The Department of Health’s goal is to have 3.25 million children between the ages of 12 and 17 years vaccinated by mid-January. Matrics will be prioritised, so that they have enough time to recover from possible side-effects before their exams.
Pfizer’s Covid-19 vaccine is the only jab that has received approval from the South African Health Products Regulatory Authority (SAHPRA) for use in people of 12 years and older. Johnson & Johnson’s (J&J) jab – the other shot used in South Africa’s rollout – can, so far, only be given to people 18 or older.
Although teens are less likely than adults to fall seriously ill with COVID, vaccinating them will help reduce absenteeism in classrooms and lower the risk of COVID outbreaks in schools.
Teens will not be vaccinated at school premises this year, but the country’s vaccination programme may expand to include such a component in 2022. Adolescents, who make up 11% of South Africa’s population, will for now, be able to go to any private or public vaccination site to get their shot.
There’s no need for teens’ parents to approve their immunisations as children between 12 and 17 years old can consent to medical treatment and surgery, according to the Children’s Act.
Teenagers will only get one dose of vaccine – unlike the two doses, six weeks apart, that adults in South Africa currently receive.
This is because the country’s ministerial advisory committee on COVID vaccines (VMAC) wants to allow for more time for additional safety data to be gathered about potential side-effects within this group, because of a very small risk of inflammation of the heart muscle or outer lining of the heart.
These two conditions are, respectively, also known as myocarditis or pericarditis, and they occur more frequently among boys than girls.
But scientists are in agreement that the benefits of vaccinating teens far outweigh the risks, as studies have shown Pfizer’s jab is safe to use in teens and provides very high levels of protection against COVID and also against COVID-related hospitalisation.
Pfizer’s jab was originally only approved for emergency use in South Africa for people 18 years and older. But in September, SAHPRA approved the use of the jab, known as COMIRNATY, for everyone 12 years and older. This approval recommended that everyone who uses it gets two shots.
As a precautionary measure, the VMAC has, however, advised that children only be given one dose of the Pfizer jab – for now. This way, South Africa makes sure that more safety data on second shots can be gathered about potential side-effects among teens. Once the VMAC is satisfied that there is enough information, it will decide if and when teens should return for their second dose.
Why are there concerns about second shots?
Some cases of myocarditis and pericarditis have been observed in a small proportion of people (particularly young men) receiving two Pfizer shots. Both are typically the body’s response to an infection and people who develop these symptoms after being vaccinated tend to fully recover within a few days.
It’s extremely rare for people to experience myocarditis or pericarditis after vaccination, but it can occur.
CDC data shows 2 574 people in the US reported that they experienced some form of heart inflammation after being vaccinated, as of 18 August. This was most commonly seen in those who had been immunised with two Pfizer shots, with men at higher risk than women. Most cases occurred in men between the ages of 12 to 24.
To put that into perspective, June data from the CDC found that only 1 226 people reported heart inflammation out of the nearly 300 million people vaccinated. That means this extremely rare side-effect was only seen in 0.0004% of vaccinated people.
Two recent studies from Israel published in the New England Journal of Medicine have also confirmed that the risk of heart inflammation after vaccination is extremely low.
The risk of experiencing heart inflammation post-vaccination seems to increase after getting two shots of the vaccine. The CDC’s June data showed that among the just over 1 000 cases reported, around three-quarters were in people who had gotten their second dose of either Pfizer or Moderna.
Parents will have to check with the country their teen is travelling to if it will accept one Pfizer shot as proof of full vaccination for adolescents, as all governments have their own policies.