The information in this post was adapted from the above Mini-Medical School presentation that was recorded in mid-January, 2022. Dr. Amy Shriver is an assistant professor of specialty medicine at Des Moines University and a practicing pediatrician at Blank Hospital in Des Moines.
As a practicing pediatrician 2022 has started with a bang in terms of the numbers of children we’re seeing in our clinic, the volumes in our clinic, and frankly, the number of sick staff and sick providers limiting our abilities to take care of everyone.
Children are among the biggest victims of the COVID-19 pandemic. Children aren’t dying at as high a rate as grownups, but we know that children have suffered in numerous ways in terms of their learning, physical health, emotional health, grief, and loss. There’s been so much tragedy in terms of what children have been experiencing and we know that children of color are disproportionately affected by this pandemic.
How do the COVID-19 Vaccines work?
mRNA vaccines work on the same principles of training your immune system as previous vaccines but go about it in a more complicated way. Learn all about mRNA vaccines.
What ages can receive the COVID-19 vaccine?
Children ages five and above are eligible to receive the COVID-19 vaccine.
The Pfizer vaccine was released for children ages 12-17 in May 2021 and for ages 5-11 in November 2021. After Omicron surged, we saw a Pfizer booster that was available and offered to children in January 2022.
We still have not had emergency authorization for children ages 2-5 or children younger than two. And we still don’t have authorization for boosters for children, ages 5-11.
Why Children Need Covid-19 Vaccinations
Many people think that COVID in kids is a benign illness like a cold and it should go away, so we shouldn’t be afraid of it and don’t need to vaccinate, but that is not true.
So here are a few reasons why, as a physician, I chose to vaccinate my kids:
Breathing Problems
COVID infections damage and kill a lot of cells in your respiratory tract, including your nose and lungs, this can create breathing problems, both during acute COVID and later in your life. Watching your child struggle to breathe is something that I would not wish on any parent.
Cardiac Problems
The genome of COVID can be injected into cardiac cells, which can cause acute myocarditis and may cause long-term negative effects on your heart. Children are vulnerable to having severe damage to their hearts. COVID vaccines can reduce the risk of myocarditis in children.
Hindering Growth and Development
With COVID we see a lot of people losing their sense of smell and taste. When you lose your taste and smell, you’re not actually losing it because cells in your nose or cells on your Inflammation in your brain affect the way you smell and taste. We’ve seen some concerning complications regarding COVID and child nutrition.
COVID infection can change the way children taste and smell food. In some cases, children may find the smell or taste of food disgusting. These children are at risk for Avoidant/Restrictive Food Intake Disorder (ARFID). Children with this disorder have difficulty maintaining growth and nutritional needs because they cannot eat certain foods. place children at risk for developing a condition called avoidant restrictive food intake disorder or ARFID. in which children find the taste or smell of food disgusting. If you find all food disgusting, you’re not going to be able to eat, and you will lose weight at a time in your life when you are supposed to be well-nourished and growing.
So, we may see regression in speech, gross motor skills, fine motor skills, and social and emotional development. However, it’s too early to yet know all the long-term implications of how COVID can affect our children’s development.
Brain Fog
What is brain fog? It’s the inability to concentrate, the delay in your effectiveness, in getting things done. It affects the way children learn, the way they feel about school, and the way they feel about themselves. That mental effort and fatigue have a huge impact on children during their school year.
Physical Fatigue
Let’s not forget the physical fatigue. When you have COVID oftentimes you feel like you can’t even lift your head up off the pillow. One of my friends who had COVID said, “I had to choose if I was going to brush my teeth or wash my face because I only had energy enough for one.” So, there’s a lot of physical fatigue that goes along with COVID that can last a long time. And although it is rare, children can develop long-haul COVID, which means that their fatigue impairs them at school and at home and affects every part of their life. Long COVID is debilitating, and difficult to treat.
Mental and Behavioral Health Concerns
Children’s mental health has been affected by the pandemic in more ways than one. We’ve seen the isolation and virtual school disconnecting children from peer groups. This has led to an increase in depression, anxiety, eating disorders, and other concerns. In fact, the Surgeon General declared a children’s mental health emergency in November 2021. But we are also concerned about the short-term and long-term mental health effects of COVID infection on kids’ developing brains.
Multi-System Inflammatory Syndrome
One of the more familiar complications of COVID in children is called the multi-system inflammatory syndrome in children, or MIS-C. This is a brand-new thing as of 2020, that didn’t really exist before. There have been over 6,430 cases so far and We’ve seen 55 deaths across the country over this time. Notably, this condition seems to disproportionately affect children of color.
