The US is now considering extension of COVID vaccine EUA's to 12-15 year olds, and Pfizer is expected to file for Emergency authorization in 2-11 year olds in September.

A thread with 5 thoughts on this, in the context of our article on the topic... https://twitter.com/bmj_latest/status/1390705639555538953

1) It should not need to be said, but thinking that a blanket EUA is not appropriate right now is not the same as thinking child COVID vaccines are a bad idea, or aren't likely to be safe.

The discussion is about the appropriate regulatory scrutiny before mass child vaccination.

2) Because the U.S. vax program is not supply constrained, child C-19 vaccines can begin with one of the fastest rollouts in recent memory; indeed, faster than adult C-19 vaccinations.

This means that millions of shots can be given before A.E. reporting systems would respond.

3) Generalizing safety data from different age groups is necessary and sensible, but also has limits. Indeed the AZ/J&J rollouts showed that risk of rare events could be significantly different in different age groups.

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Indeed, initial reports of a causal link between AZ and clotting events faced skepticism (from me too!) based on the lack of events in the large rollout in the UK, but this, it turns out, was a bad predictor b/c they were vaccinating a different age profile at the time.

4) Wherever one comes down on the question of whether an EUA is appropriate now for 12-15 y.o.'s, this decision is coming again for 2-12 year olds in September, and we should be prepared, again, to seriously ask whether an emergency is taking place in that age group at that time.

5) There shouldn't be any sliver of a doubt that these are important questions and that considering them seriously is not "anti-vax" or "anti-child".

It is precisely because of the importance of vaccination programs and the preciousness of children that the Q's have such weight.