COVID vaccinations for young children - a major ethical issue

[doreen]

@MandaJo

I can see an argument of “it’s new, and so may have unknown risks, so parents should err on the side of caution and first do no harm”. But I really can’t see “My child’s right to bodily autonomy overrides their obligation to old people, but not young people”.

I agree with this - but I want to point out that as best as I remember , the point of the rubella vaccine is not to prevent another child from being born blind and deaf 25 years from now. It’s to prevent a young child from picking it up and giving it to his pregnant mother next week . Because Mom may no longer have immunity from her own vaccines - and rubella in a young child can be so mild it might not even be noticed.

[MandaJo]

@Treppenwitz

As for what you quoted, it comes down to pragmatism - count the QALYs. As I said, it’s “in the matter of what we might call health balance sheets” - I’m not adopting an ethical position. Is it easier to ask a child for altruism in order to prevent a full lifetime of disability (the potential consequence of German measles); or to prolong an eighty five year old’s life by a couple of years (COVID)? When it comes to those two questions, I don’t think we’re comparing like with like.

It’s entirely an ethical question. There’s no pragmatics here. Maybe we are using this in different ways? For one thing, we aren’t talking about “ask”. The OP was talking about giving the vaccine to very young children–under 10 or 12. We are talking about whether or not it’s okay to put a child’s health under (extremely small) risk to benefit others but to little or no direct benefit to the child.

Given that, I don’t see how it could be acceptable to risk my child’s life to potentially save an anonymous future sex partner (or sex partner’s sex partner’s sex partner) from cancer, but not to save a potential anonymous COVID victim. We are comparing like with like with the key factor here: neither of the people impacted are my child. They are a random stranger. They may or may not ever exist, and we will never know either way. I mean, if I make my child help me volunteer at a soup kitchen,(an activity that objectively carries more risks than a vaccine, and is also of no direct benefit), does the nature of the people we help change whether or not exposing my child to that risk is ethical?

[Treppenwitz]

I’m talking here about what you quoted, which was:

There have been some very useful comparisons drawn. HPV vaccination is an excellent example. My slight concern with it is that, in the matter of what we might call health balance sheets, I find it an awful lot easier to be comfortable with asking a young person to be altruistic towards another young person, rather than towards someone who is old or very old. There’s a big difference in QALYs there. Likewise German measles.

This is not an ethical point. It’s about why I think HPV is a good but not perfect comparison - which comes down to how a young person may view the value of being altruistic in light of what their altruism is likely to achieve in the case of vaccinations for HPV (or German measles) versus COVID. You could argue that the ability to think like this is part of Gillick competence.

Of course, I don’t know that they will see these two cases differently, but I can imagine that there may be an issue.

j

[nelliebly]

@eschrodinger

it is not yet fully approved, we don’t yet know the side effects for kids, until they are I wider use – whether risks could emerge like the ones seen in the AZ and J&J vaccines in young adults.

So if parents won’t have an acceptable degree of certainty until vaccines are in wider use among children, how do we get to that level of wider use?

[puzzlegal]

I think German measles is a better comparison than HPV. Men get throat cancer from HPV. I had my son get vaccinated when it had just barely been approved based on the benefit to him.

But German measles is mostly a problem if you are a fetus, and not terribly serious for either children or adults.

[puzzlegal]

@nelliebly

@eschrodinger

it is not yet fully approved, we don’t yet know the side effects for kids, until they are I wider use – whether risks could emerge like the ones seen in the AZ and J&J vaccines in young adults.

So if parents won’t have an acceptable degree of certainty until vaccines are in wider use among children, how do we get to that level of wider use?

The practical answer is that different parents will make different decisions. I am surrounded by parents eager to get their children vaccinated. In a year we will have tons of data about the safety and efficacy of the vaccine in 12 year olds.