is adolescent vaccination justified?

« All vaccinated, all protected. “The slogan of the Ministry of Solidarity and Health now knows its variation for middle and high school students:”For a safe return to school, get vaccinated!», « How are you ? That’s it!“. Unless you live on the planet Mars, it is difficult to escape the messages … On the day of the start of the school year, already more than half of 12-17 year olds had received (mainly) a first dose of the anti-Covid-19 vaccine Comirnaty (Pfizer-BioNtech), at the same dosage as adults, in order to obtain their precious sesame (see covidtracker.fr). From 1is October, the health pass will be extended to 12-17 year olds in all public places, transport (except metro and TER), libraries, restaurants, museums, performance halls, but also sports halls, stadiums, etc. And to facilitate the vaccination of middle and high school students, the government has decided to involve the schools themselves. “Different modalities can be set up: dedicated slots in vaccination centers located in the immediate vicinity of establishments, vaccination in ephemeral centers or within establishments by mobile teams”, is it detailed on the website of the Ministry of Health. ‘National Education.

A device at the very least unprecedented. It is up to the principals and heads of establishments to ensure its proper execution (provision of rooms, back-up staff for vaccination monitoring, etc.), some having taken the lead from the end of August , others dragging their feet to get out of their role. “We must ensure pedagogical continuity; not transforming ourselves into health auxiliaries», Protest the latter. It is also up to the volunteer teachers to organize role plays and debates around vaccination, based on the documents available on the ministry’s website. Unpublished fact, again: no need for the agreement of both parents for the anti-Covid vaccination, that of one of the two is enough. And from the age of 16, the teenager will be able to do without parental authorization. For the moment, only 12-17 year olds are affected by these measures.

« We did not return our jacket »

The National Professional Pediatric Council (CNPP) gave the green light on July 22 for rapid and massive vaccination of adolescents, deeming the benefit-risk balance favorable, whereas it had hitherto been rather opposed to it; and this in agreement with the Haute Autorité de santé. Advanced arguments: “The greater contagiousness of the Delta variant and the increase in the proportion of adolescents and young adults infected […] which appear to play an increasingly important role in the dynamics of the epidemic. »

CNPP members also put forward “reassuring results regarding the low frequency of reported side effects, which are otherwise of no consequence in the short and medium term, after more than 3.5 billion doses have been injected worldwide and 7.5 million 12-18 year olds received two doses of vaccine in the United States.“Asked by Famille Chrétienne, Christèle Gras-Le Guen, member of the CNPP, president of the French Pediatric Society and head of the pediatric emergency department of the Nantes University Hospital, explained:”We did not return our jacket, our position has changed because the situation has changed. Although SARS-CoV-2 is not a pediatric disease and affects adolescents much less seriously than adults, the circulation of the virus in schools is worrying. In addition, there is an urgent need to vaccinate all teenagers to allow them to resume a normal life and preserve their mental health (avoid the anxiety and depressive disorders which have jumped in 2020).“In a forum in Le Monde on August 9, around thirty doctors and teachers, including epidemiologists Dominique Costagliola and William Dan, were also alarmed by the multiplication of clusters in day camps and summer camps, as well as the increase in hospitalization in children and adolescents; quite relative increase, however: 1.2% of 0-9 year olds tested positive (for the past year), not much more for 10-19 year olds.

Disagreements over the safety of messenger RNA vaccines

On the parents’ side, however, many concerns remain. The current anti-Covid vaccines have indeed been the subject of an early (or conditional) marketing authorization in the name of the “state of emergency” and the absence of curative treatments. Pharmaceutical companies did not wait for the end of clinical trials for their marketing (October 2023 concerning Pfizer), yet crucial and incompressible steps. In any case, this information leaves some doubts about the harmlessness of these vaccines. “We must be more than ten million doses delivered now“, Reassures Christèle Gras-Le Guen …”The cases of myocarditis (inflammation of the heart muscle) that have been reported, especially in young boys (Israel and the United States), are mild, and today we have no worrying signal of pharmacovigilance. which lights up in our pediatric networks.Is that what we should therefore welcome the new messenger RNA (mRNA) vaccines that are simpler and faster to produce than “classic” vaccines, made from live attenuated or inactivated viruses? “Yes, it’s pretty amazing that we got such an effective vaccine so quickly. The mRNA, for which we have only very positive things to say, is destroyed very quickly within the cell … The legitimate concerns about any new technology have no rational support.»