What we’re seeing is between about two and six weeks after someone has had COVID, some children can develop vasculitis syndrome, which causes inflammation of at least two of these organs: your heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal system. This can cause lasting cardiac damage and or death in some children.
If your child has had a COVID infection in the last 2 months, be on the lookout for the following symptoms: If they have severe abdominal pain and vomiting, bloodshot eyes that you can’t explain for any other reason, long-lasting diarrhea in combination with some of these other symptoms, dizziness and light-headedness, or signs of low blood pressure, skin rash, and vomiting. If you have combinations of those things, then they should seek care.
Myocarditis
Myocarditis is inflammation of your heart muscles, which gives you symptoms like chest pain, palpitations, and shortness of breath. It makes it very difficult to even climb a set of stairs. This can be mild, or it can be very severe and it can leave permanent damage, or it can kill you.
It sometimes has been seen to be a rare side effect of getting the Pfizer vaccine in teen males. The theory is that it may be due to the exaggerated immune response but it is not deadly in that form and self resolves in all cases. Whereas, you can also get myocarditis with COVID-19. And in fact, you have a 37 times higher risk of getting myocarditis if you are un-vaccinated.
It’s important to know that if you get COVID and you get myocarditis, it is much more severe than if you were to get it from the vaccine. So children with moderate or severe COVID cannot necessarily jump right back into sports. They need to see their doctor. They need to be cleared for things like sports because of this potentially damaging effect on your cardiac muscle.
New-Onset Type One Diabetes
As of January 7, 2022, retrospective data from two large databases have shown an increase in the incidence of new-onset type one diabetes, also known as juvenile diabetes in children under age 18, about 30 days after they’ve had a COVID-19 infection.
Why? Well, the mechanism that’s proposed is potentially a direct attack of your pancreatic cells or stress hyperglycemia. When you have COVID, your body releases all the stress hormones and cytokines, and that can cause hyperglycemia or precipitation or you were already predisposed to having it like you were on the borderline of having diabetes, and it just tipped you over.
Death
And then of course we certainly don’t want our kids dying.
The cumulative percent of children of total COVID cases is about 17%, which is up drastically from the end of 2020 when it was closer to 12%. Over 9.5 million children have tested positive for COVID-19 as of the 13th of January 2022.
So far, we’ve seen 862 children die of this disease.
Some hopeful developments…
The Pfizer vaccine can reduce risk of MIS-C
A study that was released January 7th says in children 12-18 with 2 COVID vaccines, the vaccine was 91% effective in preventing MIS-C.
That is fantastic news. My child who is 14 has had two doses of her Pfizer vaccine and recently got COVID, but she had a very mild case. I can feel confident that she is not going to develop MIS-C.
Omicron may be wrapping up in the U.S.
Another little light at the end of our tunnel is a discussion that was had at the American Academy of Pediatrics, January 10th town hall.
Bonnie Maldonado, the chair of the AAP committee on infectious diseases, says “from the data we’ve seen from South Africa, it does appear that Omicron’s rapid doubling time depletes the pool of susceptible.” That means everyone’s getting it and then drops off rapidly. We are predicting based on the number of different models that by February, most of Omicron should be done in the U.S. I’m going to say fingers crossed, nobody can predict that with complete certainty, but we hope that that’s a light at the end of the tunnel. We are happy to see that whatever the surge is now, it should be short-lived.
Myth Busting
Okay, so let’s do a little myth-busting.
Myth 1. There are harmful ingredients in COVID vaccines
The number one concern that I have heard in my practice is that there might be some weird ingredients in COVID vaccines. Good news, nearly all the ingredients in your COVID vaccines are also ingredients that you just ingest in foods, fats, sugars, and salts. COVID-19 vaccines do not contain preservatives, aborted fetal cells, antibiotics, food, proteins, medicines, latex, heavy metals, or microchips.
They do have messenger RNA, which is a little message that has your body recognize COVID, create antibodies for it and protect you.
Also, we all know they don’t have microchips.
Myth 2: Natural immunity is better than being vaccinated
Myth number two is that natural immunity from getting COVID is better than getting a vaccine. Well, that’s not true.
Getting the COVID-19 vaccine is safer and a more dependable way to build up your antibody protection. We know that if a child were to get COVID, they are more likely to see downstream effects such as MIS-C. Vaccinated children are much less likely to see those downstream effects.
