¿Es pertinente la vacunación frente a COVID-19 de los niños y adolescentes desde el punto de vista bioético?  <span class="so-article-trans-title" dir="auto"> Translated title: Is vaccination against COVID-19 appropriate for children and adolescents, from a bioethical point of view? </span>

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Abstract

Durante la pandemia de COVID-19 hemos vivido en todo el planeta una situación sin precedentes que nos ha exigido tomar decisiones urgentes basadas más en el sentido común que en las evidencias. Lo urgente nos hizo olvidar lo importante, pero, después de la experiencia de año y medio, es momento de analizar con calma lo que hemos aprendido para poder aplicar medidas sanitarias con prudencia y evitar los daños no deseados. No debemos olvidar que somos científicos, porque somos médicos. La ciencia consiste en cuestionar y buscar evidencias firmes donde apoyar decisiones complejas que ofrezcan las mejores opciones a nuestros pacientes. La Bioética debe guiarnos en esta misión, valorando todas las aportaciones y enfoques, sin buscar una verdad absoluta, haciendo un ejercicio de prudencia, reflexión, responsabilidad y auténtica deliberación. En este marco, como pediatras, debemos preguntarnos seriamente si es pertinente la vacunación de los adolescentes y niños, a la vista objetiva de los datos que tenemos.

Translated abstract

During the COVID-19 pandemic, we have experienced an unprecedented situation around the world that has required us to make urgent decisions based more on common sense than on evidence. The urgent made us forget the important, but after the experience of a year and a half, it is time to analyze with serenity what we have learned in order to apply sanitary measures wisely and avoid unwanted damage. We must not forget that we are scientists, because we are doctors. Science consists of questioning and looking for firm evidence to support complex decisions that offer the best options to our patients. Bioethics must guide us in this mission, valuing all contributions and approaches, without seeking an absolute truth, exercising prudence, reflection, responsibility and authentic deliberation. In these circumstances, as pediatricians, we must seriously ask ourselves whether the COVID-19 vaccination in adolescents and children is appropriate, objectively taking into account the data we have so far.

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Most cited references 12

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Household SARS-CoV-2 transmission and children: a network prospective study

Antoni Soriano-Arandes, Anna Gatell, Pepe Serrano … (2021)

Abstract Background The role of children in household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains uncertain. Here, we describe the epidemiological and clinical characteristics of children with COVID-19 in Catalonia (Spain) and investigate the dynamics of household transmission. Methods Prospective, observational, multicenter study performed during summer and school periods (1 July-31 October, 2020), in which epidemiological and clinical features, and viral transmission dynamics were analyzed in COVID-19 patients <16 years. A pediatric index case was established when a child was the first individual infected within a household. Secondary cases were defined when another household member tested positive for SARS-CoV-2 before the child. The secondary attack rate (SAR) was calculated, and logistic regression was used to assess associations between transmission risk factors and SARS-CoV-2 infections. Results The study included 1040 COVID-19 patients <16 years. Almost half (47.2%) were asymptomatic, 10.8% had comorbidities, and 2.6% required hospitalization. No deaths were reported. Viral transmission was common among household members (62.3%). More than 70% (756/1040) of pediatric cases were secondary to an adult, whereas 7.7% (80/1040) were index cases. The SAR was significantly lower in households with COVID-19 pediatric index cases during the school period relative to summer (p=0.02), and when compared to adults (p=0.006). No individual or environmental risk factors associated with the SAR were identified. Conclusions Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission.