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The U.S. is at the forefront of the race to vaccinate young children. Many governments elsewhere are treading more cautiously.

In Mexico, the president says he won’t be held hostage by vaccine makers and there are no plans to inoculate under-18s except those at risk. In many parts of Africa, rollouts are going so slowly that vaccinating children is a distant ambition. Some governments are waiting to see how the campaign in the U.S. goes before moving ahead.

The U.S., where children between 5 and 11 are getting shots for the first time this month, isn’t alone: Children as young as 3 are being vaccinated in countries such as Colombia, Argentina and China.

The case for vaccinating older people and those with underlying health problems has always been clear-cut: Trials and real-life experience show recipients as gaining significant protection against catching the disease and particularly from being hospitalized and dying from it.

For children, who rarely suffer severe illness from Covid-19, the benefits accrue mainly—though not exclusively—for others: older people with whom they come into contact while infected and the broader population. Advocates of vaccinating children also say it will help restore some normalcy to schools and reduce quarantines.

Leah Lefkove, 9, shows off her vaccination sticker just before being the first child to be vaccinated at the Viral Solutions vaccination and testing site in Decatur, Ga., on the first day COVID-19 vaccinations were available for children from 5 to 12 on Wednesday, Nov. 3, 2021. (AP Photo/Ben Gray)

Leah Lefkove, 9, shows off her vaccination sticker just before being the first child to be vaccinated at the Viral Solutions vaccination and testing site in Decatur, Ga., on the first day COVID-19 vaccinations were available for children from 5 to 12 on Wednesday, Nov. 3, 2021. (AP Photo/Ben Gray)

Many governments have now decided that the upside—further reducing the minor risk of so-called long Covid and other consequences of the disease in children, and curbing the spread of the virus in the population—outweighs the risks of rare side effects.

In Colombia, 253 children—172 of them 12 and under—have died from Covid-19 in a population of 50 million, according to government statistics. "It’s not a number that is irrelevant," said Health Minister Fernando Ruiz, adding that Colombia vaccinates children against diseases far less dangerous than Covid-19.

Marcela Guerrero, 37, said she didn’t think twice when she heard Colombian authorities were vaccinating children at a concert arena in the capital, Bogotá. "It’s our children’s health at play, and the most important thing is that they’re safe," said Ms. Guerrero as her 5-year-old boy, Christopher, waited for his shot.

The U.S. this month extended its vaccine campaign to children 5 and older, after the Centers for Disease Control and Prevention recommended use of the vaccine made by Pfizer Inc. and BioNTech SE in 5-to-11-year-olds. These children will receive two shots three weeks apart that contain one-third the dosage of the vaccine delivered to adolescents and adults.

In doing so, the U.S. has moved ahead of countries in Europe in vaccinating children. Across Europe, only children of 12 and older can be vaccinated—though doctors sometimes use their discretion to vaccinate at-risk younger children.

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The U.K. recommended most 12-to-15-year-olds get a single dose of the Pfizer vaccine—underlining how different jurisdictions are giving different dosage instructions. After initially resisting the move, government advisers decided that young teens faced other health risks such as missing out on school due to illness. In the European Union, over-12s receive two shots of the Pfizer or Moderna Inc. vaccines.

Australia and New Zealand have also held back approval for younger children. Australia’s chief medical officer, Paul Kelly, said Tuesday that Australia would await the real-world experience of the U.S. before committing to vaccinating younger children. The clinical trials for that age group in the U.S. were, "I must say, rather small," he said.

Japan has authorized shots for ages 12 and above, and more than 60% of 12-to-19-year-olds are fully vaccinated, according to government figures. On Wednesday, Prime Minister Fumio Kishida said vaccination of children 5 to 11 would begin after regulators review Pfizer’s application for that age group, filed earlier that day.

The FDA also adivsed avoiding delays in kids’ medicines by having broader programs. (iStock)

The FDA also adivsed avoiding delays in kids’ medicines by having broader programs. (iStock)

In Israel, which raced ahead of the world in administering the Pfizer vaccine to its adult and teenage population, the issue of vaccinating under-12s has become divisive.

The country waited until the U.S. approved inoculating children before starting professional discussions that will largely determine government policy. Even so, public-health officials and their civilian advisers have faced threats and invective from some Israeli parents fearful of inoculating their children.

