COVID-19 vaccines and children
The Australian Technical Advisory Group on Immunisation (ATAGI) recommendations on the use of COVID-19 vaccines in all young adolescents in Australia is available here.
Important note: In New South Sales, more than 200 children have required social support (known as “home in the hospital”) as their parents or carers and other family members have been hospitalised with SARS-CoV-2, leaving no one to care for them. As such, it is important to reiterate to parents that they also need to get vaccinated to stay healthy and keep themselves out of hospital.
Current vaccine eligibility
The Therapeutic Goods Administration (TGA) has approved the use of the Pfizer (Comirnaty) and Moderna (Spikevax) COVID-19 vaccines in children aged 12 years and over.
The ATAGI recommends vaccination for all individuals aged 12 years and over with the Comirnaty (Pfizer) vaccine. It is particularly important for:
- children with specified medical conditions that increase their risk of severe COVID-19
- Aboriginal and Torres Strait Islander children
- children in remote communities
- children on the National Disability Insurance Service (NDIS) as well as unpaid or informal carers
- anyone aged 16 and above.
Australian Government-run vaccination clinics including general practice, pharmacy, and Aboriginal and Torres Strait Islander Community Controlled Health Organisations, and Queensland Health’s Vaccination Locations, will vaccinate the above groups as well as any other individual aged 12 to 15 (in addition to the adult cohorts).
Risk of SARS-Cov-2 in 12-15 year-olds
- Preliminary evidence suggests children have a lower susceptibility to SARS-CoV-2 than adults, play a lesser role in transmission, and have a much lower risk of severe infection.
- Children, adolescents, and young adults with underlying medical conditions are an exception, with some studies showing that these patients have an increased likelihood of developing severe disease and complications when infected with SARS-CoV-2.
- However, these studies do not reflect the epidemiology related to the more recently emerged variants such as the Delta variant.
- The Delta variant is much more infectious than the Alpha variant or the original strain of SARS-CoV-2 and is infecting more children and young people in Australia and overseas than previous strains.
- Reassuringly, data from the UK suggest admission rates for children have not increased.
- Severe complications and serious illness from COVID-19 remain uncommon in children.
Vaccine safety and efficacy in adolescents
- Research from the United States supports the safety of the Pfizer vaccine in children aged 12 years and older. A trial of more than 2,200 adolescents showed the vaccine was safe and effective in reducing infection and produced a detectable immune response.
- Before recommending vaccination for this cohort, ATAGI reviewed available data on the safety and efficacy of the Pfizer vaccine in individuals aged 12-15 years, the risk of COVID‑19 in this age group, and evidence of wider benefits and risks of vaccinating children.
- Children under 12 years are not yet eligible for the COVID-19 vaccine, however international trials are underway.
- Table 1: Expected adverse effects from the Pfizer Comirnaty vaccine in adolescents
Adverse reactions in the 12-15-year-old group are similar to the 16-25 age group however occur at a lower rate (0.6 per cent in 12-15 year-olds versus 1.7 per cent in 16-25 year-olds). This article provides more details for this age group and suggests injection site pain, fatigue, chills and headaches as the most common side effects.
Queensland Health has developed a guideline for Hospital and Health Services to use when developing COVID-19 vaccination referral pathways from primary care which may be of use to general practices when determining suitability of a referral.
Adolescents aged 12 years and older with an underlying medical condition do not need a referral from a GP to receive their vaccination at a Queensland Health facility.
Queensland Specialist Immunisation Service COVID-19 Children’s Immunisation Advice (QSIS)
GPs and other health professionals seeking advice about the COVID-19 vaccination for children with complex medical conditions and/or concerns of adverse events following immunisation can contact the Queensland Specialist Immunisation Service (QSIS) COVID-19 Immunisation Advice Service on 07 3068 1111. NOTE: this phone number is for clinician use only, not for the public. The QSIS service is available Monday to Friday from 8am to 4pm. Children who require a medical review before vaccination can be referred to the QSIS for an appointment, referrals can be made via the Children’s Health Queensland website.
QSIS will also provide statewide clinical consultation if required. For referral criteria, please see the QSIS website. To make a referral, visit the referral forms page on the Children’s Health Queensland website.
