Covid Shots for the little ones/Answers to frequently asked questions

 

Covid shots for the little ones!!

The Covid 19 vaccination is now approved for children who are 6 months and older. Many parents are celebrating this. Some have questions. Sadly most of us are not immune to the politicization of this issue. I am betting that many people are getting a barrage of strong opinions from either side. Uncle Frank is warning you that your child will be irreparably damaged from the shot, while cousin Harriet is prodding you to get it as soon as possible or you are a bad parent. Others agree that they want the shot, but aren’t sure of the timing, or how to choose which vaccine. Consider the following quote: “Statistics are like bikinis. What they reveal is suggestive, but what they conceal is vital.”― Aaron Levenstein I am not going to inundate you with slides that can be interpreted depending on who is looking at them. You can find statistics to validate your point of view in plenty of other places. If you are interested in learning more about my data, shoot me an email and I will be happy to share my sources. The purpose of this post is NOT to pressure you in any direction or to judge your decisions. My goal is to present up to date information that might answer some of the more frequent questions. Here are my takeaways, starting with the question “why should I get my child vaccinated for COVID?” Vaccination can protect your child from severe disease It is very fortunate that for the most part children have weathered the various strains of COVID much better than the adults. But some kids DO get quite sick and some can die. Deaths due to Covid are higher than from any other vaccine preventable illness. Ever since vaccinations have been approved for children from 5-17 the data has clearly shown that hospitalization, critical illness and deaths are all much more common among kids and teens who are not vaccinated than kids and teens who are vaccinated and boosted. I am guessing that we will see the same trend in the younger kids. Multisystem inflammatory syndrome in children (MIS-C) is another reason to avoid Covid. This is a rare but serious condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. They don’t know yet what exactly causes it but most children with MIS-C had Covid -19 or a strong Covid exposure. Kids do get long covid. Mt. Sinai in New York has been actively studying this and came out with some findings this week that even the youngest children can experience long covid. There was a study this week in the Lancet Child & Adolescent Health. It concluded that while long covid symptoms are generally ailments that kids might get anyway, headaches, fussiness, tummy issues and fatigue…etc., the kids in the study who had previously tested positive for Covid-19 were more likely to experience at least one of these symptoms for two months or more than the children who had never tested positive for the virus. The study also revealed that a third of the kids who had tested positive experienced at least one long-term symptom that was not present before testing positive. You might also have read that Israeli studies are linking the new and mysterious case of pediatric hepatitis to Covid. It is still too early to make a definite connection. The bottom line is, if you have a choice of having your child getting covid or avoiding it, I would prefer that they get some immunity from the shot rather than risk the unknowns that come along with this virus. Vaccination can protect others. Kids are an enormous vector of disease; in other words, they have cooties. Seriously, parents who send their kids to daycare for the first time can attest to the fact that kids bring home all sorts of colds and illnesses. Kids who are not showing signs of COVID because they have such a mild case can still be spreading the virus. Babies under 6 months, people who can’t get the shot, older vulnerable and immunocompromised people, need our help stopping the spread. I don’t know about you, but I am willing to take any steps that I reasonably can to move out of this pandemic. Would I put the young kids at risk in order to do this? Absolutely not. The vaccine is safe  During the trials, short term side effects from the shot were minimal. The most common ones were fever, headache, fatigue, body aches, chills and nausea with vomiting. It was interesting to see that across the board, the reactions from the placebo were remarkably similar to the reactions from the shot. This is because at any given time, kids tend to have those symptoms from other little illnesses that they tend to get. There were no reports of myocarditis in this age group. In fact, in the adolescent group where this was showing up, the incidences of myocarditis were 6 times higher in patients from having the Covid virus then from the vaccine. Every possible issue was reported. My favorite example of this was recounted by the awesome epidemiologist Katellyn Jetelina: In the Pfizer clinical trial, one potentially life-threatening adverse event occurred in an infant—coffee was spilled on them causing a thermal burn. Pfizer reported it to the FDA. This is an example of the rigor and comprehensiveness