Pfizer and BioNTech recently presented positive immunogenicity and safety data from their Covid-19 vaccine, Comirnaty, in children aged 5–11 years. In the Phase II/III trial, 2,268 children received two 10µg doses three weeks apart. Antibody responses and adverse events were comparable to those seen in young adults aged 16–25 who received 30µg doses. Pfizer and BioNTech will apply for authorisation of Comirnaty with the US Food and Drug Administration (FDA) and the vaccine will likely become available soon for this age group.

Because children have a low risk of contracting severe Covid-19, a detailed record and careful evaluation of adverse events is important. Rare cases of myocarditis have already been recorded after vaccination with mRNA vaccines in young adults, although it has been shown that the risk of myocarditis after infections with SARS-CoV-2 is much higher. And while protecting this age group is important to resume regular school classes with fewer restrictions and curb the spread of the virus within schools, it will be a delicate measure to broadly mandate vaccination for children.

The public, and particularly parents, must be convinced of the benefits of vaccination in children without scaring them off or putting too much pressure on vaccine-sceptical parents. Vaccinating children is important, as their daily close contact with many peers at school increases their likelihood of catching SARS-CoV-2 and becoming vectors for the virus, potentially bringing it home to vulnerable relatives. Adult vaccination rates in the US, however, are lower than those in many other developed countries, with less than 60% of adults fully vaccinated in several states. As such, public health measures and outreach programmes should focus on getting more adults vaccinated. As it will be very difficult to convince every adult to receive a Covid-19 vaccine, parents and children who have already decided to get vaccinated should have easy access to the vaccine.

The fourth wave of Covid-19 infections in the US, caused by the Delta variant, is showing signs of slowing down. Most hospitalisations and deaths are still being recorded in unvaccinated people and although breakthrough infections can occur in vaccinated people, the likelihood of developing severe disease is much lower. Protecting children from Covid-19 will be another important step towards ending the pandemic and will be a relief for parents concerned about in-person learning at schools, especially in states that have little in the way of Covid-19 regulations and restrictions.