The UK government's announcement that the vaccination programme would be extended to 12–15-year-olds, and would begin on September 20, felt long overdue to many.
While their peers in much of Europe and the United States had already been vaccinated earlier in the summer, teenagers in this country were to return to school for the new academic year unvaccinated and with few, if any, mitigations in place to curb infections.
It came as little surprise, therefore, that by the beginning of October, official Department for Education (2021) figures showed that more than 200 000 pupils were off school for COVID-related reasons – or 2.5% of the school population. In the previous 2 weeks, infections levels had grown by more than two thirds. Furthermore, an estimated ten children have died from COVID since the new school year began, including a 15-year old girl from the South of England, who passed away on the day she was due to have the jab (BBC, 2021). She had developed myocarditis, or inflammation of the heart, days after contracting the virus.
Government guidance for the vaccination of Year 8s upwards stated that healthy children who are 12 years old and over on the day that the School Age Immunisation Service (SAIS) attended the school would be offered the vaccine (UK Health Security Agency, 2021). This would be administered by healthcare staff on the school premises unless this was not possible for some reason.
Year 7 pupils who were already 12 and had consent ‘will be identified by SAIS and vaccinated at the same session’ as older children. Follow-up vaccination appointments are to be offered to students who are absent on the day of the vaccine programme, including those who were unwell on the day their peers were being immunised.
Consent was to be sought from parents or guardians, and schools were expected to share leaflets and information, as well as to send out reminders. The only benefit of vaccination cited in official government guidance was educational, and the expectation it would reduce absenteeism and outbreaks.
The programme extended the provision of vaccinations to school-aged young people, with 16- and 17-year-olds having earlier been offered jabs through the adult vaccinations system. However, some senior doctors, including members of the Independent Sage group of experts said the programme should have started much earlier.
Dr Jacqui Bradley, a GP in the Midlands, said she had been inundated with inquiries from anxious parents throughout the summer, both with concerns about the effects of the vaccine and from those who were keen to have their children immunised at the earliest opportunity.
‘There was a lot of interest in the proposals to extend the programme to younger children both from parents and children who had fears about side effects, and from families who frankly couldn't wait to vaccinate for all sorts of reasons – ranging from the child's own health and wellbeing to living with vulnerable family members.
‘I did have some concerns about vaccinations taking place in schools, as over the months we've become aware of a number of parents in some areas being anti-mask and anti-vax, and lobbying schools not to mitigate. The government's guidance on loosening mitigations will have played into the hands of these parents to some extent, as well as those headteachers who were now able to say they were merely aiding by government guidelines.
‘Some regions also have a shortage of healthcare staff to administer the vaccines, which could yet turn out to be problematic.
‘However, anecdotally, we are hearing that vaccinations have been administered with few problems in most schools and that the take-up has been very good – though this may vary from area to area once a national analysis is done.’
‘It came as little surprise, therefore, that by the beginning of October, official Department for Education figures showed that more than 200 000 pupils were off school for COVID-related reasons – or 2.5% of the school population.’
‘However, anecdotally, we are hearing that vaccinations have been administered with few problems in most schools and that the take-up has been very good – though this may vary from area to area…’
Sharon White, chief executive at SAPHNA, welcomed the decision to offer the COVID vaccine to 12–15-year-olds:
‘School health services/immunisation providers across the UK have, as ever, mobilised rapidly, professionally, and fuelled by the grit determination unique to public health nursing, so that we might expedite this ask to ensure our children, young people, families and wider community are better protected from Coronavirus and, importantly, so that their education and attendance at schools is least disrupted.
‘School and public health nurses have a strong, positive and transferable legacy of delivering mass immunisation campaigns and have no doubt that they will achieve the optimum uptake possible.’
The UK's chief medical officers recommended a single shot of the Pfizer vaccine for healthy 12–15-year-olds, after the Joint Committee on Vaccination and Immunisation concluded that the medical benefit to children was marginal. The NHS aimed to have most children in the group vaccinated before October half-term.
However, 3 weeks before the start of half-term it was becoming apparent that this target may be missed due to the rise in infections among young people of school age. Some headteachers said they were still waiting to be given a date for their vaccination sessions, while others complained that too few vaccinators were turning up to meet demand from pupils.
Further delays were building up as pupils who test positive for coronavirus are required to wait 28 days before they can receive the COVID vaccination and need to be offered a later appointment.
Dr Helen Salisbury, a GP in Oxford and an Independent Sage member said ‘half-hearted endorsement’ of the vaccine in the younger age group and ‘stretched services’ risked further delaying vaccinations in teenagers. Sending children back to school without masks, extra ventilation, bubbles and isolation policies was ‘a total recipe for ensuring everybody gets exposed’, she added.
Meanwhile, Prof Kate Ardern, director of public health at Wigan council, told the all-party parliamentary group on coronavirus that the government's half-term target was laudable but there was likely to be ‘a real delay’ in delivery of the programme because of high infection rates in schools.
In some parts of the country, health teams comprising just two members attended schools expecting to vaccinate hundreds of pupils in one day and have had to schedule future dates for those pupils who missed out.
Dr Bradley added: ‘I would strongly urge parents to consent to young people having the vaccine. All the evidence suggests this is the safest response to this pandemic and offers protection from serious illness not only to the children themselves but also reduces the risks of taking COVID home to vulnerable family members.’
The Department for Education said it was ‘rolling out the vaccine to 12-to 15-year-olds as quickly as possible’ and reminded students and schools staff to do twice-weekly lateral flow tests to reduce school absenteeism.