The JCVI Speaks: “Natural Infection in Children Could Have Substantial Long-Term Benefits On COVID-19 in the UK”

“There are reasons that children get sick. Getting sick is not a bad thing.”

Children should not be used as human shields.

In a previous article, I explored what I thought it meant to be anti-vaccine. In that article I wrote, “the core that unites anti-vaccine thought is: 1) inappropriate minimization of the risk from the virus, and 2) inappropriate minimization of the safety and efficacy of the vaccine”. Some anti-vaxxers take the first of these tenets to an extreme and claim that it’s actually beneficial for children to get vaccine-preventable diseases. As American Loon #1,931, Jennifer Margulis said,

Why are we giving children so many vaccines? They get four times the number of vaccines than I got when I was child growing up in the ’70s. As a parent, I would rather see my child get a natural illness and contract that the way that illnesses have been contracted for at least 200,000 years that homo sapiens has been around. I’m not afraid of my children getting chickenpox. There are reasons that children get sick. Getting sick is not a bad thing.

Statements such as this are rightly characterized as not just anti-vaccine, but pro-virus. The idea that disease-causing viruses are good for children is relatively common in the anti-vaccine world, and it leads to some pretty bizarre claims, such as that measles helps prevent cancer. Of course all of this is just the appeal to nature fallacy on steroids. This fallacy is usually associated with scientific luminaries such as Gwyneth Paltrow who said, “I don’t think anything that is natural can be bad for you”.

“Natural infection in children could have substantial long-term benefits on COVID-19 in the UK”

With this in mind, let’s take a trip to the UK and meet the Joint Committee on Vaccination and Immunisation (JCVI), which advises UK health departments on vaccine policy. In September, the JCVI declined to recommend the COVID vaccine to all children between 12 and 15 years old, saying that the benefits were only “marginally greater than the potential known harms”, and the margin was “too small to support universal Covid-19 vaccination for this age group at this time”. The JCVI recently released minutes (here and here) of their meetings this May that reveals a window into their decision-making process. While some of their discussions seem to represent a necessary and thoughtful approach to balancing the risks and benefit of the vaccine, much of their rhetoric is full of the type of COVID-19 minimization I have discussed several times previously. However, other talking points were much more problematic.

Some of the JCVI’s arguments against vaccination were:

• Children rarely develop severe disease or die of COVID-19; even children with underlying comorbidities have a very low risk.
• All adults will be vaccinated and there is a low risk of child-to-child transmission. Staff and parents will be protected.
• Childhood infections reflect adult infection in the community; vaccinating adults will lead to lower community infection rates and lower risk of transmission to children.
• There is an argument for allowing the virus to circulate amongst children which could provide broader immunity to the children and boost immunity in adults.

The minutes also included the following statements:

• The Committee agreed that there was little direct or indirect benefit from routinely vaccinating children aged 12-15 years.
• Members commented that natural infection in children could have substantial long-term benefits on COVID-19 in the UK.
• Members commented that the vaccination of children was unlikely to have a substantial impact on a fourth wave.
• Members commented that given the very low risk of serious disease in children, that routine vaccination of those aged 12-15 years may not be necessary. The theoretical advantages of exposure to natural infection (with very low risk of serious disease) were noted.
• Members considered that in the absence of vaccination, future generations would be exposed to COVID-19 in childhood, with a relatively mild disease. This early infection would then provide protection against severe disease throughout life. Circulation of COVID-19 in childhood could therefore periodically boost immunity in adults through exposure.

Though the UK government eventually overruled the JCVI’s recommendation, allowing one vaccine dose for adolescents, it was mostly too little too late. As the JCVI intended, the virus spread unchecked throughout the pediatric population. According to an estimate by Britain’s Office for National Statistics, “9.14% of older school children had COVID-19 during the week ending Oct. 22.” Even though the vast majority of children do well with COVID-19, when large numbers of them get sick, some suffer. Over 10,000 children have been hospitalized in England alone thus far, and according to news reports, over 100 children there have died, including “13 children dying in the seven weeks since schools reopened”. The death toll includes some children who would have been eligible for vaccination had they lived outside of the UK. The JCVI’s statement that “Children rarely develop severe disease or die of COVID-19” will be cold comfort to the families of these children.

