Let’s talk about Covid-19 and children
It's been a year and a half since we first started to hear about the Covid-19 virus, and we still have a lot to learn. I, too, often feel frustrated that there is no absolutely right answer to every question. Science works by providing the questions and the techniques to begin to answer those question. Much later we get closer to the truth. Right now we do have some answers, and I will try to apply them to issues that affect children and adolescents.
First of all, corona viruses are different from some other epidemic viruses we've had to deal with. The influenza virus, for example, is less life-threatening, and generally less contagious. The masking and social distancing that we have used to prevent Covid-19 has significantly reduced influenza cases. Of course, we have had both anti-influenza medication and influenza vaccines for a long time. For me, one very interesting difference is that influenza is spread through children where Covid-19 is not. For example, when Japan managed to immunize all the children under 5 years old with the influenza vaccine, no older adults died. The influenza season was stopped in its tracks. By contrast, we have learned that the people most susceptible to serious illness and death from Covid-19 are the elderly and the obese, and they are directly infected by adults in crowds or groups with poor air flow.
When we speak in generalities, we can say that children tend to catch Covid-19 less frequently and spread it less effectively because the amount of virus they carry is smaller. They also tend to be less symptomatic when they do get sick. This is true of children under the age of 12 years. However, a very small segment of the pediatric population can develop a very serious and sometimes fatal illness caused by the virus called MIS-C (Multi-system inflammatory syndrome in children).
The big question, then, is, “How important is it to give children the Covid-19 vaccine?” Given the scientific understanding of the disease and our current concerns that world-wide there is limited economic feasibility of immunizing all the susceptible adults, health agencies have concentrated on protecting the elderly and everyone 16 years old and older. While we are especially worried about people with chronic illnesses, we do not know which illnesses might make children more susceptible to Covid-19. Eventually, however, we will need to vaccinate as many children as possible. Here are some of the reasons why:
If not, children will remain a potential reservoir of virus preventing herd immunity.
We want to prevent MIS-C.
There are certainly some diseases like cancer that will prevent a child from receiving the vaccine but will make that child more susceptible to Covid-19.
There are sure to be factors like obesity that will make some children susceptible as well.
Finally, children keep getting older. While a 5 year old or a 10 year old may presently be relatively safe, we are likely to be dealing with virus for many more years to come. The more effectively we protect our population, the less likely we are to have waves of epidemics.
Please be sure to get the vaccine. Protect yourself. Protect your family.
Robert B. Golenbock, MD
For La Tribuna