[COLUMN] Vaccinate kids?

IT is now clear that vaccination against COVID-19 is highly effective and safe at preventing SARS-Co-V2 infection and deaths, and that those who got infected anyway after getting the shots had less severe symptoms and shorter illnesses. Also, the gap between the two shots of the Oxford-AstraZeneca vaccines up to 4-5 weeks “actually led to a stronger immune response, compared with the recommended interval.”

Among the vaccinated, there were more than 6,000 who still got infected with COVID-19. These are called “breakthrough infections” since these vaccines are 90-95 percent effective and 5-10 percent could still get COVID-19. Some of these are caused by the variant strains.

The Delta (UK strain) and Gamma (new Brazilian strain) variants are already in the U.S. and dozens of other countries. These could be more deadly to people who have not been vaccinated.

Potential new waves

About 20 percent of the U.S. population are refusing to get vaccinated. That translates to about 65 million individuals who will be a reservoir of the virus and as SARS-Co-V2 virus goes from one unvaccinated person to another, it mutates to become more formidable: it develops greater transmissibility and causes more severe and deadlier illness. This could result in new waves of worse COVID-19, like in India, and prevent the U.S. from achieving herd immunity.

It is mind-boggling that some people have to be bribed to protect their own life. To resist vaccination and expose other people, society in general, to a potential killer infection like COVID-19, is simply selfish and a waste of scientific advances in medicine. As of this July 4th, only 67 percent of Americans had at least a shot. What a waste of resources! People around the world, including the Philippines, ravaged by COVID-19, are scared and frustratingly waiting to be vaccinated, and here we are, with 65 million playing Russian Roulette.

Typhoid and measles

One single unvaccinated individual is enough to start an outbreak, and perhaps another wave or a pandemic of more serious mutant strains. Typhoid fever was accidentally started by Mary Mallon (now known as Typhoid Mary), an Irish-born cook, the first one in the U.S. detected to be an asymptomatic carrier of the gastrointestinal illness, Salmonella typhi, through fecal contamination.

The measles outbreak in the United States in 2019, following a 25-year hiatus, was caused by a lowered vaccination rate in the country and unvaccinated American travelers returning to the U.S., unaware they were infected abroad and were carriers of the measles virus. Vaccine hesitancy then was caused by concern among parents that the measles-mumps-rubella vaccine (MMR) could cause autism, which was already scientifically debunked in 1998. The 2019 measles outbreak killed children and infants and some adults. Today, measles, like COVID-19 anywhere, is a risk everywhere in this shrinking world. Vaccination is the best way to counter contagious diseases.

The current vaccines may need to be “upgraded” to deal with variant strains of COVID-19, like the Delta, Gamma, and other expected strains to follow from mutations of the virus as it passes from one unvaccinated person to another. This will also impact the medical reality of whether vaccinated individuals would require an annual booster shot, like what we have for the seasonal flu to protect themselves against new and deadlier strains.

Jabs for kids?

Marty Makary, MD, MPH, editor-in-chief of MedPageToday and a professor at the Johns Hopkins School of Medicine, Bloomberg School of Public Health, reported this, a sentiment echoed in an editorial of the British Medical Journal:

“In reviewing the medical literature and news reports, and in talking to pediatricians across the country, I am not aware of a single healthy child in the U.S. who has died of COVID-19 to date. To investigate further, my research team at Johns Hopkins partnered with FAIR health to study pediatric COVID-19 deaths using approximately half of the nation’s health insurance data. We found that 100% of pediatric COVID-19 deaths were in children with a pre-existing condition, solidifying the case to vaccinate any child with a comorbidity. Given that the risk of a healthy child dying is between zero and infinitesimally rare, it’s understandable that many parents are appropriately asking, why vaccinate healthy kids at all?

“To those parents, I would say the primary reason to give a healthy child the vaccine may not be to save their life, it’s to prevent the multisystem inflammatory syndrome (MIS-C), which can be painful and have long-term health sequelae. According to the CDC, there have been 4,018 cases of MIS-C after COVID-19 with the average age being 9 years old. A total of 36 children died. Cases of MIS-C were heavily skewed toward minority children (62% were Hispanic/Latino or Black), likely due to the disproportionate rates of childhood obesity and chronic conditions in these populations. This finding again supports COVID-19 vaccination in any child with a medical condition, including being overweight.

“In my opinion, the COVID-19 vaccine makes sense for any child who is overweight or has a pre-existing condition. It also may make sense for a teenager given their closer physiologic similarity to adults and the fact that historically, vaccines safe in adults have been safe in kids when dosed appropriately. But given the case-report level rarity of a healthy child dying of COVID-19, I would not recommend a two-dose vaccine regimen for a healthy child ages 0 to 12 years until we have more data. Each parent will have to assess their own child’s individual risk, but in my opinion, the case to vaccinate young healthy kids is not compelling right now.”

For vaccinating children, a reduced dose might be appropriate, and one dose enough. The unique complications in the past were seen after the second dose. For children who have recovered from COVID-19 infection or positive for COVID-19, natural immunity was found to be strong enough not to require vaccination, unless they are immune-compromised.

For adults, and children with health issues, getting the vaccine is safer than getting COVID-19, which has killed more than 4 million around the world, around 622,000 in the United States and about 26,000 in the Philippines.

Vaccine hesitancy can be deadly. History has repeatedly proven this. Unless we develop herd immunity (with at least 80 percent of the population vaccinated), we as a nation, and as a world, will be at the mercy of killer viruses, which themselves are (naturally and expectedly) trying to survive by mutating into deadlier strains to kill us, the hosts. When protected by vaccines, we prevent the viruses from infecting us. Without a host, the virus self-destruct.

The viruses are “smart” survivors. Let’s be smarter. Let’s get vaccinated.

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The main objective of this column is to educate and inspire people live a healthier lifestyle to prevent illnesses and disabilities and achieve a happier and more productive life. Any diagnosis, recommendation or treatment in our article are general medical information and not intended to be applicable or appropriate for anyone. This column is not a substitute for your physician, who knows your condition well and who is your best ally when it comes to your health.

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Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian foundation in the United States. Websites: FUN8888.com and philipSchua.com; Email: scalpelpen@gmail.com.

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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