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The Ethics Behind Vaccinating Children For COVID-19


Associated Press

Pfizer announced last week that its COVID-19 vaccine is 100 percent effective in kids ages 12 through 15.

As the company awaits approval from the FDA, there’s a good possibility kids ages 12 through 15 could be eligible for the shot before the new school year.

That leaves many wondering if a vaccine for COVID-19 should be mandated by the school district. Dr. Johan Bester is the director of bioethics at UNLV's School of Medicine.

He said there is a history of requiring vaccines for children to stop the spread of diseases like measles and Diptheria. 

“The reason why vaccine mandates exist is to protect the child that is being vaccinated, directly against disease, and the other is to protect the public because the more people we vaccinate the greater the chance of creating herd immunity and the greater our chance of stopping the spread of dangerous diseases,” he said.

Parents can ask for exemptions from mandated vaccines. Nevada allows children to be exempted for medical or religious reasons. Right now, there is no mandate for a coronavirus vaccine for children, Dr. Bester said, because it hasn't been approved for children.

When it is shown to be both safe and effective for children, he believes it a good idea for children to get vaccinated.

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“Thus far, it all seems like the right thing to do for children would be to vaccinate them,” he said.

Some people have argued that children don't need the vaccine because they're less likely to get seriously sick from it. Some people have even argued that children are immune from the disease, which Dr. Bester said is not the case.

“There’s a pretty worrying side effect, which is an inflammatory condition that overwhelms the body that we’ve seen in thousands of children, young children, related to COVID,” he said.

In addition to that, the larger percentage of the overall population to get the jab the closer the entire society comes to herd immunity, which Bester said kicked in when between 60 and 70 percent of the population is immunized. 

“So, herd immunity is absolutely something we should go for as soon as we can, but to reach that goal, it seems like we will have to vaccinate a proportion of our children,” he said.

For now, while children can't get the vaccine, Dr. Bester said it is important for adults to get it. There is no mandate for Clark County School District teachers to get the vaccine, but Bester believes they should.

“The best thing we can do for children right now is: make sure that we, as adults, get vaccinated," he said, "That not only protects us as adults and keeps us healthy so that we can serve children say with teachers or doctors or whatever we are, but it also gets us closer to limiting spread, which also protects children and gets life back to normal.”

Everyone understands how difficult this past year of social distancing, canceled school and postponed activities has been on children, he said.

“I think we could make a good argument for saying we have an obligation to get the vaccine on behalf of children who can’t get it themselves right now and to get life back to normal,” Dr. Bester said.

Arguments against the vaccine have come from people who are against all vaccines. Dr. Bester said the anti-vaccine people have usually been exposed to false information about vaccines, usually on the internet.

There are those who try to downplay the diseases vaccines are designed to prevent by claiming they weren't that bad or that it is actually good for people to be exposed to diseases like measles because it strengthens their immune system.

Another group believes vaccines have too many risks and can cause conditions like autism, which numerous studies over decades have shown is not the case.

“These are all false. We really know what the benefits and risks of vaccines are. It is one of the most well-studied things in medicine,” Dr. Bester said.

Other people don't have concerns about vaccines in general but are concerned about the coronavirus vaccine in particular. They are worried that it was not studied enough.

“We actually have studied this vaccine really well," Dr. Bester said, "Of course, we don’t have 19-year data or 15-year data like we have for some other vaccines, but the data we have compares very favorably with other vaccines that we have.”

Because the new COVID vaccine data mirrors other vaccines, researchers can know a lot about how they will perform in the real world.

“These studies have been very rigorous, and I certainly am confident about getting the vaccine myself,” he said.

Besides the research, Dr. Bester noted that without a vaccine there is little protecting a person from getting COVID-19, which he said is a "nasty disease."

“What we do know about the vaccine is that it will stop you from dying and it will stop you from going to hospital. That is great! If you want to take your chance with COVID, I would say that that is unwise,” he said.

He believes there needs to be active messaging from the government and businesses about the importance and safety of the vaccine so we can move closer to getting to herd immunity, and therefore, back to normal life.

Bester would also like to see health care providers get involved in messaging.

“I think a promising avenue is that doctors speak to their patients about that,” he said.

He said research has shown that people who have a good relationship with their doctors are more likely to be resistant to anti-vax messaging.

As the vaccine rolls out, there is now a lot of discussion about vaccine passports or some kind of document to prove that someone has been immunized.

Bester said that idea pits two values against each other. One value is the desire to get back to normal life and eliminate the disease. The other is not wanting to create a two-tiered society where those who have the vaccine are favored over those who haven't.

“We don’t want to create a privileged and non-privileged kind of thing,” he said.

Bester said there needs to be a balance between those wanting to protect public health and those wanting to prevent a two-tiered system.  

Keeping the government out of the vaccine passport decisions is a way to do that and letting individual businesses decide what is required to access their products or services is a better way to approach the issue, he said.


Dr. Johan C Bester, Director of Bioethics,  UNLV School of Medicine  

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