COVID-19 vaccination registration for children aged 12 years and older
Parents/carers can register their interest in having their children vaccinated on the Queensland Health Vaccine Bookings website by completing the following steps:
- Register their child by visiting https://www.vaccinebookings.health.qld.gov.au/
- Select “I want to register my interest to be vaccinated” and complete the registration form with their child’s details. Parents/carers may use their own email address and mobile contact number if the child does not have their own. If parents have already registered for the vaccine, they can add their child/children as dependents on their profile.
- Select the relevant cohort “Persons 12 and over with an underlying medical condition, including people with a disability” or “children aged 12-15 years”
- Once the registration has been submitted, an email will be sent by Queensland Health to the parent/carer inviting them to book an appointment when one becomes available:
- If the family would like to book an appointment closer to home, follow the instructions in the email from Queensland Health.
- If the family would prefer to have their child vaccinated at the COVID-19 Vaccination Clinic at the Queensland Children’s Hospital (South Brisbane), please email email@example.com after they have registered their child. The hospital’s clinic staff will then contact the family to arrange an appointment time.
Alternatively, parents/carers can opt to use the Australian Government’s Vaccine Eligibility Checker.
What to take to a Queensland Health vaccination appointment
- Medicare card
- Proof of age
- COVID-19 vaccination card (if applicable).
Informed consent is required before administering a COVID-19 vaccine. The Queensland Health Guide to Informed Decision-making in Health Care is a useful reference. A guide to informed consent in young persons for COVID-19 vaccination is available online.
For young persons, please see the Queensland Health Guidance on Age of Consent for Vaccinations and the application of Mature Minor (or Gillick) Competence in Queensland. In Queensland:
- individuals under the age of 18 years can consent to health care where they have sufficient capacity to do so
- there is no fixed lower limit below 18 years of age at which children or young persons are deemed to be able to consent to health care (i.e. Gillick Competent)
- individuals aged 12 to 15 years will generally require a parent/legal guardian/other person to provide consent
- individuals aged 16 years and older are generally deemed to have capacity to consent for vaccination in most cases.
- The clinicians providing the vaccination at the vaccination location or clinic will make this assessment or refer the individual to an appropriate service if the clinicians do not consider the individual to have the capacity.
For young people who are subject to child protection orders and/or placed in out of home care, please see this following guide from the Department of Child Safety in relation to specific consent requirements.
For more information please refer to the Pfizer Comirnaty Protocol available online.
In addition to discussing the risks and benefits of vaccination of 12-15 year-olds, healthcare workers are also encouraged to emphasise the need for parents to get their child tested for COVID-19 when symptoms are present or when asked to do so under a Public Health Order.
Testing children and adolescents may be a relatively new concept for some families because previous strains have not infected this age group as frequently as the Delta variant. As a result, some parents and carers may not be attuned to the importance of testing and how to get tested. The key messages to convey are:
- Children with symptoms of COVID-19 must get tested. Symptoms include fever, sore throat, cough, shortness of breath, fatigue, vomiting or nausea, loss of smell and/or taste, runny nose, diarrhoea.
- There are lots of clinics in Queensland that test children for COVID-19. The test is free and results usually take 24-48 hours.
- Children who are unwell must not attend school or childcare until their symptoms have resolved and they have returned a negative result.
- If a parent or carer is unsure, they can phone 134 COVID (13 4 268) for health advice.
Throughout the pandemic many specialists and health professionals reported lower appointment attendance rates for both adult and paediatric patients. Following recent and current lockdowns, this trend appears to be re-emerging in Queensland and New South Wales. As delays to accessing to healthcare can adversely affect patient wellbeing and outcomes, please remind patients that:
- Hospitals and healthcare services in Queensland remain open and ready to receive and treat patients of all ages.
- There is no need to be concerned about picking up the virus in a hospital, healthcare facility or testing clinic.
- If a child requires urgent care or has an important procedure, do not delay bringing them to hospital.
- If a child is on prescribed medication or a treatment plan, it is important they continue this regime.
Questions or concerns
For general enquiries related to the COVID-19 vaccination, community health professionals should first contact 134 COVID (13 42 68).
Any consumer questions about the COVID-19 vaccination should be directed to 134 COVID (13 42 68) or visit the dedicated COVID-19 hub for families on the Children’s Health Queensland website.
- Australian Technical Advisory Group on Immunisation - statement dated 2 August 2021
- Therapeutic Goods Administration
- Australian Department of Health
- Queensland Health
- Vaccination information for healthcare workers