Awards support risk-benefit analysis of COVID vaccination in children

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A newly funded project will evaluate how to improve vaccine risk communication to boost vaccine uptake in children.

Child getting COVID vaccination.

Children aged 5-11 have the lowest COVID vaccination rate of all eligible age groups. (Image: AAP)


Since October 2021, the Immunization Coalition’s COVID-19 Risk Calculator (CoRiCal) has been available to help people with uncertainty about COVID-19 vaccines about the risk and benefits based on individual factors.


The tool has received a number of updates in the months since its initial launch, including information on vaccine-related myocarditis and pericarditis, as well as the creation of a chart to help clinicians discuss the benefits of booster vaccinations following the emergence of Omicron.


Now, the team behind CoRiCal hopes to expand the tool’s capabilities to include the risks and benefits of COVID vaccination in children – the age groups with the lowest vaccination coverage in the country.


While children are less likely to die or suffer serious consequences from COVID-19 than adults, other adverse effects such as hospitalization and prolonged COVID-19 remain important factors for parents to consider when deciding whether to vaccinate their children.


General practitioner, NHMRC Fellow and University of Queensland School of Public Health Professor Colleen Lau is principal investigator of the project. She said newsGP that her team has already started developing risk calculators and charts, based on Australian and international evidence.


Like existing CoRiCal elements, parents can enter their children’s age, gender, vaccination status, timing since the last dose and level of community transmission, and the calculator will display personalized risks such as:

  • chances of getting COVID-19 and dying based on vaccination status
  • chances of getting myocarditis and dying from vaccine versus COVID-19 infection.

“Children are much less likely to die from COVID-19 than adults, so CoRiCal-Kids will target other adverse outcomes such as hospitalization, ICU admission, prolonged COVID, multisystem inflammatory syndrome, isolation [away from school, friends, sport]and poor mental health outcomes,” said Professor Lau.

‘One of the biggest challenges of this project is the constantly evolving evidence from scientific studies around the world – we are learning new things every day, but it is very time consuming to review, distill and incorporate this information into our models. ‘

The CoRiCal-Kids project recently received further support in the form of two GSK Excellence in Immunization awards, both of which included $20,000 in funding, presented last month at the Communicable Diseases and Immunization Conference in 2022.

Professor Lau, who received one of the awards, said the funding will allow her team to make faster progress in developing and expanding CoRiCal-Kids with all the other outcomes important to children and parents.

“While it is highly unlikely that children will die from COVID-19, there are many other possible health outcomes that are still poorly understood,” she said.

‘CoRiCal-Kids will include tools to compare the risk of these poor outcomes in vaccinated versus unvaccinated children.

Even if a child is not sick enough to be hospitalized because of COVID-19, they can develop problems that can significantly affect their quality of life, such as persistent fatigue, prolonged COVID-19 and persistent loss of taste and smell.

“We also don’t fully understand the potential health effects of repeated COVID-19 infections.”

dr. Carissa Bonner, a NHMRC and Heart Foundation Research Fellow at the University of Sydney’s Medical School, also received a GSK Immunization Award for her work related to CoRiCal. She said newsGP the project she is working on aims to build health literacy around vaccination.

“This award funds a research program to ensure that the CoRiCal tool meets Australians’ health literacy needs,” said Dr Bonner.

“Our research in the Sydney Health Literacy Lab has shown that people with lower health literacy levels find it difficult to understand, access and act on COVID-19 prevention advice.

‘Most health information is too complex for the average person to understand. We can now test several ways to help people weigh risks and benefits in the CoRiCal tool so they can make informed decisions about COVID-19 vaccination.”

The uptake of COVID-19 vaccines in Australian children has been relatively low to date.

As of July 6, 2022, only about 52% of 5-11 year olds have had their first dose, while less than 40% have had their second dose. In comparison, 96% of people age 16 and older have had at least two doses.

“One reason for the low uptake in young children is parents’ concerns about side effects, such as myocarditis, which have received media attention,” said Professor Lau.

‘mRNA vaccines’ [Pfizer and Moderna] have been associated with myocarditis, especially in younger people and in men, and may have caused hesitation in some families. However, myocarditis is much more common after infection with COVID-19 than after vaccination, but this information may be less known to parents.

‘CoRiCal-Kids will use interactive visualizations to quantitatively compare the risk of myocarditis after vaccination, after infection and background figures.’

Ultimately, said Professor Lau, the tool will help parents and children make more informed decisions about vaccination and help make shared decisions between clinicians and patients, thus promoting uptake.

‘Hopefully [it will] make the job easier for doctors and nurses when they explain the benefits of vaccination to patients,” she said.

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