Introduction
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has swiftly spread around the world, causing a global pandemic (COVID-19) declared by the World Health Organization (WHO). COVID-19 resulted in a significant increase in morbidity and death, as well as significant economic damage (1). As of November 20th, 2021, there have been more than 257 million confirmed cases and more than 5 million death cases reported to WHO.
The highly contagious coronavirus strain has overwhelmed the global healthcare systems for the third time in this century. The first coronavirus pandemic was started in 2002 by a severe acute respiratory syndrome coronavirus (SARS-CoV-1). As a result, healthcare workers were at a higher risk of developing the disease than others in the population (2). In 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) spread globally, causing the second outbreak. According to the World Health Organization, the MERS-CoV virus is still circulating with a 35% fatality rate compared to 9.5% for SARS-CoV-1 (1). SARS-CoV-1 has a case fatality rate of 2%–3%, according to reports (3).
Nowadays, the world suffers from the third coronavirus infection (SARS-CoV-2) and causing severe acute respiratory syndrome (4-6). It began back in December 2019, when Chinese health officials in Wuhan discovered severe respiratory distress due to pneumonia in a cluster of people. On Jan 7th, 2020, the new coronavirus strain dubbed novel coronavirus 2019 came from these patient clusters (2019-nCoV).
In the united states (US) alone, 9–12% of diagnosed patients with COVID-19 were Children (7). About 90% of children who tested positive were asymptomatic or had mild-to-moderate symptoms. Only 15 children required critical care in a survey of 2572 pediatric cases, with three deaths documented (8). Another study across North America found that 18 of 48 children brought to ICUs required invasive ventilation, where 16 children survived and two died (9). Children under the age of one year, as well as those with additional comorbidities or underlying diseases, were found to be at higher risk of severe illness (10-12). It is suggested that COVID-19 in the pediatric population was less severe compared to cases in adults, and diagnosed children had different symptoms than adults do (13, 14). Interestingly, children might not have coughing or fever as frequently reported in adults (14).
Vaccinations and preventive measures are crucial for all ages to protect children from new variants of this virus-like Delta and Omicron and for patients with comorbidities and to have more control over disease transmission.
Accordingly, WHO granted a global emergency approval of vaccines (15). The fast development of COVID-19 vaccines raised many concerns and questions. In 2020 and during this pandemic, the mRNA type of vaccines have been used on humans and showed a significant efficacy rate (16-20).
The BioNTech-Pfizer COVID-19 vaccine is developed from a single-stranded mRNA made in vitro transcription from a DNA template that encodes the viral spike protein (21).
This review aims to offer healthcare workers and non-healthcare workers a comprehensive and up-to-date overview of the currently available information about the BioNTech-Pfizer vaccine on children and adolescents. Also, to provide the scientific readers with useful data that can aid in early recognition and effective prevention and management of children affected by COVID-19 and the BioNTech-Pfizer vaccine.