COVID-19 and flu vaccination 2022 to 2023: child rights and wellbeing impact assessment

Introduction

Please note that this Child Rights and Wellbeing Impact Assessment (CRWIA) has been published retrospectively therefore some of the vaccination cohort eligibility and vaccines used between 2022-2023 may differ to what is being offered currently.

As set out in Part 1 of the Children and Young People (Scotland) Act 2014, Scottish Ministers must keep under consideration whether there are any steps which they could take which would or might secure better or further effect in Scotland of the UNCRC requirements, and if they consider it appropriate to do so, take any of the steps identified by that consideration. Undertaking a CRWIA helps Ministers to fulfil this duty.

The World Health Organization declared COVID-19 a global pandemic on the 11 March 2020.

On the 8 December 2020 the Scottish Government began its national vaccination programme. Since its inception, the aim of the COVID-19 vaccination programme has been the prevention of severe COVID-19 infection, hospitalisation and death.

The delivery of Scotland’s vaccination programme has been guided by expert advice received from the Medicines and Healthcare products Regulatory Agency (MHRA), the Joint Committee on Vaccination and Immunisation (JCVI), and the UK 4 nation Chief Medical Officers (CMOs).

On 2 December 2020, following a thorough review carried out by the MHRA, the first COVID-19 vaccine, developed by Pfizer/BioNTech, was approved for use in the UK for use in those over 16 years of age.

On 4 June 2021, the same vaccine was approved for use, by the MHRA, in those aged 12 to 15 years of age.

On 22 December 2021, following a thorough review carried out by the MHRA, the COVID-19 childhood formulation, developed by Pfizer/BioNTech, was approved for use in children aged 5 to 11 years the UK.

Following these regulatory approvals, subsequent advice was received from the JCVI regarding how these vaccines should be rolled out to children and young people:

• 19 July 2021: JCVI advised that children and young people aged 12 years and over with specific underlying health conditions that put them at risk of serious COVID-19, plus those aged 12 years and over who are household contacts of persons (adults or children) who are immunosuppressed, should be offered 2 doses of Pfizer-BNT162b2 vaccine.
• 4 August 2021: JCVI advised that all 16-17 year olds be should be offered a first dose of Pfizer-BNT162b2 vaccine.
• 1 September 2021: The JCVI advised that a third primary dose be offered to individuals aged 12 years and over with severe immunosuppression in proximity of their first or second COVID-19 vaccine doses in the primary schedule.
• 3 September 2021: The JCVI expanded the list of underlying health conditions that make 12-15 year olds eligible for a 2 dose vaccination schedule.
• 13 September 2021: The UK Chief Medical Officers, based on the additional likely benefits of reducing educational disruption, and the consequent reduction in public health harm from educational disruption, recommend that an offer of vaccination be made to all 12 – 15 year olds.
• 14 September 2021: The JCVI advised that those who received vaccination in phase 1 of the COVID-19 vaccination programme (priority groups 1 to 9) should be offered a third dose COVID-19 booster vaccine. This included 16-17 year old with underlying health conditions, or who were household contacts of the immunosuppressed.
• 15 November 2021: The JCVI advised that all 16-17 year olds should be offered a 2^nd dose of Pfizer vaccine 12 weeks or more from the 1st dose or 12 weeks from COVID infection.
• 29 November 2021: In response to the Omicron wave, the JCVI advised that all children and young people aged 12-15 years should be offered a second dose of the Pfizer-BioNTech COVID-19 vaccine.
• 22 December 2021: The JCVI advised that booster vaccinations to be offered to at risk 12-15 year olds, 12-15 year old household contacts of the immunosuppressed, 12-17 year old severely immunosuppressed who have had 3rd primary dose and all 16-17 year olds. It also advised vaccination of at risk 5-11 year olds.
• 16 February 2022: JCVI advised a non-urgent offer of two doses of the Pfizer-BioNTech COVID-19 vaccine to children aged 5-11 years of age who are not in a clinical risk group. This is a time limited offer for those turning 5 before 1 August 2022.
• 21 February 2022: The JCVI advised a spring booster for individuals aged 12 years and over who are immunosuppressed.
• 15 July 2022: The JCVI advised an autumn booster for at risk 5-17 year olds, household contacts of the immunosuppressed aged 5-17 and unpaid carers aged 16 and 17.

The benefits and risks from COVID-19 vaccination in children and young people – under the age of 18 – are finely balanced largely because the risks associated with SARS-CoV2 infection are very low.

When formulating advice in relation to vaccination of children and young people, the JCVI has consistently held that the main focus of their considerations is the potential benefits and harms of vaccination to children and young people themselves.

Different cohorts of children and young people have become eligible for vaccination at different stages of the programme, as per JCVI advice, based on clinical and other risk factors, with those at higher risk of severe COVID-19 outcomes being prioritised.

Full details regarding the JCVI advice which outlines what groups became eligible and when and for how many doses the should be give can be found here - JCVI eligbility 2022

The JCVI continue to review their advice in relation to the vaccination of children and young people, taking into account new data and information that becomes available.i

This CRWIA sets out the consideration which has been given to the vaccination of children and young people and how vaccination may impact upon children’s rights and wellbeing.