The Importance of Advancing Severe Acute Respiratory Syndrome Coronavirus 2 Vaccines in Children

While the role of children in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains to be defined, children likely play an important role based on our knowledge of other respiratory viruses. Children are more likely to be asymptomatic or have milder symptoms and less likely to present for healthcare and be tested for SARS-CoV-2. Thus, our current estimates are likely under-representative of the true burden of SARS-CoV-2 in children. Given the potential direct benefit of a SARS-CoV-2 vaccine in children and the substantial indirect benefit through community protection, or herd immunity, we argue that planning and implementation of SARS-CoV-2 vaccines should include children. Furthermore, community protection occurred after widespread implementation of prior childhood vaccines against Streptococcus pneumoniae, rubella, and rotavirus. We detail considerations for vaccine clinical trials, potential barriers to the implementation of widespread vaccination and argue why children would be an ideal target population for vaccination.

Automated summary

Despite the unclear role of children in SARS-CoV-2 transmission, they are likely to play an important role based on our knowledge of other respiratory viruses. Due to children being more likely to be asymptomatic or have mild symptoms, current estimates of SARS-CoV-2 burden in children may be underestimated.