«Corona vaccination for children: in one year at the earliest»

Mr Aebi, what is the situation like for you at Inselspital?

We are currently seeing more children being tested for Covid on the Covid Track in paediatric emergencies. Only very few of them test positive and we still have very few children who are hospitalised in an emergency due to Covid.

Why are more children being tested?

This increase reflects the overall number of infections, which are currently increasing massively. This figure colours children who could potentially be infected. However, most of the children we test are still negative. Since the beginning of the pandemic, around 1 per cent of tests have been positive.

Does it make sense to test as many children as possible?

Together with the Federal Office of Public Health (FOPH), we at Paediatrics Switzerland have developed a scheme for when exactly children under the age of 12 should be tested. With these guidelines of 25 September, the testing of children was reduced, which has been applied in practice ever since. This recommendation will not be changed from one day to the next, even if the situation is currently difficult to predict. We must not forget: Children are infected less frequently than adults and are less likely to pass the pathogen on to other people. It makes sense to test children if they have certain symptoms or have had contact with an adult who has tested positive. The most important signs of a possible Covid infection in a child are fever and a severe cough. However, it makes no sense to test them if they only have a banal cold.

«Children are infected less frequently than adults and are less likely to pass the pathogen on to other people.»

Who has the right to have a child tested? Can the school, for example, prescribe a test?

It is only a doctor or the health authority, together with the parents, who can arrange for a child to be tested. If parents wish to have their child tested, even though such a test would not be necessary according to the current criteria, then an individual solution must be found together with the paediatrician. This happened just before the autumn holidays, for example, as some airlines requested tests from children. A test can be carried out here, but this is not covered by health insurance.

Is the smear test also carried out through the nose in children? Many adults find this very painful.

The standard is still the deep nasopharyngeal swab. If this is not possible, an anterior nasal or throat swab is acceptable.

Do children have to stay at home if a parent is tested?

No, a child without symptoms does not have to stay at home until the test result is available. However, if the test is positive, the child must go into quarantine.

Many schools have clear guidelines for sick children, based on the chart from the FOPH and Paediatrics Switzerland (see image): Children with a cold and a slight cough are allowed to go to school. Do you expect these recommendations to be tightened up soon?

I hope not! There is no medical-scientific reason to do so, even if the number of infections among adults is rising massively. Firstly, there is no new evidence that children are the drivers of the pandemic. And secondly, even with the start of the second corona wave, in most cases it is not the case that the disease takes a severe course in children.

The subject of vaccinations: In the summer, people were still saying that you should have your children vaccinated against the flu this year. What do you think?

Currently, the same vaccination recommendations still apply as every year: We recommend the flu vaccination for children who have an increased risk of complications from flu due to pre-existing illnesses, as well as for those around such children. This recommendation has not changed. However, regardless of coronavirus, the question arises as to whether children should be vaccinated more often against influenza. The role of children is completely different with influenza than with coronavirus; they are important drivers of the winter flu epidemic and experience in other countries has shown that vaccinating children can protect people at risk in the older generations. At present, however, the flu vaccine is mainly used for people at risk. So if a child wants to be vaccinated «just like that», it is not the top priority. Another half a million flu vaccine doses will become available at the end of November and may also become available to healthy people.

Is there any information on a corona vaccination for children?

Personally, I don't think we can expect a coronavirus vaccination for children in the next twelve months. This is because, as already mentioned, children are not among the drivers of the pandemic and severe cases are rare. The safety of new vaccines must also be well documented before they can be administered to children. The possibility of serious side effects must be largely ruled out. Put simply, the less severe the disease, the safer the vaccine must be and the fewer possible side effects it must have.

Keyword safety: How do you assess the risk of grandparents looking after their grandchildren?

This is not an easy situation and there were already major discussions in the spring. Every family has to weigh up the risk for itself. Yes, children are infected less often and yes, they pass on the virus less. But less doesn't mean never, it's not all or nothing. In practice, I suggest that healthy grandparents who have no additional risk factors should be allowed to look after or meet their grandchildren as long as these children do not have an acute fever or a new severe cough, i.e. according to the same criteria as exclusion from school or daycare.

Now comes Halloween, Father Christmas meetings and lantern parades: Join in or skip it this year?

It's not really up to me to answer that, it falls under the current regulations on the limited number of people of the cantons or the federal government. But it certainly makes no sense to be more restrictive for children than for adults.

Suspected coronavirus: when should a child be tested?

Based on the current FOPH recommendations, Inselspital Bern has developed the online Corona Bambini test, which provides parents and carers with information on whether or not children under the age of 12 are allowed to attend school or daycare and when they should be tested. The same criteria apply to young people over the age of 12 as to adults.

Helpful links:

• Online-Test bei Verdacht auf Corona bei Kindern: Corona Bambini

• Die meist gestellten Fragen vom BAG in Bezug auf Kinder und Schule

• Wann darf ein Kind in die Schule, wann nicht: Chart von Pädiatrie Schweiz zusammen mit dem BAG, wurde von vielen Schulen übernommen

Other relevant topics on corona and family:

• Wie viel Corona können Eltern ihren Kindern zumuten?
  Die zweite Corona-Welle ist hier und täglich sind wir mit Nachrichten über Neu-Infektionen und neuen Vorgaben konfrontiert. Wieviel davon sollen Eltern ihren Kindern zumuten? Und wie reagiert man, wenn das Viruswirklich nah ist; Freunde, Verwandte oder das Kind selbst betrifft? Jugendpsychologin Nadine Messerli-Bürgy gibt Antworten.«Frau Rösler, was macht die Corona-Krise mit der Chancengleichheit in der Schule?»
  Corona-Krise und Fernunterricht stellen die Chancengleichheit im Unterricht auf eine harte Probe. Dagmar Rösler, Präsidentin des Dachverbands Lehrerinnen und Lehrer Schweiz (LCH), sagt im Interview, was das für Kinder, Eltern und Schule bedeutet, und zieht ein erstes Fazit zur Schule auf Distanz.«Kombi von Präsenz- und Digital-Unterricht wäre ideale Lernform»
  Digitalexperte Philippe Wampfler hat mit den eigenen Schülerinnen und ­Schülern erlebt, was es bedeutet, wenn es nur noch Fernunterricht gibt. Der Gymnasiallehrer sagt, welche Lehren er aus der Corona-Krise zieht, welchen Einfluss der Lockdown auf die Digitalisierung der Schule hat – und was Kinder, Eltern und Lehrpersonen an ­Veränderungen erwartet, wenn wieder alle regulär zur Schule gehen.