By Juanita Carnes FNP, Board of Health chair and Joseph Rouse, Health director
COVID-19 cases continue to increase globally. Coronavirus cases have tripled in the U.S. in two weeks. Pediatric cases are also on the rise. Over 4 million U.S. children have been diagnosed. 12,000 pediatric cases were documented in the first week of July, increasing to 19,000 the second week. Dr. Richard Besser, pediatrician and former acting CDC director, states, “We will see more cases in children. We will see more hospitalizations in children and unfortunately we will see more deaths in children.” This is an extremely disturbing prediction because we have the knowledge and resources to greatly reduce this risk.
The U.S. government recently ordered another 200 million doses of Pfizer-BioNTech COVID-19 vaccine. 65 million of these are planned for children under 12 to make it readily available as soon as the vaccine is authorized for children. President Biden suggested it may be available as soon as August, although most other sources suggest a timeline of fall to early winter, depending on the age group.
For many parents and grandparents, it is difficult waiting for its availability and the protection it will give our children. The delay is a little easier when it is understood why we are waiting. Children are not just little adults. Immunizations and medications work differently in children. Trials for children under 12 years old were launched in March. The FDA has requested Moderna and Pfizer to expand the clinical trials in children in an effort to ensure the studies capture all side effects and understand benefits. The agency is asking for four to six months of data. Adult trials required just two months. The estimated timeline for 5- to 11-year-olds is September, soon after for 2- to 5-year-olds and early winter for 6 months to 2-year-olds. Israel has already started using the vaccine in 12-year-olds and under during the surge.
In a recent survey of parents of 12- to 18-year-olds, 39 percent of them already vaccinated their children, 21 percent said they were likely to do so and 40 percent said it was unlikely their children would be vaccinated. In another survey of parents of 3- to 18-year-olds, it was almost evenly split, with 49 percent saying they would vaccinate and 51 percent planning to decline the vaccine. It is suggested that many are hesitant to vaccinate because the vaccine has only received emergency approval. In actuality, there is not much difference between emergency use authorization and full approval.
In general, children have not been getting as sick as adults with COVID-19 infections. There is no evidence that the Delta variant is more harmful to children but is highly contagious, making unvaccinated children more vulnerable. But some are still getting seriously ill and dying. The death of a child that is completely preventable with a safe vaccine, in this day and age, is criminal. 344 American children have died from COVID-19. One in twenty children hospitalized have developed neurological complications. One third of those patients have had symptoms persist when otherwise recovered. We have already seen more COVID-19 deaths in children than from influenza. Children with COVID are also suffering from multi-inflammatory syndrome. The risk of disease complication is far greater than the one-in-a-million rare event of vaccination. COVID vaccinations are safe. In the spirit of “First do no harm”, no pediatrician would recommend a vaccine that was harmful. The American Academy of Pediatrics strongly and emphatically encourages vaccination.
Massachusetts’ Joint Commission on Public Health and the Joint Commission on COVID-19/Emergency Preparedness and Management held a public oversight hearing to discuss COVID-19
vaccination for children. State health officials expect vaccines for children to be available in the fall and want to be prepared when emergency use is granted. Administration for children will not be distributed through mass vaccination sites as for adults. It is thought the delivery will be more effective through pediatricians and schools. Officials are attempting to think outside of the box to increase vaccine rates. Massachusetts has one of the highest pediatric vaccine rates in the country. This trend will hopefully continue with the COVID vaccine.
On the minds of teachers, parents and students is the fear of returning to school in the fall without vaccines and without masks. The decision by the state was made weeks ago that masks would not be required but recommended when staff and students returned to school in the fall. We are in a different place since that decision was made. Masks, social distancing and hand washing are as important as ever during this surge and while we wait for emergency vaccine approval for children. Effective Friday, July 30, the state issued a mask advisory mirroring the CDC’s recently updated guidance: “Fully vaccinated individuals are advised to wear a mask or face covering when indoors ,outside of your home, if you have weakened immune system, are at increased risk for COVID-19 or if someone in your household is at increased risk or unvaccinated.” Masks are still mandatory in health care settings and on public transportation. Unvaccinated individuals are still advised to wear masks indoors and when they can’t socially distance.
Communication with parents, schools and pediatricians is crucial to an efficient roll out. Education to parents and children is vital. Easy access to medical offices and school clinics for administration creates convenience for parents and a safe and comfortable place for children. Westfield Health Department nurses have been in meetings with the state and the school department in hopes of providing our community with the most efficient plan for vaccinating our children.
Take care of yourself and someone else.
Dedicated health department members who have been working tirelessly throughout the pandemic are: Debra Mulvenna RN, Assistant Director Evelyn Bristol RN, Steve Cipriani, Health Inspector Thomas Hibert, Office Manager Crystal Dugay, Kathi Cotugno, CORE coordinator Other Board Members: Margaret Doody, Stan Strzempko MD.
WE KEEP WORKING TO KEEP YOU SAFE