Effects of COVID-19 Vaccination among School Children Aged 12-15 years - A Pilot Survey Study

Introduction

India's National coronavirus disease-2019 (COVID2019) Vaccination Program was built on scientific and epidemiology evidence, WHO guidelines and global best practices. The program started with the vaccination of health care workers (HCWs) and frontline worker (FLWs). The program ambit expanded in a phased manner, with the inclusion of all individual aged 18 years and above from 1st May 2021. The program coverage was further expanded to children 15 to 18 years of age from 3rd January 2022. The expert group decided to expand the COVID-19 program to children aged 12 to 14 years from March 2022.¹

No medication or therapies were found to be effective in controlling the COVID-19 pandemic. The fast-track development of COVID-19 vaccine brought some hope among health practitioners globally. The major challenge seemed to be safety, efficacy, and acceptance of the vaccine.²

Reasons for Vaccinating Children

The advantages of COVID vaccination for children in India are summarized below:

• Children constitute a low-risk group for COVID complications, hospitalization and mortality, and mostly display mild symptoms. However, that does not mean that there is no risk. Some children suffered severe symptoms, and even were hospitalized. Multisystem inflammatory syndrome in children (MIS-C) is a recognized, serious and often delayed complication of COVID. Children who had mild COVID can also suffer effects of long COVID.
• There are many children with immune compromised conditions and co morbidities who can have more severe COVID and therefore deserve high priority and urgency for vaccination (heart or respiratory conditions, organ transplant, kidney ailments like nephritic syndrome, corticosteroid therapy or cancer chemotherapy, childhood obesity, diabetes, etc.).
• Children can transmit infection to high-risk or elderly adults in the household vaccinated almost 8-10 months ago. Therefore, vaccinating children is important for overall family health and reducing community transmission.
• Even though the administration ordered opening of schools, many parents were reluctant to send their children to school as they were not yet vaccinated and were hoping that vaccination for children would start soon. This apprehension has only increased due to the tremendous talk in the media about the cases of recent Omicron variant increasing in the country.³

Vaccines greatly reduced the number of deaths caused by COVID-19. They achieved this by alerting our immune system about the components of the virus without having to go through an actual COVID-19 infection. Once long-term immune memory is formed, future responses are more balanced and proportionate. The body can get rid of the virus without suffering damage to vital internal organs. Although other benefits exist, prevention of severe disease and death remains the primary objective of vaccination.

A recent survey in India reported a 15 percent reinfection rate. Some countries experienced more infection than others. In other words, unlike in 2020, we are no more an immune-naïve population.

That being said, unlike measles or chickenpox, having antibodies against Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) either from vaccination or by natural infection does not provide long-term protection against infection. With new variants escaping prior immune protection, hybrid immunity appears increasingly relevant. This is essentially an augmented immune response that occurs when the vaccine is administered to someone who had a prior natural infection.⁴ The objective of this study is to assess the status of COVID-19 vaccination among children aged 12 to 15 years at a rural school.

Materials and Methods

Source of Data: The study data was collected from rural schools of Uchagaoun, Belagavi. The data was collected through a validated questionnaire.

The following criteria were used for data collection.

Study design: Prospective study

Type of research: Observational pilot study

Selection criteria: Subjects of both sexes aged between 12-15 years fulfilling the inclusion and exclusion criteria as part of the selection criteria.

Sample size: Seventy students from rural area.

Duration of study: Five months (1/3/2022 to 31/7/2022)

Tools used for the study: Self-structured questionnaire was used to determine the effects of COVID-19 vaccination among school children.

