Schools are coming back in session, and rising COVID-19 numbers among all age groups have parents concerned about how to protect their children.
Since early June in Delaware, cases in children ages 0-4 have increased by 236% and cases in the 5-17 age group by 517%, according to the Division of Public Health. The greatest increases are in Kent and Sussex counties, where vaccination rates are the lowest in the state.
To answer some of parents’ most common questions about vaccines, masks, cases, risks and more, DPH Director Dr. Karyl Rattay led a virtual discussion with three Delaware pediatricians Tuesday.
Dr. Priscilla Mpasi, pediatrician and public health manager at Henrietta Johnson Medical Center in Wilmington; Dr. Marisel Santiago, chief of pediatrics at La Red Health Center in Georgetown; and Dr. Craig Shapiro, attending physician in the Division of Pediatric Infectious Diseases at Nemours Children’s Health in Wilmington, joined Dr. Rattay.
In Delaware, pediatric hospitalizations quadrupled from seven to 28 in the last month. Two of the 430 child deaths from COVID-19 are from Delaware. Dr. Rattay added that approximately 30% of hospitalized children have no underlying health conditions.
“Pediatric hospitals in southern states like Florida, Louisiana and Texas are reportedly overwhelmed with COVID-19,” Dr. Rattay said. “We do not want to follow in their footsteps, especially when we know how to prevent these infections.”
‘A family approach’
She said the vaccination rate among eligible youths who have gotten at least one dose is just over 50%. All of the doctors on the panel agree that the best way to protect children who are unable to get vaccinated is for adults to get vaccinated.
“We have to remember that keeping our children healthy is really a family approach,” Dr. Mpasi said. “All family members who are eligible to get the vaccine should get vaccinated because that will actually further protect your child who is not able to get the vaccine from getting COVID-19.”
Dr. Rattay added that eligible staff, visitors and students in schools who are choosing to not get vaccinated are putting others at risk.
Dr. Santiago said one of the most common concerns among parents is possible side effects from the vaccine. However, although COVID-19 wasn’t as severe in children last year, kids who did exhibit severe symptoms are still showing respiratory issues. She also said the delta variant is much more contagious and much more severe in children.
“We try to explain to them and give them the data of how the (case) numbers are coming down and how we know that the vaccine works,” Dr. Santiago said. “Sometimes it’s a little harder in different populations to explain this. But we try our best.”
Dr. Mpasi said many parents are reluctant to vaccinate their children because they are the least likely to fall critically ill.
“I could understand that thought process, but I really want to think about how we employ general safety measures,” she said. “With the vaccine, they might be exposed to COVID-19, but it would then actually decrease their symptoms overall and they might not even have symptoms at all. It’s a protective measure.”
Parents are also questioning the effectiveness of natural immunity compared to the vaccine. Dr. Shapiro said that natural immunity is not nearly as long lasting or protective as vaccinations. He also added that natural immunity to the original strains will not protect people from new strains like the delta variant.
“To develop natural immunity, you first have to be infected with the infectious agent, and with that, you run the risk of developing severe disease or even possibly death from being infected,” he said. “That’s not going to happen if you are immunized, so you take that risk out of the realm of possibility.”
Dr. Mpasi noted that the side effects from the vaccine are “similar to all of our childhood immunizations and vaccines,” including soreness and redness at the injection site and an elevated temperature that lasts only a few hours.
Dr. Shapiro acknowledged some adverse effects from the vaccine, such as myocarditis or pericarditis, which is inflammation of the heart muscles and is most commonly seen in males under the age of 30. He said that the benefits far outweigh those risks.
“We know that developing inflammation of the heart is much more common when you are infected with COVID than it would be from receiving the vaccine,” Dr. Shapiro said. “And the inflammation caused by the virus itself is likely to have more long-term implications than what is being found in patients who are developing side effects from the vaccine.”
He added that even those who have needed some sort of medical care to treat the adverse effects tend to get better within 24 to 48 hours.
Dr. Shapiro said that, depending how much data the FDA wants to see, a vaccine could be approved under emergency use authorization for kids ages 5-11 between October and December of this year.
“A child’s immune system is very different than a teenager’s or an adult’s immune system, so the dose of vaccine that they would give a young child is going to be less than what we would give a child in that 12 to 17 age group who are getting the same dose that adults do,” Dr. Shapiro said.
Parents are also concerned about another potential school shutdown. Dr. Rattay said that identifying the threshold for which schools would go back to virtual learning is tricky, but schools were ultimately able to operate safely when mask wearing was enforced. She added that masking has become “way more controversial than it ought to.” She said the science is clear that masks are the next best protection method for those unable to get vaccinated.
“They do not impact lung development. In fact, they can help protect developing lungs from COVID-19,” Dr. Rattay said. “They don’t weaken the immune system, they don’t make it harder for children to breathe, they don’t trap the CO2 or force us to re-breathe the air we exhale.”
Dr. Shapiro said that because a majority of the adolescent population is not fully vaccinated, and therefore still at risk, even vaccinated children can get infected and spread the virus.
“Based on how much COVID is in the community now, vaccinated individuals are at risk, as well,” he said. “As great as these vaccines are, if you’re exposed to high levels of this infection in the community, there’s a risk that you may get infected … until enough people are vaccinated, the main way we can keep schools open is to keep masks on kids.”
All children 12 and over are eligible to receive the Pfizer vaccine.
The full FDA approval for Pfizer includes a name change for the vaccine to Comirnaty. It is approved for ages 16 and older.