minimal risk Covid poses to healthy children, any danger posed by the vaccine must be even smaller. And any social benefit of vaccinating the young needs to be extremely compelling. Considering that the vaccines do not seem to confer lifelong immunity nor prevent transmission of the virus to others, it’s hard to see how vaccinating healthy kids will help much to protect the vulnerable from Covid.
The JCVI’s recommendation is not the last word on the matter, however. Its advice is that the accumulation of ‘longer-term data on potential adverse reactions’ may ‘allow for a reconsideration of the benefits and harms’. It could well be that the risk posed to children by the Covid jab turns out to be much smaller than is currently thought. But it could also turn out that jabbing children provides them with more limited protection than natural infection does. In that scenario, the case for vaccinating kids collapses, both in relation to their own health and to the pursuit of wider population immunity. Our understanding of the vaccines and of Covid itself is still evolving, and in that context the ‘precautionary approach’ recommended by the JCVI is wise.
The trouble is that the JCVI refused to give the advice that the political establishment wanted. It had widely been anticipated that the committee would rubber-stamp the vaccination of teenagers. An extension to the existing vaccine rollout was already being planned accordingly. The JCVI had been under considerable pressure to give the ‘right’ answer, not least from education secretary Gavin Williamson. Last week, he claimed that both the health service and schools would be ready to deliver a programme of jabs for under-16s ‘at pace’. He said that he ‘very much hoped’ the JCVI would make its decision ‘very, very soon’.
Before the pandemic, we might have noted the irony of a government ordering independent health experts to make the decision it wants. Now we are more surprised when an expert committee sticks to its guns and throws the ball back into the government’s court. The JCVI stated that it was not within its remit to ‘consider the wider societal impacts of vaccination, including educational benefits’. It has suggested that the government ‘may wish to seek further views’ from the chief medical officers of England, Scotland, Wales and Northern Ireland. So it’s over to Chris Whitty and the gang to make the final call. Whitehall insiders are apparently ‘confident’ that the CMOs will ‘give a green light’ for health secretary Sajid Javid to roll out vaccines through schools.
Vaccines minister Nadhim Zahawi has assured parents that they will be asked to give consent before their children are jabbed. But he has also suggested that if parents refuse their consent, then children will be able to overrule their parents, under the precedent known as Gillick competence. This has caused outcry among some parents, who have vowed to keep their children off school for the duration of any vaccination programme because they are concerned that their kids will be pressured into having the jab. Teaching unions, meanwhile, have issued dire warnings about the ‘educational disruption’ that will result if kids aren’t vaccinated.
What a mess. Again, we have to ask: to what end? If jabbing kids won’t stop them getting Covid or passing it on, how will it minimise educational disruption? The only reason children have been denied education during the pandemic is that the government and schools have refused to provide it. All they need to do is keep schools open. Children can come in if they are well and stay at home if they are ill, as was the norm prior to 2020.
If the government decides that the JCVI’s advice should be sidelined because it is politically inconvenient, this will further dent public confidence in public health. People will wonder to what extent policy decisions about Covid are really being guided by scientific evidence and clinical judgement. It may well be that many children want to have the Covid jab and that their parents want them to have it too. In that respect, it is not sinister or dangerous to offer it to them. But there is a troubling approach to medical intervention at work here. The government wants to create a demand for something that is unnecessary by framing education as a privilege that is contingent on vaccination.