COVID-19 vaccination of children aged 5 to 11 and the use of bivalent vaccines

Since December 2021, all children aged 5 to 11 have been offered a vaccine against COVID-19. At the time, the Health Council of the Netherlands recommended doing this for protection against MIS-C, a rare but very serious disease that may develop following infection with the SARS-CoV-2 virus. The number of children aged 5 to 11 who remain at risk of MIS-C is extremely low. This is because around 95% have already been infected with SARS-CoV-2, and development of MIS-C after another infection is rare. Moreover, the risk of developing MIS-C after infection with an Omicron variant of the virus is much lower than the risk associated with earlier virus variants. The risk of developing serious COVID-19 after infection with an Omicron variant is also much lower. For most children aged 5 to 11, therefore, the COVID-19 disease burden is presently low. In the opinion of the Health Council, this reduces the benefits of vaccination for this group.

At the same time, the Health Council believes that vaccination is still beneficial for children who are at a higher risk of becoming seriously ill with COVID-19, as vaccination can reduce the risk of hospitalisation. That is why the Health Council is recommending that children aged 5 to 11 are only offered a vaccine against COVID-19 if they belong to a medically at-risk group. This includes children with a heart condition, an immune disorder, lung disease (other than asthma), diabetes mellitus, obesity or a neurological condition. This advice also applies to repeat vaccinations against COVID-19. According to the Health Council, children who have already received the primary course of vaccinations should only be offered a repeat vaccination if they belong to a medically at-risk group.

Alongside monovalent vaccines, bivalent vaccines are currently available for both children and adults. The Health Council is expressing no preference as to whether a monovalent or bivalent mRNA vaccine should be used for the primary course of vaccinations, recommending instead to leave the choice up to the administering organisation.