The vaccine creates a more predictable immune response. Those that are vaccinated are less likely to be hospitalized or die if they get COVID-19 and then vaccines provide added protection if you’ve already had COVID. So, you might have antibody levels that are at a certain level, but you will boost them up much higher and be better protected.
And then again, if you have had COVID and you decided not to get vaccinated, you’re twice as likely to get COVID again.
Myth 3: COVID vaccines make you magnetic
Nobody is magnetic except for Magneto from the X-Men. Receiving your COVID-19 vaccine will not make you magnetic.
There’s a lot of stuff on the internet, you guys. So, if it sounds ridiculous, it’s probably ridiculous. Always read information with a large amount of skepticism and hopefully use your scientific brain to realize that if there are no metals in the vaccine, then you can’t be magnetic.
Myth 4: The vaccine can give you COVID-19
I can see why people might be worried about that. People tell that to me all the time when I talk about getting their influenza vaccine and they say “oh, last time I got the flu after I got my flu shot.” Good news: it’s impossible for you to get COVID from the shot because none of the COVID-19 vaccines used in the U.S. contain the living virus.
these vaccines contain coding for that spike protein. A little message that gets sent to your cells to say, “Hey, could you please make the spike protein for me?” You’re not making the whole COVID virus, you’re just making a piece of it and then your body says, “that’s not supposed to be there” and creates antibodies to combat it.
Myth 5: COVID-19 vaccines affect pregnant women
Good news: COVID-19 vaccines have been shown to be safe and effective in pregnant women. COVID-19 does not affect your fertility if you are female or male.
Where did this idea originate? Some researchers noted a similarity between antibodies for spike protein and antibodies for receptors on the placenta and got theoretically worried. Good news: studies now show that COVID antibodies DO NOT attack the placenta. In fact, pregnant women are at higher risk for severe COVID than others, and getting the vaccine is recommended to protect them and their fetuses.
We also know that the COVID-19 vaccine is now recommended for people who are trying to get pregnant or for people who are pregnant. COVID-19 vaccinated pregnant women can offer that antibody protection to their newborns. If you are a pregnant person who is not vaccinated, you are twice as likely to be hospitalized or die than if you are vaccinated.
Take-Home Points
Don’t underestimate potential long-term effects of COVID
Before saying “well, it’s going to be mild for my kids, so I’m not worried” or “I’m just waiting to see what happens,” please consider the risks of NOT vaccinating. Severe illness, disability, and death are possible for our children (even the healthiest ones!) if they get COVID.
COVID vaccines help keep schools open and prevent new strains
There are so many reasons to immunize our children. If your child is vaccinated, they are less likely to get sick and pass COVID onto friends, loved ones, neighbors, and teachers. It could prevent problematic downstream effects and keep them learning and in school.
The vaccine could prevent the evolution of new strains. The more people that are vaccinated, the less COVID will be circulating in the community and the less likely we are to see mutations. And then COVID vaccines will again, help kids succeed in school, be with their friends more often, feel more confident, develop their social skills as they develop into adolescents and teens.
COVID vaccines are extremely effective and safe for children
While it is true that most children who get COVID have a benign illness, there also can be a very serious disease and death, and long-term side effects. COVID-19 vaccines are extremely effective and safe for children.
The side effect profile for COVID-19 vaccines in adolescents is like adults. Sometimes you will see some fevers and body aches, some sore throat, some lymph node swelling, and those should resolve over time. mRNA vaccines are associated with rare cases of myocarditis, especially in males, but again, you will have a much higher risk of getting myocarditis from getting COVID infection.
Vaccines are extremely effective in PREVENTING CHILD DEATH. They help them not go to the hospital or leave the hospital sooner. They help them from having long-term symptoms and they help support a normal-ish life, whatever that looks like these days.
At every visit for pediatricians, whether they are doing a physical, taking care of kids in the inpatient, urgent care, or ED, it’s going to become routine that we ask about your child’s COVID vaccine and that we help them get their COVID vaccine should they want it.
Do it for the children
Everyone out there, get your COVID vaccines. And if you haven’t had your booster yet, get your boosters. There was some recently released information that booster shots are actually very helpful in protecting against reducing your chances of Omicron.
Continue good hand washing, wear your masks when you’re around large crowds and indoors. Test often and make sure to follow the Centers for Disease Control (CDC), isolation, and quarantine precautions for you and your children if you happen to get COVID.
