THL updates its recommendations for coronavirus vaccinations for children under the age of 12 – some children could benefit from the vaccine

The Finnish Institute for Health and Welfare (THL) has updated its coronavirus vaccination recommendations for children under the age of 12. THL is not recommending coronavirus vaccinations for all children, but based on individual evaluation, some children could benefit from a vaccination. 

THL recommends that municipalities should offer coronavirus vaccinations to children aged 6 months to 4 years based on individual consideration. Those children in this age group who may have underlying diseases that make them susceptible to severe coronavirus disease, could benefit from a basic series of vaccines against COVID-19. Extensive coronavirus vaccinations of small children are not seen as necessary at the present stage of the epidemic.

”Municipalities, and from the beginning of next year, the wellbeing services counties, are responsible for arranging coronavirus vaccinations. They inform residents where and when the vaccine is available. Parents can discuss the vaccination of their own child with the doctor caring for the child or, for example, at the child health clinic”, says THL Medical Specialist Anniina Virkku. 

Underlying diseases that may increase susceptibility to severe coronavirus disease include, for example, cardiopulmonary diseases and certain neurological conditions. In addition, those with severe immune deficiencies are at a higher risk. THL will specify the children's at-risk groups on its website. 

The Government has issued a decree under the Communicable Diseases Act on voluntary COVID-19 vaccinations. Under Article 2 of Chapter 2 of the decree, a child five years old or older may be offered a vaccine. THL has proposed that the Ministry of Social Affairs and Health should amend the decree to make coronavirus vaccines available also to children aged six months or more. The vaccination of children under the age of five can begin only after the decree is amended. 

New recommendation also for children aged 5–11

THL has previously recommended two vaccine doses for children aged 5–11 in at-risk groups as well as for children in that age group who are in close contact with a person with a severe immunodeficiency. It has also been recommended that the possibility for two vaccine doses should be offered to others aged 5–11. 

Under the new recommendation those aged 5–11 who may have an underlying disease exposing them to the possibility of severe coronavirus disease, could benefit from a basic series of vaccinations based on individual consideration. THL is no longer recommending offering coronavirus vaccinations to others aged 5–11 on medical grounds. However, their vaccinations need not be immediately suspended. THL recommends that especially those series of vaccinations that have already been started can be completed. 

For groups for whom the vaccines are recommended, the benefits of the vaccinations outweigh the possible harm related to them. 

For groups for whom the vaccines are not recommended, a comparison of benefits and harm either shows no medical basis, or the benefits of a vaccine are seen as minor or uncertain. 

“The vaccinations are not being recommended for healthy children aged 5–11 because their risk of their contracting severe coronavirus disease is very small. Affecting this are the variant viruses that are currently circulating as well as the protection coming from earlier coronavirus infection and from vaccinations that have already been received”, explains THL Head Physician Hanna Nohynek.

Coronavirus recommendations for those aged 12–17 have not changed. THL recommends that children and young people aged 12–17 who are in at-risk groups should be given three doses of the vaccine. For other 12–17-year-olds two coronavirus vaccine doses are recommended.

More researched information on vaccinations for small children is needed

Children rarely contract severe coronavirus disease. In May 2022 in the Hospital District of Helsinki and Uusimaa (HUS) area 73 percent of people under the age of 18 were found to have antibodies suggesting a previous infection with coronavirus. All in all, antibodies coming from either a coronavirus infection, or the combined effects of an infection and vaccination, were found in 76 percent of children aged 1–4, in 89 percent of those aged 5–11 and in 98 percent of those aged 12–17. As the coronavirus pandemic has continued beyond the spring of 2022, it is likely that a larger proportion of children and young people now have antibodies formed as a result of infection.

Studies have shown that underlying illnesses increase the risk of severe coronavirus disease among children. In Finland, children who have been hospitalised have had conditions such as immune deficiencies, chronic cardiopulmonary diseases and neurological illnesses and conditions.

In October the European Medicines Agency (EMA) recommended the approval of mRNA vaccines also for children between the ages of six months and four years. The European Medicines Agency approved the expansion of the sales permit. Children in this age group are given the Biontech-Pfizer Comirnaty 3 micrograms/dose vaccine, in which there is less of the active ingredient than in the vaccines for older children or adults. 

The coronavirus vaccinations for children aged six months to four years have been found to be safe. However, more researched information is needed on their safety and clinical effectiveness. 

THL continues to monitor the effectiveness and safety of children's coronavirus vaccines and will later give clarifying instructions on underlying illnesses that might increase the risk of severe coronavirus disease, and on dosages for children's vaccines. 

THL is monitoring the aggregate researched information and the progression of the epidemic both in Finland and elsewhere, and will alter its recommendations for medical reasons, if necessary.  

Recommendations for coronavirus vaccines are based on evaluations made by the National Advisory Committee on Vaccines (KRAR) and THL.

Further information:

THL statement on children's coronavirus vaccinations 22 November 2022 (in Finnish, PDF 189 KB)
Material of the National Advisory Committee on Vaccines KRAR (in Finnish)

Hanna Nohynek
Chief Physician
THL
[email protected]

Anniina Virkku
Medical Specialist
THL
[email protected]