Some members of the government’s advisory committee felt they couldn’t speak freely without fear of reprisal, said Dr. Gili Regev-Yochay, an adviser to the committee and a director of the infectious-disease epidemiology unit at the Sheba Medical Center. On Wednesday, the committee voted overwhelmingly in favor of vaccinating young children.

As far back as June, Chinese officials approved the emergency use of vaccines made by Sinopharm and Sinovac Biotech Ltd. for children between 3 and 17. Since then, city and provincial governments have begun rolling out the program for that age group. At the end of October, Beijing started vaccinating children between 3 and 11.

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Communist Party-run paper the Global Times, citing Chinese vaccine experts, said vaccinating children over 3 is key for the country to reach herd immunity.

In Colombia and Argentina, children as young as 3 are also being immunized with Chinese vaccines. Both countries have used Chinese and other vaccines to combat the disease.

Three studies provided by Colombia’s Health Ministry to The Wall Street Journal said the Sinovac vaccine was safe and that side effects, such as dizziness, chest discomfort and rashes, weren’t serious. Officials said they also relied on results from Chile, where the same vaccine is being used on children 6 and above.

Mr. Ruiz, the health minister, said authorization to administer the Sinovac vaccine to small children was aimed at preventing transmission as more schools reopen.

"It’s absolutely necessary that children return to classes because of the effects we’re seeing, like obesity, mental-health problems in children, loneliness syndromes, even abuse in families," he said.

In Cuba, children as young as 2 are getting the shot with a vaccine made on the island. Venezuela, which has employed Cuban and Chinese vaccines for older Venezuelans, on Monday also began vaccinating children as young as 2.

In Argentina, the health minister, Carla Vizzotti, announced the use of China’s Sinopharm vaccine early in October for children 3 to 11, saying, "It’s one of the safest vaccines."

Leah Lefkove, 9, covers her face as her dad Dr. Ben Lefkove gives her the first COVID-19 vaccine at the Viral Solutions vaccination and testing site in Decatur, Ga., on the first day COVID-19 vaccinations were available for children from 5 to 12 on Wednesday, Nov. 3, 2021. (AP Photo/Ben Gray)

Leah Lefkove, 9, covers her face as her dad Dr. Ben Lefkove gives her the first COVID-19 vaccine at the Viral Solutions vaccination and testing site in Decatur, Ga., on the first day COVID-19 vaccinations were available for children from 5 to 12 on Wednesday, Nov. 3, 2021. (AP Photo/Ben Gray)

There, critics in the medical community say authorities haven’t provided enough information about the approval process. "The number of parents who reject vaccinating with the Sinopharm is growing," said Roberto Debbag, president of the Latin American Pediatric Infectious Diseases Society in Buenos Aires. Argentine health authorities didn’t return calls seeking comment.

Russia hasn’t yet authorized use of the vaccine for under-18s. Russian health officials said Wednesday that studies on the use of the Covid-19 vaccine for adolescents have been completed and the results are being analyzed.

Mexico has been more strident, saying it has no plans to vaccinate anyone under 18, other than an estimated one million minors with pre-existing conditions like diabetes or asthma. Government health officials argue that since minors don’t normally get serious cases of Covid-19, they don’t need the protection from a vaccine.

President Andrés Manuel López Obrador has said pharmaceutical companies want to scare countries into buying more vaccines, either for children or a third dose. "We’re not going to be hostage to that," he said.

Parents in Mexico have sued the government to be allowed to vaccinate their children. A federal judge in October ordered the government to vaccinate minors, saying the policy violated Mexico’s constitution by discriminating against teens and children by blocking their access to a vaccine that was available to other age groups. The government has appealed the decision.

Mexico has officially registered 1,110 deaths from Covid-19 in people 19 and under, according to the health ministry.

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Most countries in sub-Saharan Africa have little choice about whether to vaccinate children because their rollouts are going so slowly. About 6.3% of Africans are fully vaccinated. With most governments still struggling to get shots to their most vulnerable citizens, few have opened up vaccinations to those under 18.

Among the few exceptions are South Africa, which started vaccinating those from the age of 12 with a single dose of the Pfizer vaccine on Oct. 20, and Guinea, which said it would start vaccinating teenagers this week. Unusually, in South Africa, parental permission isn’t needed for teenagers to get vaccinated.