What to expect with Covid-19 vaccines for kids ages 5 to 11...

‘Here’s what the science reveals about the safety of the Pfizer shot for this age group, the doses involved, and the role it will play in protecting everyone from the disease...

‘A recent Swedish study confirmed the value of this ring of protection: Families where one member is immunized have up to a 61 percent lower risk that others in the home will get COVID-19, while three or four immunized members gives more than a 90 percent reduction.

‘Inoculating children in an effort to protect others already happens in the U.S., Levy says. “Some say it’s not ethical to vaccinate kids for a disease that doesn’t affect them as much,” he says, but children are currently immunized against rubella when the main risk is to pregnant mothers, he points out.’

Read here (National Geographic, Oct 30, 2021)

Pfizer announces positive results for Covid-19 vaccine for children

‘Pfizer and BioNTech on September 20 announced positive results from a Phase 2/3 trial of their SARS-CoV-2 vaccine in children aged 5 to 11 years. The researchers found that a 2-dose regimen of 10µg doses administered 21 days apart demonstrated a favorable safety profile and robust neutralizing antibody response. The findings—which are neither published nor peer-reviewed—are a crucial step toward a SARS-CoV-2 vaccine becoming available for younger children, and the companies expect to submit an application to the US FDA for the vaccine’s authorization for that age group by the end of September. US regulators have issued warnings to the general public to wait for authorization before seeking vaccination for younger children, as the full adult dose of 30µg may put children at a higher risk for adverse side effects, including myocarditis.

‘The trial included nearly 2,300 children, and two-thirds of them in the vaccine group. The vaccinated children also were compared with a separate cohort of 16-25-year-old individuals who received the full adult course of the vaccine (2 doses of 30µg). The trial found that the neutralizing antibody response was similar between both vaccinated groups, with the neutralizing antibody levels within 5% of each other. Both groups also experienced similar post-vaccination adverse events.’

Read here (Pfizer news release) and here (Stat News, Sept 20, 2021)

The countries that are vaccinating children against Covid-19: As at mid September 2021

‘While many high-income nations, including the United States and most members of the European Union, now offer Covid vaccines for children 12 and older, a handful of countries have now authorized the shot for younger people. Meanwhile, severe vaccine inequality persists on a global level, with many developing nations continuing to struggle to provide first and second doses to high-risk groups -- with the very idea of getting shots to children still a pipe dream. Here's a global snapshot of where things stand.’

Read here (CNN, Sept 17, 2021)

Sinopharm vaccine for children: Some findings

‘Results from another study evaluating the Sinopharm SARS-CoV-2 vaccine in children were published on September 15 in The Lancet Infectious Diseases. The Phase 1/2 trial examined the safety and immunogenicity of the vaccine in a cohort of children aged 3-17 years, with participants broken into several age groups (3-5, 6-12, and 13-17 years) and dosing groups (0 [control], 2µg, 4µg, and 8µg). Three (3) doses of each vaccine dosage or placebo were administered 28 days apart. All adverse events were categorized as mild or moderate severity, but the article does not report on serious adverse events. The study concluded that children who received the vaccine had robust immune responses and similar levels of neutralizing antibodies to those observed in older vaccine recipients. The study recommended a 2-shot 4µg dose regimen for future Phase 3 trials. Additional data are being collected through a Phase 3 trial currently taking place in the UAE. 

Read here (The Lancet Infectious Disease, Sept 15, 2021)

Nutrition and Covid-19: WHO

• Nutrition advice for adults during the COVID-19 outbreak
• Feeding babies and young children during the COVID-19 outbreak
• Breastfeeding advice during the COVID-19 outbreak

Read here (WHO East Mediterranean as at Sept 2020)

Covid-19: What is coming our way? — Dr Amar-Singh HSS

‘We have all been occupied by the political situation in the country, but the Covid-19 virus is not. It is continuing its relentless march forward, whether we are focused on it or not. While an efficient government that deals with the pandemic decisively is crucial for the country, Malaysians need to be prepared for what is coming our way. I would like to share with you some possible scenarios for the coming weeks and months, and some thoughts and opinions based on current data.

• Continued recovery in the Greater Klang Valley
• Worsening crisis outside the Klang Valley
• Infections in children the next wave?
• Resolving Sinovac vaccine efficacy issues
• The myth of herd immunity and a resurgence of Delta as immunity wanes?

Read here (Code Blue, August 19, 2021)

Should we vaccinate our children against Covid-19 in Malaysia? — Amar-Singh HSS

While we take every protective measure to prevent children from getting infected, we need to ask ourselves if we should consider vaccinating children against Covid-19. Some issues to consider the risk and the benefit are discussed below.

• How severe is Covid-19 in children? Will vaccines benefit children?
• Are Covid-19 vaccines safe to use in children?
• Are there benefits to the family and society?
• Remember that children cannot be a priority for vaccination until we first vaccinate all adults that are keen. This includes the elderly, those with chronic illness, younger adults who comprise our workforce and our migrant workers.
• What are other nations doing?

