Anticipating Post-vaccine Adverse Events in Children

Kompas/Bahana Patria Gupta

Students take part in the Covid-19 vaccination for children aged 6-11 years at Kaliasin I State Elementary School, Surabaya City, East Java, Wednesday (15/12/2021).

The Covid-19 vaccination rollout for children aged 6-11 has started in a number of provinces. Vaccine coverage has been expanded amid the widespread transmission of the newly detected Omicron variant.

JAKARTA, KOMPAS — The government has started administering Covid-19 vaccines for children aged 6-11, targeting 26.5 million children in several provinces in the initial stage. The expanded vaccination is expected to protect children and people around them from Covid-19. However, adverse events following immunization (AEFI) in children need to be anticipated.

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On Wednesday (15/12/2021), President Joko “Jokowi” Widodo made an inspection visit to Cideng State Elementary School in Gambir, Jakarta, which had commenced vaccinating children aged 6-11 against Covid-19.

“I have come to observe vaccination commence for 6- to 11-year-old children, with a total of around 26.5 million children across Indonesia to be inoculated. Particularly in Jakarta, 1.2 million children are to be vaccinated,” said the President.

World Health Organization (WHO) director general Tedros Adhanom Ghebreyesus said at a press conference on Tuesday (14/12) that, by this week, the Omicron variant had been found in 77 countries. He warned that the variant had likely spread undetected to most nations “at a rate we have not seen with any previous variant”.

WHO senior advisor Bruce Aylward warned all parties against “jumping to a conclusion that this [Omicron] is a mild disease”.

“We could be setting ourselves up for a very dangerous situation,” he added.

President Jokowi asked that the Covid-19 vaccination program be adjusted to fit the regular immunization schedule against other diseases for children aged 6-11.

To protect people from Covid-19, including the Omicron variant, the government has expanded the targeted vaccination coverage to children aged 6-11. President Jokowi asked that the Covid-19 vaccination program be adjusted to fit the regular immunization schedule against other diseases for children aged 6-11.

“Our children should also be vaccinated against other diseases,” he said.

Recommendation

On his inspection of the Covid-19 pediatric vaccination program, the President was accompanied by Education, Culture, Research and Technology Minister Nadiem Makarim, Deputy Health Minister Dante Saksono Harbuwono and Jakarta Governor Anies Baswedan.

KOMPAS/FRANSISKUS WISNU WARDHANA DANY

DKI Jakarta Governor Anies Baswedan when inspecting the Vaccination Center of Kompas Gramedia Bentara Budaya Jakarta, Palmerah, Central Jakarta, Monday (28/6/2021).

The pediatric vaccination drive is based on a recommendation from the Indonesia Technical Advisory Group on Immunization (ITAGI) issued on 9 Dec. 2021, based on a study of Covid-19 vaccines for children aged 6-11. Health Minister’s Decree (KMK) No. 6688/2021 regarding the Implementation of Covid-19 Vaccination for Children Aged 6-11 stipulates that vaccines are to be administered in two doses at an interval of at least 28 days between doses.

The first vaccine dose of 0.5 milliliter is to be administered as an intramuscular injection in the upper arm. Pre-immunization screening is required. The pediatric vaccination rollout for children aged 6-11 is to run in regions with first-dose vaccination coverage of more than 70 percent and over 60 percent coverage for the elderly. A total of 115 regencies/cities in 19 provinces fulfill the criteria.

On Tuesday, the Covid-19 vaccine rollout for children aged 6-11 kicked off in several provinces, including six regencies and cities in North Sulawesi in addition to other regions such as Bali as well as 21 regencies and cities in East Java, West Java and East Kalimantan.

Cissy Kartasasmita, a member of the Indonesian Pediatric Society’s immunization task force, said that vaccinating children against Covid-19 was not very different from administering other routine vaccines. But several requirements need to be met in order to prevent undesired side effects. Therefore, screening was required prior to being vaccinated.

The Covid-19 vaccine must be delayed for children who have received other vaccines within the past two weeks.

The KMK No. 6688/2021 has an attachment containing questions for initial screening. The Covid-19 vaccine must be delayed for children who have received other vaccines within the past two weeks.

This should receive due attention, as it could overlap with the Immunization Month for Schoolchildren program, which inoculates children against measles, rubella, tetanus and diphtheria. “The appropriate interval between the regular immunization [schedule] and Covid-19 vaccination is 14 days,” said Cissy.

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> Omicron Variant Transmission Expanding

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Furthermore, children who had contracted Covid-19 needed to postpone their Covid-19 vaccination to one month after recovery. If their symptoms were severe, their Covid-19 vaccination is postponed until three months after recovery. The Covid-19 vaccination must also be postponed for any children who have fever, cough, running nose, diarrhea or are vomiting.

Children with a history of severe allergic reactions to other vaccines as well as those who have hemophilia, a condition in which the blood does not clot properly, are recommended to get their vaccine at a hospital for better monitoring.

“After injections, a wait of 15-30 minutes is needed for further observation to anticipate any serious reactions,” said Cissy.

KOMPAS/KRISTIAN OKA PRASETYADI

North Sulawesi Health Service officials wear the Santa Claus attribute in the Covid-19 vaccination program for children aged 6-11 years at Graha Governoran, Manado, North Sulawesi, Wednesday (15/12/2021).

Hindra Irawan Satari, a pediatric consultant on infectious and tropical diseases who chairs the National Commission on Post-Immunization Adverse Events (Komnas KIPI), explained that the research showed that the CoronaVac vaccine developed by Sinovac as safe for use in children aged 6-11 and was tolerated well.

Localized adverse events at the injection site were typically pain, swelling and itchiness. Meanwhile, the systemic symptoms included fever, cough, headache, nausea, vomiting, muscle pain and exhaustion. Adverse events normally cease within three days after getting the vaccine.

(CAS/TAN/AIK/OKA/CIP/COK/BRO/ETA/XTI/HRS/VAN/REUTERS/AFP/BEN)

(This article was translated by Aris Prawira).