COVID-19 Vaccine in Children: Current Evidence and Recommendations

Vaccination against COVID-19 (coronavirus disease 2019) was a fundamental tool in the pandemic control strategy and its benefits were greater in the groups at higher mortality risk. Children and adolescents with COVID-19 generally present with mild and often asymptomatic disease, but they may have severe respiratory and/or inflammatory clinical manifestations resulting in hospital admission with around one-third requiring intensive care. Mortality from COVID-19 in children and young adults is low and the existence of chronic diseases or underlying medical conditions is relevant to clinical severity and prognosis. Currently, after the end of the pandemic was declared in May 2023, vaccination of children in Portugal no longer covers healthy children, but includes children with immunosuppression and chronic diseases. Following WHO recommendations, several European countries have adopted a similar strategy. Other countries, such as the United States of America (US), continue to vaccinate healthy children as part of the public health strategy to control the disease and improve immunity. In Portugal, the vaccination of children belonging to risk groups requires the involvement of pediatricians, who are involved in the care of children with diverse chronic diseases in various areas and who may play a relevant role in overcoming vaccine hesitancy of the parents that results from lack of knowledge, misinformation or a mistaken perception of low risk.