Summary

‘The pandemic impacts all of us, even those not infected. We will have to grapple with these issues as parents and a society as we decide about Covid-19 vaccination for children. How effectively we control the outbreak locally and the spread and impact of variants (mutations) will also determine our response and decision regarding this issue.

‘In Malaysia we have yet to make a serious impact on vaccination rates for those at high risk of severe illness and death (the elderly and those with chronic illnesses). No matter how much we want to support children, it is imperative that we push for those at highest risk to be vaccinated before we vaccinate children. In addition, it is vital to vaccinate young adults who are working and mobile as they are important drivers of the pandemic. However we should consider selectively vaccinating children with severe disabilities in residential care, especially if at high risk of exposure to Covid-19.

‘My personal preference would be not to subject our children to mass vaccination against Covid-19 however to control Covid-19 in the community we may have to vaccinate children aged 12-17 years. The recovery of our nation from Covid-19 means the recovery of our children from the severe mental strain that currently impacts them daily. Lives are currently being lived on a ‘pause button’ and vaccination is an important measure to return our society to a semblance of normality.’

Read here (The Malay Mail, June 6, 2021)

Pakistan can get the dangerous Indian Covid situation, warns Indian doctor

‘A very important public service message started circulating in WhatsApp groups in Pakistan and India. It highlights that new Indian COVID variant can be as disastrous for Pakistan as it has been for India. It is written by Dr Pradeep Senha from Sassoon General Hospital Maharashtra. He says “COVID19 new mutation is giving false negatives in nasal swaps.”...

‘He writes, “The virus is now hitting straight into the lungs. It is carrying no symptoms like fever or cough. Just body ache, weakness, loss of appetite. Patients go from mild condition to extreme life and death situation within 8 to 10 hours.”

‘Dr Senha reports an alarming situation in India, he writes, “Our colleagues in small towns across India especially North Eastern regions are saying it is a battle we have already lost. It is now damage control and save as many lives as possible. We have seen 400 plus children just in our district die within 10 to 12 hours. Initial period they showed no symptoms and within hours their oxygen levels dropped and deceased.”

‘He says “We have also attended to several patients who traveled into Mumbai from overseas and had received their jabs and ended up contracting the Indian COVID and 17 out of 28 have died. Health services both in public and private hospitals have collapsed. Rich, middle class and poor all are affected and it is spreading fast, very fast. Any further mutation or variants will potentially be a doomsday scenario.”

Read here (Global Village Space, Apr 24, 2021)

Covid-19 in the classroom: Over 2,000 infected in three months

‘The Health Ministry has reminded educational facilities nationwide to take precautions to prevent Covid-19 infection, after three of the eight new clusters reported today involved learning institutions. Its director-general Dr Noor Hisham Abdullah said 41 such clusters have been reported to date since the beginning of the year, infecting 2,228 people so far.

‘Most of the cases (1,058 cases; 47.5 percent) involved tertiary educational institutions, although they comprised only 15 of the 41 clusters. This was followed by 631 cases (28.3 percent) involving 13 secondary school clusters, and 419 cases (18.8 percent) involving 10 primary school and preschool clusters. Other educational institutions account for three clusters, totalling 120 cases (5.4 percent).’

Read here (Malaysiakini, Mar 25, 2021)

Sinovac Covid-19 vaccine appears safe, triggers antibodies in trial in children: Researcher

‘Sinovac Biotech's Covid-19 vaccine appears to be safe and able to trigger immune responses among children and adolescents, according to preliminary results from early and mid-stage trials, the company said late on Monday (March 22). The preliminary data was from Phase I and II clinical trials involving over 500 people between the ages of three and 17 who received two shots of either medium or low dosage of vaccine, or a placebo. Most adverse reactions were mild, Zeng Gang, a researcher with the company, told an academic conference in Beijing.’

Read here (Straits Times, Mar 23, 2021)

Moderna begins study of Covid-19 vaccine in kids

‘Moderna Inc has begun dosing patients in a mid-to-late stage study of its COVID-19 vaccine, mRNA-1273, in children aged six months to less than 12 years, the company said on Tuesday (Mar 16). The study will assess the safety and effectiveness of two doses of mRNA-1273 given 28 days apart and intends to enrol about 6,750 children in the United States and Canada.’

Read here (Channel News Asia, Mar 16, 2021)

Covid-19's impact could mean millions more child marriages: UNICEF

‘The outsized impact COVID-19 has had on women in some countries could result in an additional 10 million child marriages in this decade, according to a new analysis released on Monday (Mar 8) by UNICEF. "School closures, economic stress, service disruptions, pregnancy and parental deaths due to the pandemic are putting the most vulnerable girls at increased risk of child marriage," said a study titled COVID-19: A Threat to Progress Against Child Marriage.’

Read here (Straits Times, Mar 7, 2021)

Science and society are failing children in the Covid Era

‘In spite of the increasingly polarized debate about school reopenings, community infection rates and prioritization of vaccination, it seems clear that both science and society are failing children. Children have proven uniquely resilient to COVID-19, but many are already suffering lasting educational, mental and physical harms. The greatest harm is falling on the most vulnerable children, and yet we know so little of the true extent and duration of these harms, because relatively little research has focused on them, compared to the research on COVID-19-related spread and mitigation.

