THL recommends the introduction of COVID-19 vaccinations for young people aged 12–15 who are in the risk group
The Finnish Institute for Health and Welfare (THL) recommends that the COVID-19 vaccinations are started in Finland for young people aged 12 to 15 who are in a risk group for severe COVID-19 disease due to illness or condition.
This is based on the fact that young people with certain illnesses, such as severe heart disease or asthma requiring continuous medication, are expected to benefit significantly from the COVID-19 vaccination. For example, the compiled research material of the European Centre for Disease Prevention and Control shows that, despite the small number of cases, underlying medical conditions also increase the morbidity and mortality rate of those infected with COVID-19 at the age of 12 to 15.
‘The need for hospital care due to COVID-19 among children and young people has so far been minor in Finland, but we have also had cases requiring hospital treatment’, says Otto Helve, Chief Physician at the National Institute for Health and Welfare.
‘An underlying health condition or its treatment may weaken immune defence and increase the risk of serious COVID-19 disease also in children and young people. The underlying health condition can also worsen due to COVID-19 infection.’
Biontech-Pfizer's mRNA vaccine for young people
People aged 12 to 15 wold be given the Biontech-Pfizer Comirnaty vaccine, as it is the only COVID-19 vaccine currently authorised for vaccinating those aged 12 or over. On 28 May, the European Commission approved the extension of the marketing authorisation for the Biontech-Pfizer COVID-19 vaccine to also apply to children aged 12 to 15.
The decision was made on the recommendation of the European Medicines Agency (EMA). In the pre-authorisation study, the effects of Comirnaty on children and young people were studied on 2260 young people aged 12 to 15 in the United States. According to the results of the study, the vaccine was very effective in preventing COVID-19 disease. The observed adverse effects, such as pain at the injection site, fever and headache, were transient and similar to those of age groups already vaccinated. The EMA considers the benefits of the vaccine to be higher than the potential risks, especially for children and young people who may be affected by a severe COVID-19 disease.
It was not possible to detect possible rare adverse reactions due to the small number of research subjects. In the United States, millions of people aged 12 to 17 have received the Biontech-Pfizer COVID-19 vaccine, and there have been no specific safety concerns regarding this age group.
Risk groups same as for adults, impact on adult vaccination pace low
The risk groups for children are the same as for those aged 16 or over, previously defined for the COVID-19 vaccination order. The only exception to adult risk groups is overweight, for which THL recommends using ISO-BMI, the body mass index for children. The children's body mass index takes into account the physical proportions of children and young people and their changes as the child grows. The lower limit of the ISO-BMI is recommended to be 35, which describes severe obesity in this age group.
In the instructions on the vaccination order, risk groups are divided in two according to the extent to which the underlying disease exposes the vaccinated to severe COVID-19 disease.
‘We estimate that a maximum of 30,000 young people aged 12 to 15 in Finland are at risk of severe COVID-19 disease. The group is small compared to the number of incoming vaccines, so we encourage municipalities to offer vaccination to both groups at the same time when possible. Vaccination of children aged 12 to 15 who are in the risk groups does not significantly slow down the adult COVID-19 vaccinations. In other words, municipalities do not need to cancel or postpone vaccination appointments for adults’, Helve points out.
Minors can decide on vaccination according to their development level
As with other vaccines, minors may decide for themselves to take a COVID-19 vaccine if a health care professional considers that, based on their age and development level, they are able to decide on their treatment. There is no age limit in the law for the child's right to self-determination, which is why the matter is assessed on a case-by-case basis.
If the young person is unable to make the decision on their care, the consent of the guardians is required for the vaccination decision.
Municipalities open vaccination appointments for young people in the risk group when vaccines are available. Information on where and when a COVID-19 vaccination can be obtained is provided on the websites of the municipality, notifications in local newspapers and other communications.
Vaccination of children in risk groups is possible under the COVID-19 vaccination regulation currently valid. People under 16 who are not in a risk group will not be vaccinated in Finland for the time being. The National Advisory Committee on Vaccines and the Finnish Institute for Health and Welfare are currently examining the conditions under which children's COVID-19 vaccinations could be started. The decision on the matter will be made by the Ministry of Social Affairs and Health and the Government.
Further information on vaccinations for young people in risk groups can soon be found on the Finnish Institute for Health and Welfare 's website.
Interim public health considerations for COVID-19 vaccination of adolescents in the EU/EEA (ECDC)
Further information
Otto Helve
THL
Chief Physician
[email protected]
