Think twice before giving the COVID-Vax Gi to healthy children

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The case of vaccinating children is There, but it is not mandatory at the moment. The delta variant (B.1.617.2) could change the calculation, depending on upcoming data from Great Britain, Singapore and India, where the variant may show more contagious and virulent properties in younger people. By now we should all know that it is important to be humble when dealing with this virus. An increase in cases in the UK in the past few days is worrying and should be followed closely by us.

To return to the current discussion of the risk of COVID-19 for children (ages 0-12), it is worth summarizing the best data available so far. Reading through medical literature and news reports, and speaking to pediatricians across the country, I have not yet come across a single healthy child in the United States who has died of COVID-19. To investigate further, my research team at Johns Hopkins partnered with FAIR Health to study Pediatric COVID-19 deaths, accounting for roughly half of the country’s health insurance data. We found that 100% of pediatric COVID-19 deaths were in children with a pre-existing medical history, solidifying the case to vaccinate any child with a comorbidity.

Since the risk of a healthy Child deaths are extremely rare between zero and negligible. It is understandable that many parents rightly ask why healthy children are vaccinated at all?

For these parents, I would say that the main reason for giving the vaccine to a healthy child is not to save his or her life, but to prevent the Multisystem Inflammatory Syndrome (MIS-C)which can be painful and have long-term health consequences. According to the CDC, there was 4,018 cases from MIS-C to COVID-19 with an average age of 9 years. A total of 36 children died. Cases of MIS-C were largely shifted to minority children (62% were Hispanic / Latino or Black), likely due to the disproportionate rates of obesity and chronic illness among children in these populations. This finding again supports the COVID-19 vaccination in every child with an illness, including obesity.

It is also important to note that the risk of exposure to COVID-19 in children is not linear over time. Since the new COVID-19 case rates began rapidly declining in Maywho has had the weekly rate of new cases of MIS-C related to COVID-19-19 dropped to zero. And this week, a CDC report Regarding hospitalizations of children due to COVID-19 in March and April 2021, there were no deaths in the entire cohort of children studied.

There is an argument for vaccinating children to create community benefit for children. Vaccinating healthy children can help reduce virus transmission to children at risk who choose not to be vaccinated or others who cannot receive the vaccine. On the other hand, data from Israel suggests that high vaccination rates in adults significantly reduce transmission among children – a trend that is now being seen in the United States. We also know that compared to adults, children are inefficient carriers of COVID-19. That could possibly change with new information about the latest Delta variant, but it has not yet been.

The extremely low chance of benefit to healthy children is precisely why pediatricians like Richard Malley, MD, of Harvard, and Adam Finn, MD, PhD, of the University of Bristol passionately written “Not to use valuable coronavirus vaccines in healthy children”. One recently editorial in the The BMJ repeated this feeling – also an argument eloquently articulated by Medpage‘s own Vinay Prasad, MD, MPH. From a global perspective, two doses of a globally scarce, life-saving vaccine could be more equitably used to immunize a 65-year-old couple in India or Brazil (one dose per person) rather than giving both doses to a single one. one year old healthy child. Accordingly, California’s announcement is to be spent $ 116 million Paying people to get the vaccine when much of the world is begging for it amid angry epidemics is a sad comment on the excesses, injustice and ethnocentrism of our country.

Children can also experience unique side effects from the second dose of COVID-19 vaccine onwards. Seven adolescent children were there reported develop myocarditis within 4 days of receiving the second dose of Pfizer vaccine. All were boys between the ages of 16 and 19. Both mRNA vaccines were shown to be 100% effective in preventing COVID-19 in children. But every time a drug is found to be 100% effective, the question should be raised of whether the dose is too high, the interval too short, or whether the second dose is needed at all. Pfizer is now considering lower vaccination doses for children as they mentioned Tuesday in their announcement that they will begin their vaccine study in children under the age of 12.

It is important that immunity is not only conferred by antibodies, but also a function of by B and T memory cellsthat can be suggested by the study researchers long lasting immunity. Given the near zero risk of COVID-19 death in healthy children and the recent discovery of rare myocarditis complications immediately after the second dose, this should spark a discussion of whether a single dose is the more appropriate approach for healthy children.

In my residency training, I was taught an old dictum that many of you may be familiar with: “When you donate blood to someone, always give at least two units.” It took decades for the medical community to reverse this dogma. We now understand that a second unit of blood causes rare but real harm. We have come to realize that one unit is safer than two when a second unit is not required. We should also give up the idea that the vaccine must always be given in two doses. For transplant patients, for example, there can be three. In children with a natural immunity to previous infection, it may not be.

What about children who have been confirmed to have COVID-19 infection in the past? I would recommend avoiding a COVID-19 vaccination. If one looks at the natural immunity in adults for comparison, so Observational and empirical data are overwhelming: the natural immunity is real and it works.

Cleveland Clinic researchers published a study This week it was found that “none of the 1,359 previously infected subjects who remained unvaccinated had SARS-CoV-2 infection for the duration of the study.” This is one of many studies showing that natural immunity is strong. While the long-term stability of natural immunity is unknown, it is also unknown for vaccinated immunity. We can positively postulate with convincing arguments, but to be true to science we don’t have any data beyond 18 months for either. In fact, there is more follow-up data on natural immunity than on vaccinated immunity. Based on Collecting data, Children who have had COVID-19 should not be vaccinated unless they are immunocompromised.

A final and minor consideration should be fear of needles, which has no or minimal impact in most children but can be traumatic for some. For children who should receive the vaccine and who also have fear of needles, cold therapy, and vibration devices such as: “Buzzy” device, can be applied to the skin injection site prior to injection and results in little to none Pain.

In my opinion, the COVID-19 vaccination makes sense for every child who is overweight or who has a previous illness. It can also make sense for a teenage boy, as they have a greater physiological resemblance to adults, and that vaccines that are safe in adults were safe in children when properly dosed. But given the rarity of a healthy child dying from COVID-19, I wouldn’t recommend a two-dose vaccination to a healthy child aged 0-12 until we have more data. Each parent has to assess the individual risk of their own child, but in my opinion vaccination of young healthy children is not currently mandatory.

Marty Makary, MD, MPH, is the editor-in-chief of MedPage today and Professor at the Johns Hopkins School of Medicine, Bloomberg School of Public Health, and Carey Business School. He is the author of The price we pay.

Last updated on June 10, 2021

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