‘School closures are a prominent example where following the science is not in itself an answer. These are hard decisions based on ethical and moral considerations for elected officials to make, in ways that acknowledge the evidence on the harms, the requirement for safeguarding and the emerging evidence on COVID-19. Understanding the evidence on the potential trade-offs for children is a critical component of such policies and decisions. It is time science and society elevated this central responsibility.’

Read here (Scientific American, Mar 3, 2021) 

Children’s hospitals grapple with young Covid ‘long haulers’

‘While statistics indicate that children have largely been spared from the worst effects of covid, little is known about what causes a small percentage of them to develop serious illness. Doctors are now reporting the emergence of downstream complications that mimic what’s seen in adult “long haulers.”

‘In response, pediatric hospitals are creating clinics to provide a one-stop shop for care and to catch any anomalies that could otherwise go unnoticed. However, the treatment offered by these centers could come at a steep price tag to patients, health finance experts warned, especially given that so much about the condition is unknown.

‘Nonetheless, the increasing number of patients like Delaney is leading to a more structured follow-up plan for kids recovering from covid, said Dr. Uzma Hasan, division chief of pediatric infectious diseases at St. Barnabas Medical Center in New Jersey.’

Read here (KHN News, Mar 2, 2021)

Why kids need their own Covid-19 vaccine trials

‘Adolescents are being tested now. Younger children will be next. Why did vaccine manufacturers wait to study them?...

‘The U.S. Food and Drug Administration requires that new vaccines be independently studied in children. Children’s immune systems are still maturing and are unpredictable, so they might react to the coronavirus differently or have side effects that don’t occur in adults. “They might respond better or worse,” says James Campbell, professor of pediatrics at the University of Maryland School of Medicine’s Center for Vaccine Development and Global Health. “Until you do the study with the vaccine, you don’t know what will happen.”

Read here (National Geographic, Feb 20, 2021)

Oxford University to test Covid-19 vaccine response among children for first time

‘The University of Oxford has launched a study to assess the safety and immune response of the Covid-19 vaccine it has developed with AstraZeneca in children for the first time, it said on Saturday (Feb 13).

‘The new mid-stage trial will determine whether the vaccine is effective on people between the ages of 6 and 17, according to an emailed statement from the university. Around 300 volunteers will be enrolled and first inoculations are expected this month, Oxford said.’

Read here (Straits Times, Feb 13, 2021)

Covid-19 pandemic has shown humanity at its best – & at its worst: WHO DG before the UNICEF Executive Board

‘Ultimately, our fight is not against a single virus. Our fight is against the inequalities that leave children in some countries exposed to deadly diseases that are easily prevented in others; Our fight is against the inequalities that mean women and their babies die during childbirth in some countries because of complications that are easily prevented in others;

‘And our fight is to ensure that health is no longer a commodity or a luxury item, but a fundamental human right, and the foundation of the safer, fairer and more sustainable world we all want.

‘History will not judge us solely by how we ended the COVID-19 pandemic, but what we learned, what we changed, and the future we left our children.’

Read here (IPS News, Feb 11, 2021)

Covid has a dramatic impact on children

‘It was in December that Axel Gerschlauer noticed the crisis within the crisis. In the last three weeks before Christmas, the pediatrician found himself treating three minors who had slashed their lower arms. Three youths in three weeks — Gerschlauer says he usually sees this sort of thing about once every three to six months. "This kind of frequency,” he says, "brought the scale of the problem home to me."

‘And this at a time when Gerschlauer is not even getting to see all his regular patients. Some are avoiding his practice altogether for fear of infection. His phone, meanwhile, has hardly stopped ringing, as desperate parents seek his advice. "There has been a shift of emphasis towards psychological issues, ranging from anxieties to concentration disorders to sleep disorders. In recent months, mental health issues have increased massively."

Read here (DW, Feb 4, 2021)

Why kids might be key to reaching herd immunity

‘Vaccinating kids, however, is often not just about the direct and immediate benefits to them. It’s also meant to protect children against diseases that would otherwise become more dangerous for them as adults—measles, mumps, and chicken pox are three common examples—and dampen the overall spread of these diseases. In the short term, the primary reason to vaccinate children against COVID-19 may be that the U.S. will have a hard time reaching herd immunity otherwise.‘

Read here (The Atlantic, Jan 21, 2021)

How kids’ immune systems can evade Covid

‘Their immune system sees the virus “and it just mounts this really quick and effective immune response that shuts it down, before it has a chance to replicate to the point that it comes up positive on the swab diagnostic test”, says Melanie Neeland, an immunologist who studied the family, at the Murdoch Children’s Research Institute in Melbourne, Australia.

‘Even in children who experienced the severe but rare complication called multisystem inflammatory syndrome in response to SARS-CoV-2 infection, studies report that the rate of positive results on RT-PCR range from just 29% to 50%.‘

Read here (Nature, Dec 10, 2020)