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Awards will support risk-benefit analysis of COVID vaccination in kids

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Since October 2021, the Immunisation Coalition’s COVID-19 Risk Calculator (CoRiCal) has been available to help guide those with uncertainty about COVID-19 vaccines about the risk and benefits based on individual factors.
 
The tool has received a number of updates in the months after it first launched, to include information on vaccine-related myocarditis and pericarditis, as well as the creation of a chart to help clinicians discuss the benefits of booster vaccinations following the emergence of Omicron.
 
Now the team behind CoRiCal is hoping to expand the capabilities of the tool to include the risks and benefits of COVID vaccination among children – the age cohorts with the lowest vaccination rates in the country.
 
While children are less likely to die or experience severe outcomes from COVID-19 than adults, other adverse outcomes such as hospital admission and long COVID remain important factors for parents to consider when deciding whether to vaccinate their children.
 
GP, NHMRC Fellow and University of Queensland School of Public Health Professor Colleen Lau is lead investigator on the project. She told newsGP that her team has already begun developing risk calculators and charts, based on Australian and international evidence.
 
Much like existing CoRiCal elements, parents will be able to enter their children’s age, sex, vaccination status, timing since last dose and the level of community transmission, and the calculator will display personalised risks such as the:

• chances of getting and dying from COVID-19 based on vaccination status
• chances of getting myocarditis and dying from the vaccine versus from COVID-19 infection.

‘Kids are much less likely to die from COVID-19 than adults, so CoRiCal-Kids will focus on other adverse outcomes such as hospitalisation, ICU admission, long COVID, multisystem inflammatory syndrome, isolation [away from school, friends, sport], and poor mental health outcomes,’ Professor Lau said.
 
‘One of the major challenges with this project is the constantly evolving evidence from scientific studies around the world – we are learning new things every day, but it’s very time-consuming to review and distil this information and incorporate them into our models.’
 
The CoRiCal-Kids project recently garnered further support in the form of two GSK Excellence in Immunisation awards, which both come with $20,000 in funding, were presented at last month’s Communicable Diseases and Immunisation Conference 2022.
 
Professor Lau, who received one of the awards, said the funding will allow her team to progress more quickly with developing and expanding CoRiCal-Kids to include all of the other outcomes that are important to children and parents.
 
‘While children are very unlikely to die from COVID-19, there are many other potential health outcomes that are still poorly understood,’ she said. 
 
‘CoRiCal-Kids will include tools to compare the risk of these poor outcomes in vaccinated versus unvaccinated children.
 
‘Even if a child is not sick enough to be hospitalised from COVID-19, they may develop problems that can significantly affect their quality of life, such as ongoing fatigue, long COVID, and persistent loss of taste and smell.
 
‘We also don’t fully understand the potential health impacts of repeated COVID-19 infections.’
 
Dr Carissa Bonner, an NHMRC and Heart Foundation Research Fellow at the University of Sydney’s Medical School, also received a GSK Immunisation Award for her work related to CoRiCal. She told newsGP the project she is working on is designed to help build health literacy around vaccination.
 
‘This award will fund a program of research to ensure the CoRiCal tool meets the health literacy needs of Australians,’ Dr Bonner said.
 
‘Our Sydney Health Literacy Lab research has shown that people with lower health literacy find it hard to understand, access and act on COVID-19 prevention advice.
 
‘Most health information is too complex for the average person to understand. We will now be able to test different ways to help people weigh up risks and benefits in the CoRiCal tool, so they can make informed decisions about COVID-19 vaccination.’
 
Uptake of COVID-19 vaccines in Australian children has been, to date, relatively low.
 
As of 6 July 2022, only around 52% of 5–11 year-olds have had their first dose, while less than 40% have had their second dose. In comparison, 96% of people aged 16 years and over have had at least two doses.  
 
‘One reason for the low uptake in young children is parental concern about adverse events, such as myocarditis, which has received media attention,’ Professor Lau said.
 
‘mRNA vaccines [Pfizer and Moderna] have been associated with myocarditis, particularly in younger people and in males, and may have led to vaccine hesitancy for some families. However, myocarditis is much more common after COVID-19 infection than after vaccination, but this information might be less well known to parents.
 
‘CoRiCal-Kids will use interactive visualisations to quantitatively compare the risk of myocarditis after vaccination, after infection, and background rates.’  
 
Ultimately, Professor Lau said, the tool will help parents and children make more informed decisions about vaccination and help with shared decision making between clinicians and patients, hence aiding uptake.
 
‘Hopefully [it will] make the job easier for doctors and nurses when explaining the benefits of vaccination to patients,’ she said.
 
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CoRiCal COVID-19 vaccination health literacy Immunisation Coalition vaccine hesitancy

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