As Montana physicians caring for children, we recommend strongly and without reservation that all newly eligible children — as well as all teenagers and adults — receive a COVID vaccine.
Vaccination is a tool to train your immune system to recognize a virus or bacteria before you are exposed to it. After you or your child receive a COVID vaccination, your body’s own immune cells can do a much more effective job in protecting you from illness.
Vaccination gives your body a head start, while avoiding all the risks and complications associated with getting infected. And although COVID is clearly most dangerous for older people, it presents real risks to kids. There is a myth that COVID does not harm children. Unfortunately, that couldn’t be further from the truth.
For many children, the illness associated with COVID is mild. However, that’s not always the case. More than 700 children have died of COVID in the U.S. In fact, post-Delta surge, COVID has risen to 6th leading cause of death last month for children in the 5-11 age group. This is the group that is just now becoming eligible for the vaccine.
Severe illness with COVID isn’t limited to children with chronic conditions: looking at hospitalizations in the 5-11 year old age group, over 30% did NOT have an underlying condition. Also, many of COVID’s effects are hard to predict. MIS-C, a serious inflammatory disorder, can set in weeks after recovery from COVID, even if the initial illness is asymptomatic or mild. You may have heard of long COVID as well, which consists of symptoms that last longer than 4 weeks, such as fatigue, headache, insomnia, trouble concentrating, muscle and joint pain, and limitations of activity. It is estimated that 7-8% of children infected do suffer from long COVID – fewer than in the adult age groups, but still quite a large number overall.
Medical complications aside, COVID has caused disruption to all of our lives. In many ways, children have borne the greatest burden of that disruption. It is estimated that 140,000 children in the U.S. have lost a caregiver to COVID. Rates of anxiety and depression due to loss, uncertainty, and social isolation have increased.
Montana schools have struggled with the spread of COVID this year, with at least 21 having to temporarily halt in-person learning due to sick staff members and spread among students. Many more students have had to stay home due to their own illness or exposures. Students and teachers alike have suffered from the disruption this causes.
For these reasons and others, we are thrilled that more children will soon be protected. The vaccine we have is very, very good. Data collected in trials show a 90.7% efficacy rate in preventing symptomatic infection in children in this age group, even with the Delta variant circulating.
The dose for 5-11-year-olds is one third of the adult dose, and safety monitoring showed that the most common adverse effects were fatigue, headache or muscle pain. No serious adverse events were found in the trial for this age group, and even fever and chills happened less often in kids than in adults.
Myocarditis, or inflammation of the heart, is a very rare but potentially serious adverse effect of COVID vaccination and is sometimes seen among teenage boys. With the smaller dose in this younger age group, we hope to see less myocarditis.
For teenage boys, it’s important to put the risk of myocarditis in context: Myocarditis due to COVID infection itself is much more common than myocarditis due to the vaccine, and COVID-associated myocarditis seems to have a more severe course. With the increased transmissibility of Delta, the choice is increasingly between getting COVID (or getting a second bout of COVID, for some) and getting vaccinated.
We know that COVID will be with us for some time. It’s not easy to control. All of our efforts last year — distancing, masking, hand washing, ventilation — resulted in almost entirely eliminating transmission of the flu. But we still saw COVID exploit any gaps in this layered protection. With the increased transmissibility of Delta, the choice is increasingly between getting COVID and getting vaccinated. Vaccination is the strongest shield to add to our self-protection, and as Montana physicians, we urge you to keep your family healthy by using it.
This op-ed is presented by the Montana Chapter, American Academy of Pediatrics; the Montana Academy of Family Physicians; the Montana Primary Care Association; and the Montana Nurses Association.
It is also endorsed by more than 160 individual physicians in the state of Montana.