BANDAR SERI BEGAWAN – Brunei plans to vaccinate about 40,000 adolescents once its Pfizer-BioNTech vaccines arrive in the country later this year.

Battling a surge in COVID-19 cases in the second wave, the country is hoping that inoculating teenagers aged 12 to 17 would help reduce outbreaks in schools and prevent the virus from spreading to the wider community.

In August, the government shut schools since the first coronavirus cases were detected after 15 months of zero local transmissions.

Dr Rohayati Hj Mohd Taib, consultant paediatric cardiologist at MoH, said the aim of vaccinating adolescents is to minimise disruptions to pupils’ education and prevent large outbreaks in schools.

“Once adults are vaccinated, susceptible children and adolescents will count for the high proportion of continued infections in the community.

“Children and adolescents can be the source of family clusters,” she said in an interview on Tuesday.

However, the government has yet to decide whether students would need to be inoculated before they are allowed to return to schools.

Coronavirus transmissions were reported in schools during the beginning of the second wave, including a large cluster at Chung Hua Middle School Kuala Belait with 298 cases and 46 infections at Al-Falah/Freda Radin school.

The health ministry on Monday approved the use of Pfizer for adolescents to help reach its 80 percent vaccination target by the end of the year.

As of Tuesday, 75.9 percent of the population has received at least one vaccine dose and 51.8 percent is fully vaccinated.

Dr Rohayati, who is also head of MoH’s paediatric services, said getting the jabs would also benefit children’s mental health.

“No vaccine is 100 percent effective but we want to reduce the severity and number of outbreaks in schools, avoid school closures and all extensive public health interventions”.

“It is not a silver bullet, but it’s one of the many ways we can help our young people get back to life as usual,” she added.

The health ministry is in discussions with the education and religious affairs ministries to ensure a smooth vaccine drive for teenagers, including preparing a line list of students’ details.

The line list will allow the health ministry to allocate appointment slots at vaccination centres.

Senior Medical Officer Dr Siti Rosemawati (L) and Consultant Paediatric Cardiologist Dr Rohayati speak to reporters on the health ministry’s plan to vaccinate teenagers aged 12 to 17. Photo: Rasidah Hj Abu Bakar/The Scoop

What parents need to know

Senior Medical Officer Dr Siti Rosemawati Hj Md Yussof said parents and guardians must register their children under the BruHIMS patient management system for them to get vaccinated.

Consent forms will also be distributed to parents via schools. Anyone who feels unwell on the day of their vaccination will be asked to reschedule their appointment, she said.

Asked whether they foresee any challenges in convincing parents to allow their children to get vaccinated, Dr Rohayati said, “MoH has gone on overdrive to put correct information out there, and you can’t disprove the experience of 10 million adolescents who have received the vaccines [across the world]”.

She added that parents can research more information on the vaccine and its administration on trustworthy websites.  

“It is our duty to dispel myths. Vaccinating adolescents is not just protecting them, it is protecting our community,” she said.

Teenagers will be given two doses of the Pfizer-BioNTech vaccine — a mRNA vaccine develop to trigger an immune response that produces antibodies when they are exposed to the virus.

We don’t go by weight, so if it’s a 12-year-old, we will still be giving the same vaccine dose as an adult three weeks apart,” Dr Rohayati said.

Concerns over myocarditis and pericarditis

Cases of myocarditis and pericarditis have raised concerns on the safety of mRNA vaccines among adolescents.

Myocarditis is a mild inflammation of the heart and pericarditis is a mild inflammation of the skin or coating around the heart, said Dr Rohayati.

“Cases of myocarditis were picked up after millions of children have been vaccinated.

“They found that it’s mostly boys after the second dose and it’s 40-70 cases per million. So if you vaccinate 100,000, you’d probably get 4-7 cases,” she added.

Dr Rohayati said the benefits of getting the vaccine outweigh the risk of developing heart inflammation among children and adolescents.

“When we say it’s a mild case, it goes away by itself or we give medication.

“The risks of COVID itself is much higher than myocarditis and that is one of the safety decisions [we took],” she said.

Moreover, anyone with an allergy to any ingredients/components of the vaccine or has a risk of anaphylaxis will not be allowed to take the jab.

Dr Siti Rosemawati said teenagers will not be given a second dose if they developed severe allergic reactions that require them to be hospitalised after taking their first shot.

Like any vaccine, COVID-19 jabs can cause mild side effects such as pain, redness or swelling at the injection site. 

Other side effects may include fever, chills, headache, muscle pain and joint pain.

Dr Siti Rosemawati said, “Some may feel tired or lethargic, in this case the child just needs to rest and they should recover in a few days. If there are long-lasting side effects, parents are advised to bring their child to the nearest health centre”.

Teenagers can also take painkillers or paracetamol after taking the vaccine but it is not recommended to take painkillers before vaccination.

“We also don’t know if [painkillers] have any effect on the immune response to COVID-19 vaccine, so it is best to avoid,” Dr Siti Rosemawati added.

Infected teens to get vaccine six weeks after diagnosis

Teenagers who were infected with COVID-19 will also be vaccinated to give them better protection.

They will be given vaccination six weeks after they were first diagnosed with COVID-19, said Dr Siti Rosemawati.

Children infected with COVID-19 develop immune responses towards the virus, but we don’t know if it is enough or how long the protection will be.

“It is best for them to be fully vaccinated with two doses that will give them better protection,” she added.