Inclusion criteria

• Subjects in the age group of 12- 15 years
• Subjects vaccinated for COVID-19 
• Both male and female subjects

Exclusion criteria

• Subjects not vaccinated for COVID-19
• Children with all types of pathological, genetic, congenital, clinical conditions
• Subjects below 12 years and above 15 years of age

Results

We conducted the survey at a rural school in Uchagaoun, Belgavi for estimating the incidence of COVID-19 vaccination effects among children. The data was analyzed statistically i.e., the number of male children affected due to COVID-19 vaccination in the school. Out of 40 male students, 19 students marked ‘yes’ to the question, while 21 marked ‘no’ indicating that the majority of male children experienced the effects of COVID-19 vaccination (Table 1).

The present survey was conducted at a rural school in Uchagaoun, Belgavi for estimating the incidence of effects of COVID-19 vaccination among children. The data collected was analyzed statistically i.e., the number of female children in school affected with COVID-19 vaccination. Out of 30 female students, 25 students marked ‘yes’ to the question, while five marked ‘no’ inferring that majority of female children were affected by vaccination (Table 3).

We conducted the survey at a rural school in Uchagaoun, Belgavi for estimating the incidence of effects of COVID -19 vaccination among children. The data analyzed indicated the number of male and female children in school affected with COVID-19 vaccination (Table 4).

Discussion

This was an observational study involving a survey conducted at an rural school in Belgavi. Sixty responses were considered for the study (40 from male students and 30 from female students), to evaluate the effects of COVID-19 vaccination. From this survey study, we could infer that majority of students experienced effects of COVID-19 vaccination on their health.

Key findings from this study, which sought to understand the perspectives of paediatricians and other healthcare providers working with children in India on paediatric COVID-19 vaccines during the first year of the rollout, revealed that the majority of respondents were supportive of paediatric vaccination, though half did not feel sufficiently informed. Concerns concerning vaccine reluctance among caregivers were also raised. Healthcare authorities emphasize the need for wide-spread vaccine uptake in children to combat the pandemic, as infected children could be the primary drivers of disease transmission.

As of May 2023, 21% of COVID-19 cases were in children and adolescents, with many requiring hospitalization and critical care in LMICs. Unvaccinated children face increased risk due to new variants and changes in disease symptoms.5 Studies in Italy, Kuwait, Singapore, Saudi Arabia, and the USA show strong parental hesitancy against paediatric COVID-19 vaccination due to concerns about vaccine safety and efficacy. Factors include fear of side effects, adverse events, trust in healthcare, and rapid vaccine development. Addressing these concerns requires public health leaders and healthcare providers to raise awareness and provide information.^6,7

The Indian Academy of Pediatrics recommends using motivational interviewing techniques during patient visits and partnering with schools and academic institutions to increase COVID-19 vaccination uptake.

In our survey which was conducted in rural school of Belgavi. Here 140 responses were considered for study in which Eighty per cent of the respondents had heard of the Covaxin vaccine, while 20% of respondents were aware of Covovax. From this survey study after analyzing the data the maximum number of students had a covid-19 vaccine effect. on health.

Strengths

This research contributes to understanding the effects of COVID-19 vaccination among children.

Limitations

• Sample size was very small.
• The age group included in the study was limited.

Recommendation for further studies

• Research in the form of comparative study between urban and rural schools can be conducted.

Conclusion

In conclusion, findings from this study conducted to understand healthcare provider perspectives on COVID-19 vaccination for children in India within 6months of the availability of COVID-19 vaccines for children indicated substantial support for the COVID-19 paediatric vaccine from paediatricians.

Despite the fact that numerous government health programs have been implemented to understand the COVID-19 vaccination effects among children, the available literature is sparse. The present research contributes to understanding the effects of COVID-19 vaccination in children. Most prevalent side effects included fever, pain at the injection site, headache and fatigue. In this study, in terms of effects of COVID-19 vaccination among children aged group 12 -15 years, it appears that female children were more affected compared to male children. Further studies involving larger populations are necessary to evaluate the effects of COVID-19 vaccination.

Conflicts of Interest

None

Acknowledgement

We are very grateful to the school Staffa schools that have allowed us and helped us during this study. And the department of Repertory which allowed us to conduct the camp.