However, this discourse is not unanimous within the pediatric community, and more particularly among clinical physicians. Divergent voices exist. For months, the Pediatric Health Collective, launched on the initiative of a dozen doctors, has been urging the greatest caution, while keeping in mind the Hippocratic Oath. “Rush is a bad advisor. In medicine, we learn to be prudent, humble and rigorous“, Recalls his spokesperson, Dr Marie Fabre-Grenet, a few days before his early retirement:”I chose to wait to get vaccinated against Covid-19. So I would have been legally banned from practicing medicine on September 15th», Explains this specialist in the development of the toddler. “In a young person in full development, with life ahead of him, knowing that this disease is not fatal for him (with some exceptions), we say be careful, let’s assess on a case-by-case basis the benefit-risk of an experimental vaccine whose effects medium and long term are unknown at this time.“Especially since a majority of adolescents, having already contracted the disease, have a natural immunity against SARS-CoV-2. Whether their role in the transmission of the virus is not established. And “the effectiveness of anti-Covid vaccines on [cette même] transmission requires confirmation», As indicated in a terse press release from the Ministry of Health. A fortiori on “the different variants in circulation».

“An increase in rare pathologies”

For Marie Fabre-Grenet, “in the collective unconscious, the word “vaccine” resonates as progress. When we talk about anti-Covid “vaccines”, there is systematically a cognitive bias. However, mRNA vaccines are new, even if this technique is well known elsewhere, and very promising. MRNA has so far been used primarily in cancer treatments, not globally in healthy subjects.” For now, “there is an increase in pathologies usually rare in young vaccinated and far from harmless (myocarditis and pericarditis), which must be clarified.The pediatric health collective raises other questions, in particular concerning the fate of this famous mRNA in the human body, after injection, a real point of dispute between scientists. “With the mRNA, the person receives the genetic code that will allow him to make the spike protein of the virus and to become immune to it. The hypothesis that mRNA could enter our genome in the presence of a retrovirus is probably unlikely. But not to eliminate. Likewise, a possible cross-immunity between the spike protein and syncytin, necessary for placentation at the start of pregnancy; they both have genetic similarities, would deserve to be explored before being immediately refuted. »

« « I trust the health authorities of my country »

While the vaccination campaign for 12-17 year olds is in full swing, the debate is also raging among parents of students, and sometimes among couples. “This virus is terrible, how can we deny it? We must stop its circulation and relieve congestion in hospitals. We do not have the choice“, Pleads Émilie, whose sister is a hospital doctor. Without hesitation, she had her two children, aged 12 and 15, vaccinated before the start of the school year. “I trust the health authorities in my country. For me, no difference between the vaccines against Covid-19 and the eleven vaccines that are now mandatory for diphtheria, tetanus, polio, BCG, MMR, etc.“For her part, Isabelle is not really reassured, an American friend of her niece suffered an anaphylatic shock after the injection of the Comirnaty vaccine. “But there is no school canteen in my son’s new high school, and he will need a pass to go to lunch.»

More virulent, Fanny does not, for the moment, want to hear about anti-Covid vaccination for her children of 9 and 13 years old. “It has become torture to send them to school, given the compulsory health measures wearing a mask, barrier gestures, threat of eviction in the event of Covid, and now pressure to be vaccinated.What does she fear? “Since the start of this crisis, I regularly consult the site of the European Medicines Agency, the American pharmacovigilance database (VAERS), as well as the Our world in data site. Frankly, I am shocked when I see the list and the seriousness of certain side effects: fever, headache, vomiting, disorders of the female cycle, but also facial paralysis, stroke, severe skin reactions, myocarditis … to play russian roulette with my children. »

 
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