Vaccination in Children

By Dr. Praveen Makhija in Covid-19 Vaccination

Feb 11 , 2022 | 2 min read

Children and adolescents usually demonstrate fewer and milder symptoms of SARS-CoV-2 infection compared to adults and are less likely than adults to experience severe disease. This led to the prioritization of vaccination for older people and frontline workers as the vaccine supplies were available in limited numbers initially especially noticed with the Omicron variant.


All the children are susceptible to coronavirus and account for around 1.5 percent of all the Covid-19 hospitalization in the country. It is important to note that children under the age of five years have a higher risk of other diseases with clinical presentations that overlap with COVID-19, like pneumonia and other viral upper respiratory tract infections, which will need extra caution while diagnosing and treating.  

Children and adolescents can experience prolonged clinical symptoms (“long COVID-19”), or post-acute sequelae (neuropsychiatric). Additionally, a multi-system inflammatory syndrome in children (MIS-C) although rare, was reported and treated after each previous wave. 

Several risk factors for severe COVID-19 in children have been reported including older age, obesity, and preexisting conditions like malignancy, diabetes, asthma, heart and pulmonary diseases, neurological, neurodevelopmental, and neuromuscular conditions.
Children can transmit SARS-COV2 to their families, leading to hospitalization of the elderly in the family. 


With disruption in physical activity and routines, there was the loss of access to a wide range of school-provided services such as school meals, health, nutrition, water, sanitation, and hygiene. Children with special needs such as learning support, speech therapy, and social skills training had major setbacks in their development. 

Some of the important indirect effects are related to school closures which have disrupted the provision of educational services and increased emotional distress and mental health problems. When unable to attend school and in social isolation, children are more prone to maltreatment and sexual violence, adolescent pregnancy, and child marriage. 


Internationally, Pfizer and Moderna vaccines have been given emergency use authorization. Moderna in children between 12-17 years and Pfizer between 5-11 years. In India -Covaxin, an adjuvanted inactivated vaccine developed by Bharat Biotech has been approved in India for the age 12-17 years. Another Indian vaccine approved by regulatory is ZycovD, a novel DNA vaccine, for ages 12-17 years. However, this vaccine has not yet been rolled out for use. Two other promising vaccines- Covovax and Corbevax (both subunit Vaccines) are in an advanced phase of trials.

COVAXIN-only vaccine approved for use in 15-18 years in our country. (It schedule has 2 doses 4 weeks apart). It is one of the first COVID-19 vaccines in the world to generate data in the 2-18 year age group. It has proven to be safe, well-tolerated, and immunogenic in the pediatric age. Neutralizing antibodies in children are on an average 1.7 times higher than in adults. Seroconversion was documented at 95-98%, four weeks after the second dose, indicating superior antibody responses in children compared to adults. Any child with acute illness should postpone vaccination till recovery and immunodeficiencies due to any reason is no contraindication.

School-based vaccination program with the help of government agencies or tertiary care hospitals for expediting the program in each district. No serious adverse event was reported. Pain at the injection site was the most commonly reported adverse event. No cases of myocarditis or blood clots were reported.