• Eliska Furlong, Rishi S Kotecha, Rachel Conyers, Tracey A O'Brien, Jordan R Hansford, Leanne Super, Peter Downie, David D Eisenstat, Gabrielle Haeusler, Brendan McMullan, Marianne B Phillips, Bhavna Padhye, Luciano Dalla-Pozza, Frank Alvaro, Christopher J Fraser, Wayne Nicholls, Julia E Clark, Matthew O'Connor, Benjamin R Saxon, Heather Tapp, John Heath, Sarah E Hunter, Karen Tsui, Mark Winstanley, Amanda Lyver, Emma J Best, Ushma Wadia, Daniel Yeoh, Christopher C Blyth, and Nicholas G Gottardo.
• Perth Children's Hospital, Perth, WA.
• Med. J. Aust. 2022 Apr 4; 216 (6): 312-319.

IntroductionThe Australian Technical Advisory Group on Immunisation and New Zealand Ministry of Health recommend all children aged ≥ 5 years receive either of the two mRNA COVID-19 vaccines: Comirnaty (Pfizer), available in both Australia and New Zealand, or Spikevax (Moderna), available in Australia only. Both vaccines are efficacious and safe in the general population, including children. Children and adolescents undergoing treatment for cancer and immunosuppressive therapy for non-malignant haematological conditions are particularly vulnerable, with an increased risk of severe or fatal COVID-19. There remains a paucity of data regarding the immune response to COVID-19 vaccines in immunosuppressed paediatric populations, with data suggestive of reduced immunogenicity of the vaccine in immunocompromised adults.RecommendationsConsidering the safety profile of mRNA COVID-19 vaccines and the increased risk of severe COVID-19 in immunocompromised children and adolescents, COVID-19 vaccination is strongly recommended for this at-risk population. We provide a number of recommendations regarding COVID-19 vaccination in this population where immunosuppressive, chemotherapeutic and/or targeted biological agents are used. These include the timing of vaccination in patients undergoing active treatment, management of specific situations where vaccination is contraindicated or recommended under special precautions, and additional vaccination recommendations for severely immunocompromised patients. Finally, we stress the importance of upcoming clinical trials to identify the safest and most efficacious vaccination regimen for this population.Changes In Management As A Result Of This StatementThis consensus statement provides recommendations for COVID-19 vaccination in children and adolescents aged ≥ 5 years with cancer and immunocompromising non-malignant haematological conditions, based on evidence, national and international guidelines and expert opinion.Endorsed ByThe Australian and New Zealand Children's Haematology/Oncology Group.© 2022 AMPCo Pty Ltd.

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