Children aged 12 to 15 in England are to be offered their first dose of a Covid-19 vaccine after the government accepted the advice of the UK's Chief Medical Officers (CMOs) - but how will the rollout work and what if they want the jab but their parents or guardian don't agree?
The UK's four CMO's came to the decision on Monday after considering directly how it will impact the 12-15 year old age group and did not consider its impact on wider society.
While accepting the Joint Committee on Vaccination and Immunisation (JCVI) view that the health benefits were marginal, they said there were other factors to consider which led them to conclude offering the jab to children was the right thing to do.
When will the rollout begin?
The government has been preparing for the rollout in anticipation of receiving the advice from the CMOs and JCVI.
The first jabs will be given out from Monday (September 20).
What jab will they be offered?
The Medicines and Healthcare products Regulatory Agency (MHRA) has approved the Moderna and the Pfizer jab for all people over the age of 12 in the UK, but the government said it will only offer the Pfizer vaccine to 12 to 15-year-olds.
They did not comment on why the Moderna jab will not be included but the government has ordered much more of the Pfizer jab.
How will the rollout work?
The Covid-19 vaccine rollout for children will work much the same way that they get their Polio and Tetanus jabs.
The programme will be run by the NHS with the vaccines administered in schools supported by GPs and community pharmacies.
There will be alternative provision for those who are home schooled, in secure services or specialist mental health settings.
Around three million children are set to be eligible for the jab.
Listen to our coronavirus podcast:
How will consent work for parents and guardians and the child?
If your child is offered a vaccination at school, a consent form may be handed out to give your permission.
Parental consent will not be needed if the child is considered competent to make a decision by themselves – this is known as being Gillick competent.
In other words, children under the age of 16 can consent to their own treatment if they're believed to have enough intelligence, competence and understanding to fully appreciate what's involved.
Prof Whitty said for the “great majority of cases, children and their parents come to the same decision".
Vaccines minister Nadhim Zahawi said parental consent will be needed for vaccinations of 12 to 15-year-olds, but children can overrule parents who do not want them to get the jab but will only be able to do so following a meeting with a clinician.
There would, however, be some mediation in the event of disagreements.
Vaccine minister Nadhim Zahawi outlines to ITV News the process through which consent can be obtained
He told the Commons: “As with all vaccinations for children, parental consent will be sought.
“The consent process will be handled by each school in their usual way and will provide sufficient time for parents to provide their consent.
“Children aged 12 to 15 will also be provided with information usually in the form of a leaflet for their own use and to share and discuss with their parents prior to the date of the immunisation and that scheduled time for it.
“Parental, guardian or carer consent will be sought by the school age immunisation providers prior to vaccination in line with other school vaccination programmes.
“In the rare event that there is a situation a parent does not consent but the child or the teenager wants to have the vaccine, then there is a process by which the school age vaccination clinician will bring initially the parent and the child to see whether they can reach consensus and if not, if the child is deemed to be competent, then the vaccination will take place.”
Why was the decision made?
Although the CMOs said they believed vaccinating children had a marginal health benefit they noted other factors were important to consider.
Professor Whitty said on Monday that vaccinating children would reduce the disruption in education caused by Covid-19 - which is predicted to get worse over winter.
He noted that “the disruption in education which has happened over the last period since March 2020 has been extraordinarily difficult for children and had a big impact on health, mental health and public health”.“This is most apparent in areas of deprivation,” he said.
Which countries have been vaccinating children?
Countries in Europe, including France, the Netherlands, Spain and Italy are vaccinating children 12 and over.
Further afield, the US is also going ahead with plans to vaccinate those aged over 12.
Just this month Chile became the first Latin American country to approve the vaccine for children aged six and over, South Africa started jabs for children as part of global trials for China's Sinovac Biotech vaccine.
What does the data say?
The CMOs think a single dose of Pfizer will reduce significantly the chance of a young person getting Covid and passing the virus on.
Clinical evidence shows that a single dose of Pfizer cuts the risk of catching the Delta variant of Covid-19 by 55% and has a much higher effect on preventing severe illness and death.
It also cuts transmission.
Why not two doses?
Essentially, because the JCVI was only asked to look at the impact of one dose.
Many other nations have been offering the Pfizer jab to children for weeks and so there is plenty of data on the impact that has had.
There is much less data on the impact of both doses.
What does the government have to do to convince parents to get their children jabbed?
The JCVI has been asked to look at whether second doses should be given once more data comes through internationally, this is likely to be in the spring.
Data from the US and Canada has indicated a higher rate of the extremely rare event of inflammation of the heart muscle, known as myocarditis, after a second dose, which was considered in the decision-making.
Who can get the jab already?
All 16 and 17-year-olds are being offered a first dose, with the intention of having a second at a later date.
Those aged 12 to 15 are eligible for two doses if they are at higher risk of a number of issues.
England’s chief medical officer Professor Chris Whitty added there were “no plans at the moment” to look at vaccinating under-12s.
The AstraZeneca vaccine is currently not recommended for anyone under the age of 40.
Are there any side-effects?
The most common side-effects in children aged 12 to 15 are similar to those in people aged 16 and over.
They include pain at the injection site, tiredness, headache, muscle and joint pain, chills and fever.
These effects are usually mild or moderate and improve within a few days.
The JCVI has also investigated the effects of myocarditis, after Pfizer or Moderna vaccines.
While the condition can result in short periods of hospital observation, followed by typically swift recoveries, the JCVI has concluded the medium to long-term outcomes are still uncertain and more follow-up time is needed to get a clearer picture.