Finland still does not know when 12 to 15-year-olds will be vaccinated, or what kind of measures will be taken in schools to protect children when they start the new school year.
As of late July, many municipalities had started vaccinating 12 to 15-year-olds in risk groups, who are estimated to number around 30,000. By Friday around 13 percent of them had received their first dose of Covid vaccine.
Including those not at elevated risk from Covis, there are some 250,000 children in this age group.
According to THL Chief Physician Hanna Nohynek, around 19-20 percent of 12 to 19-year-olds have received their first dose of Covid vaccine.
Yle asked Nohynek 15 questions around the vaccination of older children.
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1. How have vaccinations progressed among 12 to 15-year-olds?
Vaccination of 12 to 15-year-olds in risk groups has already started. According to the vaccination statistics around 20 percent of 12 to 17-year-olds have been vaccinated. Vaccination of 12 to 15-year-olds who are not in a risk group depends on national government changing the guidance. That proposal has now been sent out to hospital districts for comments. If the proposal is accepted in August, then vaccinations can start immediately.
2. How important would it be for this age group to be vaccinated in the autumn, when schools and educational institutions open up?
It would definitely be necessary for them to receive the vaccine as soon as possible and that we start vaccinating as soon as possible, subject to vaccine supply and guidance changes. One dose already provides very good protection against serious illness. At the same time we know that vaccine protection against the Delta variant is not the best possible, and two doses are needed to protect against that variant.
3. There is contradictory information from data and studies about how well vaccines protect against the Delta variant. Why is that?
You should always ask what has been researched. Is the research focused on the infection or the serious illness caused by the infection. We know that all the vaccines in use protect very well against serious illness caused by the Alpha, Beta, Gamma or Delta variants. When you look at mucosal immunity, that is how the virus enters the body, then vaccines' effectiveness is not the best possible so the virus gets past antibodies and infects people. The kind of immunity that would completely stop the Delta variant requires a lot more antibodies that current vaccines can give us. If you compare research into infection numbers with research into serious illness cases, then the comparison can be misleading.
4. What impact does the interval between doses have? Have positive effects been observed?
The longer the gap between doses, the better the immune system response. If you want to stop infections as quickly as possible, then a long interval is not the best solution. Health authorities should again ask what their goal is. In Finland our strategy has been that we mainly want to prevent serious illness, deaths and maintain the ability of the health service to cope.
5. Have there been any unusual side effects in the 12-15 age group?
Children have had the same side effects as adults, such as fever, muscle pains and tiredness, but you should ask Fimea for more detail as they gather data on vaccine side effects.
6. How positive are parents about vaccinating 12 to 15-year-olds?
The Office of the Prime Minister has researched parental attitudes to vaccines via the Kansalaispulssi survey. In mid-May and at the start of June there was a survey answered by around 300 adult respondents. People were asked if they would give the vaccine to their children if it was recommended. Around 75 percent said that yes, they were either totally sure or mostly sure they would.
7. Is 75 percent a lot or a little?
Three in four is in my opinion quite good. If all these parents then gave permission for their children to be vaccinated, then we would achieve a pretty good 75 percent vaccine coverage.
8. When do you think 12 to 15-year-olds will be vaccinated?
There are around 200,000 of them. A lot depends on how accurate vaccine manufacturers' delivery schedules are and whether we stick to the 12-week gap between vaccine doses or whether we shorten that interval. It will probably be October or November before all the 12 to 15-year-olds who want the vaccine have received two doses.
9. There have been reports of heart muscle inflammation after Pfizer vaccinations. Is this a cause for concern with regard to children's and young people's vaccinations?
These cases have been reported most in Israel and the United States, especially in young men after their second dose and generally around 7-14 days after it was administered. Children have also been affected by this. It is possible, but extremely rare — on average 18 cases out of a million vaccinated 12 to 15-year-olds.
10. Moderna's vaccine is currently under review by the European Medicines Agency (EMA) for use by 12 to 15-year-olds. How significant is this vaccine in the Finnish vaccine programme?
Every vaccine approved for use among 12 to 15-year-olds is of course important. If one vaccine isn't appropriate or there are supply issues, then we have options. That is relevant in fighting the epidemic.
11. How important is vaccinating this group from the perspective of the autumn and the progress of the epidemic?
We know that 12 to 15-year-olds are getting infected and they can transmit the virus onwards. For example under-10s' role in infection chains remains unclear. 12 to 15-year-olds' infections are significant for themselves too. There is serious illness among children, although it is rare. None of us know yet what is the significance of Long Covid among children in the long run. For all these reasons the working group considering the issue in Finland views it as important that this age group gets vaccinated.
12. What kind of protection measures are needed in schools in the autumn, if vaccinations among this group are only starting then? Which measures can end and which do we need to keep?
These are exactly the questions that we should discuss now. When have we achieved vaccine coverage in these age groups where vaccination is necessary and when we can then get rid of restrictions. I don't have a straight answer to this, but work is being done towards understanding what is necessary and what can end once the majority of the population has two doses of vaccine.
13. Are 12 to 15-year-olds the last age group to be vaccinated?
The guidance changes currently on the way affect 12 to 15-year-olds, but we know that pharmaceutical companies are developing vaccines for younger children too. Then when vaccines have an EMA permit, it's public health officials' turn to consider whether we need them, under what conditions and who should get them. It's not quite time for that yet.
14. What kind of epidemic situation would it need to be for younger kids, under-12-year-olds, to be vaccinated?
Vaccination decisions are always a balance of pros and cons. We have to consider how serious the disease is for under-12s, how effective and safe the vaccine is for them and what role they play in infection chains. The decision is based on all those factors. The National vaccine expert group's sub-group will consider this during autumn.
15. What kind of vaccination situation will we have in the autumn?
By October hopefully all over-16s will have had two doses and then the bulk of the population will have good protection. Vaccination of 12-15-year-olds, if we begin in August, might continue past October. Vaccination of those younger than that depends on when manufacturers get permits from the EMA to sell vaccines to administer to younger children.