Delta variant: Will returning to school put kids at risk?

Deutsche Welle: How dangerous is the delta variant for children?

Jakob Armann: Currently we actually don't have any data that the delta variant is more dangerous for the individual child than the alpha variant that was prominent before or the wild type for that matter. At this point, if you look at hospitalization rates, if you look at kids admitted to the ICU, nothing changed with the emergence of the delta variant. The delta variant is more transmissible, so you will have more people overall and for that matter more children who do get infected. But the individual risk did not change with the emergence of the delta variant. 

Does this mean that the number of kids that you're looking after there hasn't changed or are there more kids at your hospital right not because of the delta variant? 

Currently we do not have a single kid with COVID-19 in the hospital. Obviously numbers are still quite low in Germany, but there are kids infected with the delta variant in Dresden and in the surrounding areas. But none of them has been sick enough to get to the hospital. If you look at data from the UK, where the delta variant emerged earlier than in Germany, you don't see more kids being admitted to the hospital due to COVID-19 with delta being more prevalent.

We heard that the symptoms of adults getting COVID-19 through the delta variant varied compared with the original strain. Now you're saying, just to clarify, that there is no difference whatsoever with children?

No difference that we could determine at this point. We do have a national registry where all hospitalized children with COVID-19 are reported, and we don't have any difference in the last month compared to the months before. And the same is true if you talk to pediatricians in the UK for example: They don't see a difference either. Children do have mild symptoms usually, but they don't get very sick with the delta variant.

A lot of people point to the fact that we simply don't have enough data perhaps because many studies, including yours, of course, focus on children. But critics keep saying that there are way too few test subjects, and you just basically confirmed that. Does this mean that the studies, if we can call them that, are ultimately scientific guesswork and we don't really know?

Well, I think that's a bit of an overstatement. You're right, there are not as many sick children as adults, which is a good sign, but also that's a result, right? So if you don't have a lot of kids in the hospital with COVID-19, at least you know kids don't get really sick with COVID-19. And if this doesn't change with the new variant then there's no reason to fear that everything will change for the children in this particular setting.

In terms of guesswork, every study you do you can usually answer one specific question and there are a lot of questions that remain unanswered in the study, and scientists are very clear about that. However, you do have a lot of different studies from different countries and you can look at a combination of those studies and make very, very good assumptions about this.

So, even if one study doesn't have enough power to detect this and this, if you combine 10, 15, 20 different studies, you usually get a nice result. Just for comparison, for example, our school study — we had 1,500 students included in this study to approve the Pfizer-BioNTech vaccine in adolescents. 1,000 adolescents got vaccinated with the vaccine and 1,000 got a placebo, so it's not that there are not similar sized studies in children and adolescents. 

Most children aren't vaccinated. Is this going to be a problem for them?

Individually for them it's not a big problem. As I said, the risk for the individual kid to become severely ill with COVID-19 is absolutely minimal, especially if you do not have any preexisting conditions. If there are comorbidities it's a bit different but even then the risk compared to all of the population is very, very low.

Would it be beneficial to have kids vaccinated to a higher degree in terms of overall transmission rate in the society? It probably would help a little bit, yes. But, for the individual children, it does not make a huge difference. 

To me, the important part is [in an individual country's] vaccination program: If you have to choose between vaccinating adolescents or, let's say, a 35-year-old, I would always choose the 35-year-old because he has a much higher risk for any COVID-related [long-term effects] compared to the child or adolescent.

If you're in a place where you say, "okay, we now have enough vaccines for everybody and basically we don't know what to do with them," that's where you should start vaccinating your adolescents —  [bearing in mind] there's no approved vaccine for under 12 years old — but not if you have [priority groups] still.

The other point that's very important to me is: I think there should not be a connection between school attendance and vaccination rate in adolescents. We do know the negative effects of school closures and school restrictions are much higher than any risk from COVID for this age group.

So I think kids' going to school is much more important than having kids vaccinated. If you can do both, that's great, but if that's not possible they still should go to school. 

Jakob Armann is a physician at the University Children's Hospital in Dresden. 

Monika Jones conducted the interview.