behind clinical trials. What about Uncle Frank’s warning about long term consequences? These shots have been given billions (yes, with a "B") times over the past few years. In addition, the Pfizer and Moderna vaccines were created using messenger RNA (or mRNA) technology, which has been used for about 10 years in cancer treatment, with no long-term effects detected. I am much more concerned about the future consequences of long covid that are still surfacing. What are the differences between the brands? The Moderna vaccine is a 2 dose series of 25 mcg each. The doses are given 4 weeks apart. The Pfizer vaccine is a 3 dose series of 3 mcg. The second dose is given 3 weeks after the first dose. The 3rd dose is 8 weeks after the second. Your child should get the dose that matches their current age, even if they started the series at a lower dose. Your child is NOT protected from one dose. Protection starts about 2 weeks after the completion of the series. The Moderna series has shown to give quicker protection, simply because the series is shorter. For those of you eager to get your kids protected, it would seem that the Moderna is an obvious choice. If you could get the Pfizer tomorrow and might have to wait 3 months for the Moderna, then that would be a consideration. Also, some parents might be inclined to go for the lower dose. You have been so careful for so long, another 3 months might be something that you are willing to put up with. I have heard some argue that starting the Pfizer series now would give peak protection right in time for fall illness season. The most important factor is probably which one you actually have access to! What if my kid already had COVID, do they need the shot? The quality of an immune response is relative to the severity of an infection. If a child had a mild infection (which many do), then they likely had a lower viral dose and broad protection is less likely.  The current recommendation is for you to wait 3-4 months after the first symptoms of a positive test, before getting the shot. Isn’t natural immunity better? Not necessarily. Dr Ted has some extra thoughts on this down below. I have seen some people, including kids get covid multiple times. Also, consider the case of varicella (chickenpox) .Once you get the disease it stays dormant in your body for years. In some unfortunate people this shows up as shingles. People who got the vaccine for chickenpox rather than that natural virus are LESS likely to have shingles. So in regards to covid, we really don’t know all the long term implications of the virus.  What side effects should I expect? Going back up to the trials, about one third of the kids had fever, fussy, aches and perhaps some vomiting. These were worse with the second dose (which makes sense). The symptoms also seemed to be a little worse on day two. If you child is still having issues more than 4 days after the vaccination, I would get them checked. My best guess is that they have something else going on. The most serious complication was febrile seizure . This was RARE. I added my link because all parents should know about them regardless. What are some comfort measures for after the shot? Once they get the shot, I like to apply topical arnica to the area. Baths, plenty of fluids, a lovely popsicle and maybe some extra screen time can help you all get through a day or two of not feeling quite right. Of course, have Tylenol and/or Motrin on hand for a really miserable kid. If the popsicle and watching a video of trains going in and out of tunnels (Elliot’s current favorite) don’t do the trick, go ahead and give them a dose. I wish I could tell you that getting the shot was going to completely protect your child and end this pandemic. Sigh, unfortunately the protection is not 100%. What we do know is that vaccinated kids are not getting nearly as sick. Think of it like a dart board. It is probably not a bull’s eye, but at least it is on the board. My grandson will be getting his shot shortly. Dr. Ted’s Tidbits Let me talk about natural immunity and COVID-19. The people who really know me know that I’m a surprisingly big hippie when it comes to medicine. If we can do something the natural way, I’m going to recommend it. So when it comes to kids and COVID-19, it might have been safe to assume that I would support relying on natural immunity.  I wish that were the case, but it’s not. The virus that causes COVID-19 changes shapes after it invades the body and attaches to cells. So the immune system is only trained on a shape that is not very helpful for long-term protection, and that’s what we see in the data. Natural immunity from COVID-19 wanes very, very quickly, much quicker than vaccine-induced immunity. It also doesn’t seem to protect as well from complications of COVID-19 on reinfection. When it comes to avoiding the complications that Nurse Judy lists up top, nothing is better than having the vaccine on board, as it trains your body in a more lasting way. Hybrid immunity, which is infection combined with vaccination, is the absolute strongest. If your child already had COVID-19, be happy that hybrid immunity is something you can achieve with the addition of the shot.