Does anyone remember the good old days of this pandemic? That time a year and a half ago when there were two or three newly diagnosed COVID cases per day, the deaths were relegated to a friend of a friend’s grandparent, and children were asymptomatic and only found to be COVID-positive as a result of contact tracing? In recent months, there has been a shift in this pandemic – a seismic one – and the things we told ourselves about this pandemic that allowed us to sleep comfortably in our beds at night a year ago are no more. This is not 2020’s pandemic.
In the month of August, The Bahamas recorded 2,695 COVID cases as of Friday, August 27. There have been 20 confirmed COVID deaths in the past week (doctors and nurses among them), with many more under investigation. Social media timelines are reading like the obituary section of a Thursday newspaper. Our healthcare services are overwhelmed by lack of bed space, insufficient staff, and pandemic fatigue on the part of all parties involved. From a pediatric perspective, more and more children are displaying symptoms of COVID-19 infections, even requiring admission to hospital, causing parents and pediatricians alike to be concerned and want to do everything within our power to keep the country’s children healthy.
The pediatric population has suffered in a number of ways throughout this pandemic. From the very beginning, many aspects of their daily lives were altered. They moved from going to school daily, to being isolated at home, in an, at times, difficult-to-navigate virtual classroom. Their social lives, an oft overlooked part of their overall development, became non-existent. The extracurricular activities that played an important part in our children honing their social skills and maintaining their physical fitness were taken away. Added to that, children have watched helplessly as their parents lost jobs and struggled to make ends meet. Then they were forced to face death as their parents, grandparents, aunts, uncles, and those of their friends died.
Now, our children are themselves getting sick. Hospitalizations in children due to COVID-19 is up by 30 percent, when a year ago, we were grateful that they were mostly asymptomatic. Children are being hospitalized for prolonged fevers. They are being hospitalized for respiratory distress. The most concerning reason for hospitalization in children remains multi-system inflammatory syndrome in children (MIS-C), a post-COVID inflammatory syndrome which causes inflammation, dysfunction, and potential failure of multiple organ systems including the heart, lungs, kidneys, brain, skin, eyes, and gastrointestinal organs, and in many cases requires ICU admission. An additional concern with COVID-19 infections in children is the “long COVID” effects seen even in children who have had mild or no respiratory symptoms. Long COVID symptoms can include heart inflammation (myocarditis) as well as problems with cognition such as brain fog, headache, fatigue, and mental health issues.
While the month of August brought some of the worst numbers we have seen during this pandemic, it also heralded the arrival of a glimmer of hope for our children. On August 13, 2021, the first Pfizer doses were administered to children in The Bahamas. The Pfizer BioNTech vaccine is the only COVID-19 vaccine approved for use in children 12 and over. Since trials for the Pfizer vaccine in this age group began, 4.4 million children ages 12 to 18 have been fully vaccinated in the United States (US).
Notably, in the past few days, the US Food and Drug Administration has granted full approval for the use of this vaccine against COVID-19. Similarly, other countries like Canada, Israel, and Japan have also approved the use of Pfizer’s BioNTech in this age group. In The Bahamas, the Preferred Pediatric Organization (PPO) echoes the sentiments of the American Academy of Pediatrics (AAP), the World Health Organization (WHO), and the Pan American Health Organization (PAHO) in recommending that all individuals who are eligible for a COVID-19 vaccine, get vaccinated, including children 12 and older. While the vaccine is not yet authorized for use in children under age 12, trials in the five-to-11-year age group have now commenced that data from the trials in older individuals have shown the Pfizer vaccine to be both safe and efficacious.
Vaccine hesitancy girded by misinformation remains a significant barrier in protecting our children from the ravages of this pandemic. Legally, children have very little autonomy when it comes to matters of their own health. We owe it to them to make informed decisions based on information gathered from reliable sources. Parroting the rhetoric of social media pseudo-scientists who barely mastered high school biology and referencing WhatsApp posts that have been “forwarded many times” from unnamed and obscure sources is irresponsible. We owe our children and ourselves more than that. If, God forbid, you find yourself hospitalized and gasping for breath, or worse, find your child hospitalized and gasping for breath, you owe it to yourself that the decisions you made with regard to you and your child’s health, were decisions made after you availed yourself of all accurate information. It needs to be a decision you can live with, or die with, peacefully. Perhaps the only thing worse than lying in a hospital bed struggling to breathe, is lying in a hospital bed struggling to breathe through waves of guilt and regret.
