Should child with arthritis be prioritized and get Covid-19 vaccine

As a major boost to India’s fight against COVID-19, the Subject Matter Expert Committee has given the Controller General of Drugs of India (DCGI) a recommendation for the use of Covaxin by Bharat Biotech among children aged between 2 to 18 years. Covaxin will be the country’s first COVID19 vaccine that can be given to children.

According to Francesco Licciardi, Division of pediatric immunology and rheumatology, Margherita children’s hospital University of Turin, Italy, the COVID-19 vaccine can be given to a child with arthritis. Children with arthritis are more susceptible to infections, especially when disease activity is high.

Biologics, as well as disease-modifying antirheumatic medications (DMARDs) indicated for the treatment of juvenile arthritis, may exacerbate this susceptibility. As a result, it is important that they should be safeguarded against COVID-19 also.

The Pfizer-BioNTech vaccine is the only one that has gained FDA emergency use authorization (EUA) for children aged 12 and up. Pfizer-BioNTech has provided data to the FDA on September 28 validating the safety of their vaccine among children aged 5 to 11. The FDA is currently analyzing the data and is anticipated to make a judgment on whether the vaccine should be recommended for younger children, possibly by the end of October.

Despite reports of uncommon side effects like myocarditis and pericarditis, experts believe the Pfizer vaccine is safe and effective for youngsters. The adverse events were minor in a majority of the cases with symptoms such as weariness, chest pain, and an irregular heart rhythm, and all of them resolved on their own.

Although these side effects are a concern, Randy Cron, MD, Ph.D., a pediatric rheumatologist and Professor of Pediatrics and Medicine at the University of Alabama-Birmingham, believes that getting the COVID-19 vaccine is considerably riskier than any potential vaccine-related adverse effects.

According to David Cennimo, MD, professor of pediatric infectious disease at Rutgers New Jersey Medical School, there is no evidence that children with juvenile arthritis are more prone to cardiac side effects due to the COVID-19 vaccine.

However, it is vital to remember that children who get rituximab or daily glucocorticoids may have a weaker immune response to the vaccine, resulting in less viral protection.

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