This story appeared in the Cadillac News. Read the full story here.
CADILLAC — When the polio vaccine was introduced in the 1950s, children were the first group in society to be immunized, since they were most at risk if they developed the disease.
At that time, a lot of parents were nervous about their children getting the vaccine, since it was so new. Ultimately, however, many of those same parents decided to have their children immunized anyway because the consequences of getting polio were so serious.
Fortunately, COVID-19 doesn’t have the same impact on young people as polio; will that fact persuade parents not to get their kids immunized against COVID once a vaccine becomes available?
Experts hope not, for a number of reasons.
According to the American Academy of Pediatrics and Children’s Hospital Association, as of Feb. 4, child mortality rates among U.S. states and territories (that reported the information) were 0% to 0.26% of all COVID-19 deaths, with 11 states reporting zero child deaths. That means that 0% to 0.05% of all child COVID-19 cases resulted in death.
Not only are deaths from COVID-19 extremely rare in children, so too are hospitalizations.
Children were 1.2% to 2.9% of total reported hospitalizations, and between 0.1% to 2.3% of all child COVID-19 cases resulted in hospitalization.
That being said, public health experts say the answer to the question of whether or not most adolescents should get the vaccine is an unequivocal “yes.‘
“It protects them and protects others as they can’t spread it,‘ Dr. Jennifer Morse wrote in an email to the Cadillac News. Morse is medical director of District Health Department No. 10 and Central Michigan District Health Department. “Helps keep them in school, sports, extra curriculars, etc.‘
Morse cited an article published in the medical journal Clinical Infectious Diseases in September 2020 that discusses the potential benefits of a future vaccine.
“In addition to direct medical benefits, a COVID-19 vaccine could provide direct benefits on childhood education by allowing a safer return to school, a critical factor in children maximizing their potential,‘ the article reads.
“The intermittent or complete closure of schools to onsite education threatens to adversely impact that opportunity across all households that cannot provide direct educational oversight and is worse among households without adequate access to online learning — an issue disproportionately affecting racial minorities. In addition to the altered learning environment, social distancing and the lack of extracurricular activities (e.g., sports, drama, music, art, social events) impacts the emotional and psychological development of children. Thus, an approved COVID-19 vaccine for children could have far-reaching positive ramifications on health and educational equity.‘
Dr. Lisa Lowery, adolescent medicine specialist at Helen DeVos Children’s Hospital-Spectrum Health Medical Group, said currently there are no vaccines approved for kids under the age of 16.
She said there are a couple of reasons why it has taken longer to develop a COVID vaccine for kids.
For one thing, Lowery said while researchers know how much of a dose to give to adults, they’re still figuring out what the appropriate dose is for a child.
Complicating those efforts are immune system and reactivity differences between adults and children that have to be taken into account.
“There are a lot of things to make sure to get right,‘ Lowery said.
For instance, while serious illness and death are rare in children who contract the coronavirus, Lowery said some kids develop a serious condition called multisystem inflammatory syndrome in children, or MIS-C, which is characterized by different body parts becoming inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.
“This kind of inflammatory risk makes vaccine development particularly challenging in the pediatric population,‘ reads a December 2020 article published in the medical journal Pediatric Investigation. “If the vaccine is able to induce this type of antibody response, then it would potentially place otherwise healthy children at risk of severe outcome following vaccination intended to prevent illness from SARS‐CoV‐2 … It thus is critical to have a deeper understanding of the pathophysiology and mechanisms associated with those that develop MIS-C in order to effectively study vaccines in the pediatric population.‘
Lowery said many parents are understandably uneasy about the idea of their kids getting a new vaccine; the thing they should keep in mind, however, is that by the time one is available for children (several months from now at the earliest), millions of adults already would have been vaccinated. She said it’s also helpful to remember that safe and effective vaccines have been around for decades for a number of diseases.
Similar to how the virus affects adults in certain groups and with certain pre-existing conditions, some kids also are disproportionately affected by the virus.
According to the American Academy of Pediatrics and Children’s Hospital Association, out of 121 people under 21 years old that died of COVID, 78% were Hispanic, non-Hispanic Black or non-Hispanic American Indian/Alaskan Native; and 75% had an underlying medical condition, including asthma (28%), obesity (27%), neurologic/developmental conditions (22%), and cardiovascular disease (18%).
Lowery said it is especially important that these kids get the vaccine and while there are special circumstances when a child (or adult) may be advised against getting a vaccine — such as if they have a severe allergic reaction — these instances would be the rare exception rather than the norm.
“I would say to talk to your primary care provider about it,‘ Lowery said.
Lowery said not only will vaccines protect individual kids, they’ll also provide more protection for society as a whole, since immunizing kids, who comprise around one quarter of the population, will be crucial to developing herd immunity.
“It will be very difficult to get herd immunity without vaccinating those under 18,‘ concurred Morse.
“Vaccinated children would receive potential direct impact from a COVID-19 vaccine, but substantial potential for indirect effects of implementing a vaccine in children should also be recognized, as has been observed with hepatitis A, rotavirus, pneumococcus, rubella, and potentially influenza,‘ reads the article cited earlier by Morse. “Marked declines in adult pneumococcal disease occurred after implementation of 7-valent pediatric pneumococcal conjugate vaccine … Vaccination of children against COVID-19 may mimic the indirect benefits previously identified with other vaccines.‘
Dr. James Whelan, acting chief of medicine for Munson Healthcare Cadillac Hospital, added that if children aren’t immunized along with the rest of the population, they will act as a “reservoir‘ where the coronavirus can propagate and eventually spread into other segments of society once again.
While it’s hard to predict the future when it comes to COVID-19, Lowery said it’s possible that this vaccine could become an annual shot just like the flu shot. She said it’s also possible it might become routine for a few years, then be phased out.
“Only time will tell,‘ Lowery said.
In the meantime, Lowery recommends people get their children up to date on all their other vaccinations. She said there was a drop in routine vaccinations when the virus first arrived in the U.S.
“Make sure that those who can get immunized, get immunized,‘ Lowery said. “Get back to some pattern of normalcy.‘