Fear is a natural human reaction to the unknown. It seems to be the most pervasive underlying factor among people who are hesitant to get vaccinated. The reason most commonly cited is that the potential long-term complications from the mRNA vaccines are unknown. There are worries about hypothetical risks of everything from cancer to infertility. What we know about mRNA vaccines is that this is not new technology. Testing and evaluation in one form or another have been underway since 1989, with the earliest in vitro animal studies being published in 1990 and 1992. The first human trial of mRNA vaccines was in 2006, giving researchers some 15 years of follow-up data. No reports of long-term fertility concerns or cancer risk arose from those trials. What mRNA vaccine studies have shown is that these vaccines have elicited potent immunity against infectious disease targets in animal models of influenza, Zika, rabies and other viruses. The challenge in bringing these vaccines into mainstream therapeutics has been the cost of scaling up production, establishing regulations, and further documenting safety and increasing efficacy. With the arrival of COVID-19 on the world stage, independent laboratories pooled their resources to develop and scale up production of mRNA vaccines targeting COVID-19, thereby clearing the previously insurmountable financial hurdle of scaling up mass production of these vaccines while maintaining efficacy.
While the medical community cannot speak with 100 percent certainty about potential long-term side effects of the COVID-19 vaccine, we can speak to reported complications associated with vaccination. According to the Center for Disease Control and Prevention’s (CDC) adverse event reporting system, the most commonly reported severe adverse effects have been myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the fibrous sac surrounding the heart). Out of 4.4 million fully vaccinated children, there were 762 confirmed reports of myocarditis or pericarditis. This is a statistical risk of 0.018 percent. The risk of myocarditis and pericarditis with actual COVID-19 infection is nine times higher. There have been 14 pediatric deaths reported after COVID-19 vaccination – two due to pulmonary embolism, two due to suicide, two due to intracranial hemorrhage, one due to heart failure, one due to hemophagocytic lymphohistiocytosis (HLH), and six pending further investigation. This is a statistical risk of 0.0003 percent. By comparison, there have been 471 pediatric deaths in the US, due to COVID-19 infection. Considering there have been 4.5 million pediatric COVID-19 cases in the US, to date, the risk of pediatric death in COVID-19 infection is 35 times higher than the risk associated with the vaccine. There have also been reports of anaphylaxis and blood clot formation, but the one consistent finding with all reported adverse events was that they were all significantly higher in children who had COVID-19 infections when compared to children who had the COVID-19 vaccine.
The other matter we can speak about with absolute certainty is the current reality of the ravages of the actual virus in The Bahamas. Current, real facts about COVID-19 infections include that it is killing the young and the old. Children are being hospitalized at increasing numbers. The children being hospitalized with MIS-C are children who are not eligible for vaccination. COVID-19 is hospitalizing and killing people with pre-existing conditions and those without. The people being treated for COVID-19 infections within the walls of our hospitals and those being treated in the parking lot in tents are people who are not fully vaccinated. The COVID-19 patients gasping for air on our wards and silently intubated in ICU are people who are not fully vaccinated. They are the unvaccinated parents, grandparents, aunts, uncles, teachers, and family friends of my patients. My patients deserve better.
As a pediatrician, who routinely gives vaccines as a part of the health maintenance of children, I am no stranger to vaccine hesitancy. I have been accused of everything from being a child murderer working to further the agenda of some unknown evil mastermind, to being a soldier in Satan’s army delivering the mark of the beast. What I actually am is a child advocate whose singular interest is in preserving and maintaining the health of my patients. Remember, your pediatrician is a valuable resource for helping you raise happy and healthy kids. Please reach out with any questions about available vaccine options for you or your child. Let’s protect our children.
• Dr. Tamarra Moss is a pediatrician committed to helping you raise happy and healthy kids. You can find her at Dr. Carlos Thomas & Pediatric Associates in Nassau, Lucayan Medical Center in Grand Bahama, or on Instagram @mykidsdoc242.
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source https://thenassauguardian.com/kids-covid-19-and-the-v-word/
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