While the choice to leave children vulnerable to COVID-19 was itself problematic, the JCVI’s rationale for this decision is even more disturbing. Reading the minutes of the JCVI meetings, I was reminded of the pro-virus statements by Ms. Margulis. It’s clear that some JCVI members are not just against the vaccine, but like Ms. Margulis, they are actively on the side of virus. Ms. Margulis said “Getting sick is not a bad thing,” and they clearly couldn’t agree more. A sociologist advising the JCVI, Robert Dingwall, previously voiced this opinion writing that school closures may, “have an immediate cost in terms of depriving children of the opportunity to acquire immunity to the infection”. He also said, “Given the low risk of Covid for most teenagers, it is not immoral to think that they may be better protected by natural immunity generated through infection than by asking them to take the possible risk of a vaccine”. At least Mr. Dingwall can’t be accused of believing COVID-19 is an “opportunity” only for children. Praising death from the virus, he previously said the following:

There is, though, a first question: who says it is desirable to prevent every death regardless of the cost? My impression is that the loudest voices are coming from young or middle-aged people who have yet to accept that death is a normal part of life. It comes to all of us in good time. A wise person would, of course, prefer to die later rather than sooner, but they might also consider that some deaths are easier to bear than others. It is not for nothing that pneumonia was described as ‘the old man’s friend’ in the days before antibiotics. Contrary to some media coverage, no-one is advocating that any old person is abandoned to die without professional nursing care. However, we should acknowledge that many frail old people might see Covid-19 infection as a relatively peaceful end compared with, say, several years of dementia or some cancers.

We’ll see if Mr. Dingall chooses to contract COVID-19 at some point in the future to ease his own passing.

The JCVI: Getting everything exactly backwards

The notion that “early infection would then provide protection against severe disease throughout life” is standard anti-vaccine Pablum, akin to using pregnancy as a form of birth control. Of course, there was never evidence that viral-induced immunity was long-lasting. The JCVI may be surprised to learn that SARS-CoV-2 is a brand new virus, and only time will tell how long immunity to it will last. In fact, recent evidence suggests that vaccine-induced immunity is likely more robust that viral-induced immunity. The JCVI had it exactly backwards.

Similarly, there was never any evidence that allowing the virus to spread throughout the pediatric population would benefit adults. Again, the JCVI had it exactly backwards. They suggested in May that “vaccinating specific age groups amongst children had little overall impact on hospitalisations and deaths in older adults” and that “All adults will be vaccinated and there is a low risk of child-to-child transmission”. Today, the headlines report that “Children Drive Britain’s Longest-Running Covid Surge” and “England’s COVID Prevalence Rises To Highest Since Start Of Year, ONS Says“. Deaths and hospitalizations have increased as well, though fortunately, there has been some decoupling of cases and these metrics thanks to vaccines. (Predictably contrarian doctors in the US who lavishly praised the JCVI’s “nuance” and “rationality & numeracy” several months ago have absolutely nothing to say about any of this today.)

(Top image credit Paul Mainwood)

“Children should not be left to face mass infection with the very same virus they made sacrifices to protect adults from”

Even if the JCVI’s predictions happened to be right, the logic they used to justify their decision is more dreadful than Ms. Margulis’s statement. At least she genuinely believed getting sick is somehow beneficial to children. In contrast, the JCVI proposed that children be infected to “boost immunity in adults”, even as they recognized the rare child can become very sick and even die from the virus. The notion that vaccinating children will lead to increased disease in adults is also an old, evidence-free anti-vaccine trope. For example, some anti-vaxxers argue against the chickenpox vaccine for children, claiming the lack of circulating virus leads to shingles in adults. In fact, this myth may be the reason that children in the UK are not vaccinated against chickenpox.

From the viewpoint of some JCVI members, children aren’t independent agents with a right to be protected from a potentially dangerous virus. Rather, to their minds, because they can serve as human shields for more vulnerable adults, it’s downright good when children get sick. They explicitly stated that “natural infection in children could have substantial long-term benefits for COVID-19 in the UK”. Not only is this scientific nonsense, as the high number of infections in the UK clearly shows, it’s a moral abomination. As Dr. Nisreen Alwan said:

She also lambasted the UK’s policy by writing, “children should not be left to face mass infection with the very same virus they made sacrifices to protect adults from”.

Yet, children were left to face mass infection, and some suffered greatly as a result. The JCVI should be judged for their decision, as should governors in the southern USA who quietly adopted this policy without having the courage to put it in writing.