India is demographically a young country with a rich demographic dividend – a large proportion of youngsters. Those under age 19 constituted 45 % of the entire population in the 2011 census and as per population clock in 2020 roughly half of India’s population is under age 19.
Covid’s second wave, unlike the first wave, seems to have affected a higher proportion of younger individuals. Media report that in some states, roughly three times the number of children were infected during the second wave, compared to the first wave. There are fears that a potential third wave may affect an even greater proportion of children. The delayed adverse effects of Covid-19 on children are largely unknown; the Kawasaki-like syndromes – an immunologically mediated disorder that affects small blood vessels including the coronary arteries – are rare but of serious concern. The sheer number of children in India will make even rare problems a matter of large magnitude.
With school closure for the last 15 months, children have by and large stayed cocooned at home and therefore will constitute a sizeable vulnerable population. Experimental reopening of some schools during the lull in the epidemic in January- February 2021 led to clusters of infections in school-going children underscoring the susceptibility of children to coronavirus infection.
Our current vaccination policy extends to cover all those above age 18 which will be about 50 % of the population. In India, up to now, only about 20 % of those above age 45 have received at least one dose of the Covid vaccine. We need a herd immunity level of nearly 80% to contain the epidemic. It is impossible to achieve this level of herd immunity by vaccinating only those above age 18.
India must urgently draw up plans to vaccinate children under age 18. This is important for many reasons.
The fear of Covid is keeping children away from schools. There is no point in having progressive legislation such as the right to education if schools cannot be reopened quickly and safely. Parents, children, teachers, educationists, nutritionists and paediatricians are all alarmed by the prolonged school closure and its adverse effects on children’s wellbeing.
School-final examinations have been cancelled contributing to some uncertainty about future, anxiety and depression amongst adolescents who are going through challenging times both physically and emotionally. Enforced physical inactivity due to school closure is enhancing childhood obesity which is already a major problem in India according to paediatricians; this in turn has the potential to increase the number of young Type 2 diabetics in the country. Social isolation and lack of peer interaction have major psychological impact on growing children. Schools impart not only book-knowledge but also life skills and values which shape children’s character.
In India, schools provide good nutrition to disadvantaged children through the widely acclaimed mid-day meal programme. Keeping schools closed for prolonged periods will certainly have an adverse impact on child nutrition. When schools are closed, children do not have access to the school-health programmes which are vital for the wellbeing of children.
Some countries such as the United States have already extended Covid vaccination to those above age 12 whereas others such as Germany are planning to vaccinate this age group from June 2021. All these factors taken together imply that we need to urgently plan to extend the Covid immunisation programme to include those under age 18.
How exactly can we plan and execute this important task?
A central process of acquiring and equitably distributing vaccines free to every adult and child is a national public health imperative. One of our vaccine manufacturers, Bharat Biotech has initiated bridging studies by vaccinating children from 2 years. A similar study should be quickly performed with Covishield, starting with children above 12 and progressively including younger children. Once safety is established by studies, the vaccination platform for children has to be planned – vaccination camps at schools are a feasible and viable proposition.
The central and state governments should work together, supported by philanthropic organisations such as Rotary with their track record of promoting vaccination in children (polio) and adults (hepatitis B). The liberal budgetary allocation of 35,000 crore for Covid vaccine, the PM Cares Fund and donations from various philanthropic individuals and organisations including the Indian diaspora all over the world should be able to provide funding for this vital health imperative.
If we want schools to reopen at least by March 2022, we need to plan on immunising children of school-going age right now.
Views expressed above are the author’s own.
END OF ARTICLE