Last reviewed 17 September 2021

It has been recommended that a mass vaccination programme begin for 12 to 15-year olds. Michael Evans looks at some of the problems that might be faced by schools once this is rolled out.

Benefits of vaccination

It was in 1796 that a Gloucestershire country doctor by the name of Edward Jenner discovered that the dreaded disease of smallpox could be halted in its tracks by administering a vaccination.

Since then, vaccinations and other forms of immunisation have undoubtedly changed the world. A multitude of diseases, such as measles, typhoid, tetanus, rubella, rabies, TB and polio, that at one time killed or disabled millions of people every year have now effectively been wiped out or, at best, controlled.

Mass vaccination and immunisation in schools

Our parents and grandparents lived in fear of diphtheria. In the 1930s this disease killed nearly 3,000 children every year. Comprehensive diphtheria immunisation was introduced in the 1940s and older readers might remember being vaccinated in their infant school as part of a programme that gradually brought the disease under control. Today diphtheria in the UK is almost unheard of and children are vaccinated in infancy as a prevention.

Many readers will also recall the enormous numbers of people who had been paralysed by polio. Since this was usually caught in childhood, it was widely known as infantile paralysis. Many spent the rest of their lives in hospital and those that didn’t were often shut away and doomed to life in a wheelchair. At that time there was no legislation to protect people with disabilities.

By the mid-1950s, a vaccine had been discovered and this led to routine mass immunisation, often in schools. This programme was so successful that nobody has caught polio in the UK since the mid-1980s.

Another common disease was TB, often known as consumption of the lungs. This could either kill a person or seriously disable them. Until the mid-20th century the only accepted treatment was to send patients to a sanatorium, where it was hoped that plenty of fresh air would at least alleviate their suffering. Eventually chemotherapy was developed that was able to treat the disease and this led to widespread closure of sanatoria.

Prevention is always better than cure, however, and the BCG vaccination was developed. In 1953 this began to be administered in school to all 14-year-olds and it had a dramatic effect on cutting infections. This rite of passage for 14-year-olds continued until 2005, by which time it was no longer considered necessary for that age group.

Plans for mass vaccination of 12 to 15-year-olds against Covid-19

As part of its strategy to deal with the Covid-19 pandemic, the government has now announced its proposal to offer vaccinations to all children aged 12 to 15. The logical place for this to be done is in school, as has traditionally been the case with mass vaccinations of children. What is different this time is that whereas in the past, parents have been happy for their children to be immunised in this way, today they are more wary about vaccinations.

Vaccine scepticism

The wave of vaccine scepticism began to manifest itself in the 1970s, largely resulting from concerns about the safety of a whooping cough vaccine. These concerns were later proved to be completely unfounded, but by the 1980s and 1990s, a few anti-vaccine groups began to emerge in many countries.

This all came to a head in 1998 when Andrew Wakefield published a research paper in The Lancet. This was said to prove a link between 12 children who later developed autism after they had been given the MMR vaccine used against measles, mumps, and rubella. This research was later determined to have been fraudulent and Andrew Wakefield was subsequently stuck off the medical register as a result.

In the eyes of the anti-vaccine movement, Andrew Wakefield became an instant celebrity and the proportion of parents accepting the MMR vaccine for their children dropped to 80%.

The effects of social media

Unfortunately, there have been many claims on social media about the dangers of the vaccine. Some of these claims are frankly bizarre, and most have been completely without foundation. Already in the UK one in eight 12 to 15-year-olds have already had a Covid vaccination because they, or someone they live with, have been deemed to be clinically vulnerable. Many countries around the world have been vaccinating teenagers for some time and, as a result, millions of over-12s have now received the jab and the vaccine has a proven safety record.

Conflicting advice

Unfortunately, UK advice has not been consistent. While the chief medical officer, Chris Whitty, gave the go-ahead, the Joint Committee on Vaccinations and Immunisation (JCVI) failed to endorse it.

Chris Whitty emphasised that it would be up to parents to make up their own minds whether or not they wanted their child to be vaccinated. There was no suggestion of compulsion and children would only be vaccinated following their parents’ consent. Vaccination would be administered by health workers and not by school staff. The plan is to give young people one dose now, with a second dose probably next term. One NHS trust is reported to have told schools to expect the first injections to be completed within six weeks.

Anti-vaxxers point out that young people are one of the low risk groups and even if they catch the virus, it is unlikely that they will be seriously ill. During the first 12 months of the pandemic, when UK daily death rates were so high, the total death rate among under 18s during that whole year was fewer than 25.

Pro-vaccinators point out that a very valid reason for vaccinating young people is not simply to protect them, but to protect other people. What is not always considered is that unvaccinated young people can carry the virus without showing any symptoms, enabling them to pass the infection to someone more vulnerable without realising it.

The problems faced by schools

This argument does not satisfy the anti-vaxxers. Geoff Barton of the Association of School and College Leaders said that many of his association’s members had received letters from various pressure groups threatening legal action if they take part in any Covid-vaccination programme. The pressure group Lawyers for Liberty warned that school staff could be held liable if families objected and were not listened to.

Paul Whiteman, general secretary of the National Association of Head Teachers, stressed that since a decision has now been made, clear guidance on the immunisation programme was needed without delay and it was essential for the Government to immediately confirm that the process surrounding vaccinations will be run and overseen by the appropriate medical teams.

If parents had any questions, he continued, including important matters such as consent, these must be handled by the medical teams. There must be no delay in confirming this, otherwise school leaders will be put in an impossible position of having to answer questions for which they simply did not have the answers.

One potential problem would be if a young person wished to be vaccinated but the parents were against this. It is important for school staff not become involved in such potential conflict. This is something for the medical teams to sort out.

School leaders currently have enough to occupy their time as they strive to get their schools back to normal after months of disruption. They can certainly do without any additional aggravation.

Summary

  • Vaccines have led to diseases that killed or disabled millions being wiped out or controlled.

  • Vaccination programmes in schools (eg for diphtheria, polio and TB) have been massively successful.

  • Young people are a low risk group (and are unlikely to be seriously ill if they do catch Covid) but can still spread Covid-19.

  • School staff should refer any questions about vaccination, including those about consent, to medical teams.