How long should children wait to be vaccinated after COVID infection?

Around 2.3 million Australian children aged between five and 11 became eligible for COVID-19 vaccination this month, with more than 435,000 already having had a first dose ahead of the return to school.
 
Tens of thousands of children would also have been infected with COVID-19 in the past few weeks, with many parents having to reschedule previously booked vaccination appointments.
 
Given the concurrent spread of the virus and vaccination campaign, GPs are likely to field more and more questions about the optimum gap for re-arranging a first dose if a child has been infected.
 
It is also expected that some parents will inquire as to whether their children need to be vaccinated at all if they have already had COVID-19.
 
The Australian Technical Advisory Group on Immunisation (ATAGI) issued official guidelines last month, which do not give a specific indication of how soon a child can receive a vaccine dose following infection, apart from to say it should be after their recovery.
 
‘Children aged 5−11 years who have previously had SARS-CoV-2 infection can receive the
paediatric Pfizer COVID-19 vaccine,’ ATAGI states.  
 
‘This is recommended following recovery from their illness or vaccination can be deferred for up to six months. This includes children with a past history of PIMS-TS or post COVID-19 condition [long COVID].’
 
The UK counterpart of ATAGI, the Joint Committee on Vaccination and Immunisation (JCVI), is more specific, stating the minimum interval between any vaccine dose and recent COVID-19 infection should be at least four weeks for 5−11-year-olds.
 
This recommendation is supported by Murdoch Children’s Research Institute Associate Professor Margie Danchin, a paediatrician at the Royal Children’s Hospital.
 
Writing recently in The Conversation, Associate Professor Danchin says a four-week wait gives enough time to be confident children have avoided the rare multisystem inflammatory syndrome in children (MIS-C/PIMS-TS).
 
However, she also advises a degree of flexibility.
 
‘If a parent has an appointment coming up and their child has completely recovered, and has no symptoms, then – knowing the pressures on the system and approaching new school year – I wouldn’t decline that appointment,’ she writes.
 
Children who still have symptoms after a month should wait another month until vaccination, Associate Professor Danchin recommends.
 
The ATAGI guidelines do not currently offer any further guidance about natural immunity conferred by infection.
 
However, the JCVI indicated last month that data on the Omicron variant is inconclusive so far.
 
‘Based on studies conducted over the initial waves of the pandemic, immunity that develops upon recovery from infection [natural immunity] has been demonstrated to provide good protection against subsequent severe COVID-19 [severe re-infection] for at least six months.
 
‘The level of protection afforded by natural immunity against the Omicron variant is still to be determined.’
 
newsGP understands ATAGI is currently considering updated guidelines about the wait between COVID-19 infection and vaccination.
 
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ATAGI childhood vaccination COVID-19 Moderna Omicron paediatrics Pfizer