August 20, 2021, 9:05 am | Read time: 7 minutes

Children aged 12 and older have been able to get vaccinated against the coronavirus since the end of May. However, it wasn’t until mid-August that the Standing Committee on Vaccination (Stiko) issued a general recommendation. After weeks of review, the committee advocated for the COVID-19 vaccination starting at age 12. Experts explain what parents, children, and teenagers should know now.

What does the Stiko recommendation mean?

After the approval of the first COVID-19 vaccine from Biontech/Pfizer for this age group in May, Stiko had only recommended vaccination for 12- to 17-year-olds with certain pre-existing conditions or contact with high-risk patients. They initially refrained from a general recommendation, partly because there was insufficient data to assess certain side effect risks.

Due to improved data and more experience with how children and adolescents handle the COVID-19 vaccination, Stiko concluded that the benefits of the COVID-19 vaccination for those aged 12 and older outweigh the risk of very rare side effects.

Further Argument for the COVID-19 Vaccination from Age 12

According to Reinhard Berner, a pediatrician specializing in infectious diseases at the University Hospital Dresden, the vaccination recommendation for children and adolescents aged 12 and older is legitimate and logical. “That still doesn’t mean you have to get vaccinated,” says Berner. However, those who wish to get vaccinated have another argument for consideration–and can trust that Stiko’s recommendation is based on a very thorough review of the available data, according to the expert.

Vaccination for this age group has been possible since May. According to calculations by the Robert Koch Institute (RKI), about one in four 12- to 17-year-olds in Germany has already received at least one dose of the Biontech/Pfizer vaccine or the Moderna vaccine, which has also been approved for them.

COVID-19 Vaccination for Adolescents from Age 12: What Needs to Be Considered?

12- to 17-year-olds who contract the virus very rarely develop a severe COVID-19 course. But it does happen, Berner clarifies–and the vaccination protects against it.

Possible Long-Term Effects of a COVID-19 Infection in Children

Additionally, there are possible long-term effects of the infection in children, such as PIMS. The pediatric multisystem inflammatory syndrome requires hospitalization. It is rare but has always been treatable so far. Long COVID, meaning long-term effects that can manifest as shortness of breath and chronic fatigue, has also been observed in children, although the frequency cannot yet be quantified, according to Berner.

Possible Side Effects of a COVID-19 Vaccination in Adolescents

A possible severe side effect of the COVID-19 vaccination in 12- to 17-year-olds is myocarditis, which has been observed more frequently in boys. Although it is very rare, occurring in approximately 1 in 16,000 boys and less frequently in girls according to current data. “If I weigh all this,” says Berner, “I would personally say: The positive effect of the vaccination is significantly higher than a possible serious side effect.”

Benefits of a COVID-19 Vaccination in Children and Adolescents

More Carefree Social Life

Vaccination makes more things possible again, and some gatherings with friends may be more carefree. Although Berner doesn’t “like” such arguments, which Stiko also hinted at, as he puts it, because children and adolescents are now “allowed” something that was previously unjustly denied to them. Ultimately, in Berner’s view, the decision for or against vaccination should primarily weigh the health benefits for the child against the risk of a severe vaccination side effect.

In fact, vaccination makes participation in social activities and school easier, says Berner. That’s positive. However, he remains concerned that this relief for vaccinated children and adolescents has the potential to cause tensions and conflicts in families and schools.

COVID-19 Vaccination Also Protects Others

Also worth considering: While the vaccination does not protect 100 percent against infection, the risk of contracting the virus and potentially passing it on to others is lower than for the unvaccinated.

In summary, severe COVID-19 courses are very rare in children, as are severe side effects of the vaccination. Long-term effects of a COVID-19 infection can also affect children. From a social perspective, the vaccination may make more things possible again.

Many Parents and Adolescents Well-Informed

Thomas Fischbach, a pediatrician in Solingen, North Rhine-Westphalia, observes that most young people come on their own or with their parents, having already made preliminary considerations and seeking advice.

Even though he fully supports the new Stiko recommendation, Fischbach emphasizes that he would not “push” the vaccination. He clearly recommends it to 12- to 17-year-olds who belong to a risk group. Otherwise, he informs them about the benefits and possible risks. “Most come well-informed and decided to the practice.”

Avoid Sports Initially After COVID-19 Vaccination

Part of the information includes mentioning myocarditis as a very rare possible side effect. “I recommend especially to boys to avoid sports for ten days after the vaccination, even if this is not yet officially recommended,” says Fischbach. If symptoms like chest pain or breathing problems occur in the days following the vaccination, one should see a doctor. Reinhard Berner also advises young people to be cautious with intense physical activity for a few days after the vaccination. He does not specify a concrete number of days but would base the period of avoiding sports on the “general condition.”

School attendance is possible without restrictions–provided there are no vaccination reactions. Like adults, 12- to 17-year-olds can experience common side effects of the vaccination, such as fever, headaches, body aches, and general discomfort, which may last for one to two days, according to Berner. “But this is temporary and disappears again. It’s due to the stimulation of the immune system by the vaccine.”

More on the topic

U.S. Emergency Authorization for BioNTech When will the COVID-19 vaccine be available for children under 12 in Germany?

COVID-19 EMA Approves BioNTech Vaccine for Children Aged Five and Up

Child Aged 12 Wants COVID-19 Vaccination, Parents Do Not–What Now?

What can happen: The child wants the vaccination, but the parents do not. What happens then depends on the child’s age. Generally, it is assumed that from age 14, with normal development, they are mature enough to make the benefit-risk assessment on certain medical issues themselves. Whether this so-called capacity to consent is present is ultimately decided by the doctor. Fischbach tries to “always build a consensus.” In case of doubt, he would prefer not to vaccinate, says the president of the Professional Association of Pediatricians. Only from age 16 would he do it even if the parents are not on board.

Of course, the reverse scenario is also conceivable: The parents are in favor of the vaccination, but the child resists. Here, coercion is the wrong approach. Parents should listen to the child’s opinion and respect it. Ultimately, the best decision is made jointly by the doctor, child, and parents.

Where Can Children Get Vaccinated?

According to the National Association of Statutory Health Insurance Physicians (KBV), children aged 12 and older and adolescents can get vaccinated at any doctors who administer vaccinations. This includes general practitioners or other specialists. The Professional Association of Pediatricians observes an increase in demand for appointments among its members since the new Stiko recommendation.

Whether children and teenagers can also get the shot at vaccination centers depends on the approach of the respective center, according to KBV. Whether they offer special appointments for this can be checked on the respective website. In some federal states, special vaccination campaigns are planned or underway, including at vaccination centers, but also through mobile vaccination teams visiting schools. No vaccine is yet approved for children under 12.

With material from dpa