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Kids could be in line for vaccinations by summer

STORY BY LISA ZAHNER (Week of February 4, 2021)

With nearly a year’s worth of COVID-19 case information, and vaccine safety and efficacy data rolling in, public health experts are trying to answer some big, important questions about the virus so leaders from Vero to Tallahassee to Washington, D.C. can make good decisions going forward.

Kids have been a huge unknown in the race to slow the spread of COVID-19 and develop vaccines. Schools were opened based upon initial findings that kids were not at high risk for severe illness from the virus, and it was thought that younger kids did not shed the virus as much as adults.

Recent studies have mostly borne out those conclusions but have also delved more deeply into how kids catch, present with, and spread COVID-19.

The Centers for Disease Control and Prevention and the National Institutes of Health said last week that they are looking to the FDA to open up vaccinations to kids by late spring or early summer, so they will have some immunity built up before they go back to school in August.

So far 1,140 of the 8,597 minors tested in Indian River County have been positive for coronavirus. Outbreaks in 35 public, private and charter schools have caused thousands to quarantine, impeding in-person learning and disrupting the households of students and teachers for weeks.

Statistics from a University of Mississippi Medical Center study show that around 30 percent of known kid cases of the virus are asymptomatic, while about half of kids under 12 had at least one symptom and that symptom was most likely to be a fever.

Kids age 12 to 17 rarely ran fevers. The most common symptoms in that age group were a runny nose (75 percent), stuffy head, sore throat or fatigue – all of which could easily be written off as a cold, allergies or garden-variety teenage malaise.

The CDC thinks the number of kids who’ve gone undetected after contracting the virus is huge, possibly up to eight times what’s been documented.

In children ages 0 to 4, the known infection rate is 1,800 per 100,000 kids, but the CDC estimates the real number is more like 15,333 per 100,000. For kids age 5 to 12, the reported infection rate is 3,140 per 100,000 kids, but the CDC estimates the real number is more like 27,218 per 100,000 kids. So that would mean Indian River County’s 1,140 documented cases likely are just a fraction of some 8,000 to 9,000 actual cases.

With the documented cases they’ve got to work with, researchers have been able to study how kids can infect members of their household or be infected by others. Studies show that kids are less likely than adults to infect others, but that they are equally at risk of getting infected once someone in the household gets sick.

When one person in the household has COVID-19, the chance of a child getting infected is about 52 percent – the same as the chance of an adult getting sick.

But when a child is the only person sick in the household – say, if the child was exposed at school – the child seems to spread the virus less than an adult. This could be because it’s easier to isolate a child in his or her bedroom than it is for adults to isolate themselves from the rest of the family. But a study by Vanderbilt University Medical Center found that as the household size gets larger, the chances of a child spreading the virus increases.

If one child tests positive in a three-person household, no one else was likely to test positive. In a four-person household with one infected child, one person was likely to test positive. In a five-person household, two other people would likely be infected by the child.

COVID-19 and complications following infection had killed 185 people under age 18 nationwide, as of Dec. 16. Most kids who died or got severely ill had other conditions like obesity, asthma, heart or lung disease, kidney disease, or they had compromised immune systems. Influenza kills, on average, about 150 kids annually in the U.S.

Vaccinating kids will help reduce the number of hosts that the virus can infect and use to spread or morph into a better-adapted mutant strain like the ones Florida and dozens of other states are seeing.

“As long as there is a lot of virus circulating in the community, there will be mutations. Especially in people who are immunocompromised where the virus is present for a long time,” Dr. Anthony Fauci of the NIH said last week. “Don’t give the virus a chance to adapt.”

Black and Hispanic kids, when tested for the virus, have a positivity rate 2.5 to 4.5 times higher than white kids, so it’s important to get the vaccine out to all communities.

Of the vaccines currently in circulation, only the Pfizer vaccine included teens age 16 and 17 in its main clinical trials, but Moderna is in the midst of ramping up its TeenCOVE trial on adolescents.

Pfizer will soon start studying its vaccine on kids from 12 to 15, and later on kids under 12. The makers of the Oxford-AstraZeneca and Johnson and Johnson Janssen vaccines are also planning trials on kids, once their vaccines are approved in the U.S. for emergency use in adults.

The single-dose Johnson and Johnson Janssen vaccine uses a formula most like the annual flu shot, and other shots commonly given to kids, so that one seems promising for pediatric use. The CDC says the Janssen vaccine is a “platform widely used in teens, infants, children.”

The trials involving kids will also test the efficacy of half doses, quarter doses, and single doses. Those studies should answer important questions that could make the limited worldwide supply of vaccine stretch further.

The studies cited above referenced what’s called the “wildtype” virus that’s been circulating for a year in the U.S. The new variants first seen in the United Kingdom, South Africa and Brazil present the next question marks in terms of kids.

Bottom line, public health officials say people must not get lax on preventative measures now that vaccines are available – even though the initial news from vaccine makers about the effectiveness of their products on the new mutant strains seems encouraging.

CDC Director Dr. Rochelle Walensky said last week, “We should be treating every case as if it’s a variant during this pandemic right now.”