Just a few thoughts about the JCVI (Joint Committee on Vaccination & Immunisation)decision yesterday not to recommend that 12-17 year olds get the jab.
(Decided to post here because I'm commenting more on their approach than on the detailed modelling used, but happy for this to be shifted to the Modelling discussion if that seems more appropriate).
https://www.gov.uk/government/publicati ... ugust-2021Their full (though short) report is in the link above, but the report looks pretty flimsy to me, and to be honest, what you'd write if you were desperately trying to find evidence to support your pre-existing view. Several reasons why I think this.
We know that most Western countries are vaccinating children, so for any report that doesn't recommend this, there should be an explanation of why the UK's JCVI stands alone and has come to a different conclusion to other JCVI-like bodies in other countries. Are these other countries wrong, do they have insufficient data, or do they use different assumptions? This report completely ignores this crucial point.
The report says
The incidence of severe outcomes from COVID-19 in children and young people is very low.In England, between February 2020 and March 2021 inclusive, fewer than 30 persons aged less than 18 years died because of COVID-19, corresponding to a mortality rate of 2 deaths per million
This is just plain wrong - there's no other way to say it.
Firstly, to get 2 deaths per million, you need to divide the 30 deaths by the population of all those aged 0-19 which assumes that all children have had Covid. That's what a mortality rate is - of those who get infected, how many die.
Secondly, we already know that the younger you are, the less likely you are to be badly affected by Covid. The JCVI is supposed to be looking at the impacts on 12-17 year olds, so why include 0-11 year olds in their calculation? If you assumed deaths would be mostly in teenagers, than the JCVI deaths/million goes up by 50% or so, from 2 to 3. The only logical reason for including 0-11 year olds in the figures is to minimise the issue.
Thirdly, just click on the hyperlink in the JCVI report that says "corresponding to a mortality rate of 2 deaths per million". Immediately below the title and list of authors you see this -
This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
Should not be used to guide clinical practice. But it's somehow good enough to be quoted by the JCVI on whether to vaccinate 12-17 year olds? Is there some semantics here where "clinical practice" is different from "vaccination"?
Fourthly, even if we assume it's fine and dandy to use a report that says "don't use this report", the time period is Feb20-Mar21 when most children contracting Covid would have got the original Wuhan strain, or possibly the more contagious Alpha variant, but definitely not the current Delta variant. (Don't forget children were taken out of school after just 1 day back after Christmas so weren't mixing between Jan21-Mar21). Delta is the relevant strain of interest because that's now our dominant strain.
The report talks about vaccine side-effects adversely affecting the heart (myocarditis and pericarditis). It doesn't mention the incidence of these heart-related issues for people getting Covid. (Guess what, a Covid-infected child is a lot more likely to get these heart-related problems than a vaccinated child).
The report talks about effect on children's education. It only considers adverse reaction to vaccinations as a reason for a child's education being disrupted, so doesn't mention the disruption on education if a child gets Covid.
This quote below is interesting about their principles for decision-making, basically saying risk/benefit to children is solely about their individual outcomes, so (for example) them carrying the infection to their family members would have no negative effect on the children.
I was also struck by the last sentence about the UK public's view on risk/benefit for children. While their statement is almost certainly true, I can't for the life of me see why that should influence policy - I expect the UK public would probably place more value on the lives of photogenic kids rather than ugly kids, but that's not a rational basis for health policy.
(As a sidenote, back in the 60's, nobody asked for my consent when giving me a sugar lump with a polio vaccine, even though polio cases were very low, presumably pursuing the madcap idea of zero-polio, and now of course it's been eradicated.)
When formulating advice in relation to childhood immunisations, JCVI has consistently held that the main focus of its decision should be the benefit to children and young people themselves, weighed against any potential harms from vaccination to children and young people. In providing its advice, JCVI also recognises that in relation to childhood immunisation programmes, the UK public places a higher relative value on safety compared to benefits
I agree with the JCVI's statement below. Just wonder why they haven't done it?
In all instances, the offer of vaccination to children and young people must be accompanied by appropriate information to enable children and young people, and those with parental responsibility, to be adequately appraised of the potential harms and benefits of vaccination as part of informed consent prior to vaccination.
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apologies.)