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Posted November 5, 2021 by Carolyn Feltus-Atkinson, MD

We at Surfside Pediatrics have promised to advise you, our patients, based on the facts as we interpret them.  There have been a lot of questions concerning the new recommendation concerning COVID 19 vaccination in the 5 – 11 age group.

 

Let’s start with some facts (taken from the CDC, AAP, Fl Dept of Health):

At least 1.9 million kids age 5-11 have tested positive for COVID19 since the start of testing which is 9% of the cases nationwide.  It is possible that up to 42% of kids in this age group have had COVID.

Of that number:

8,300 (.8%) have been hospitalized.  2/3 of these were high risk patients.

2,600 (.27%) have developed MIS-C, an inflammatory response

94  (.005%) have died.

It is unclear at this time how many have or will have Long Covid syndrome; we just don’t have the long term data yet. It may or may not be substantial but is not zero.

The vaccine study that just came out from the FDA looks at effectiveness/side effects of COVID vaccination in the age group 5-12.  I read the entire riveting 85 page study and these are some important items to take away:

Dose: 1/3 of the adolescent/adult dose, 21 days apart.

Initial study had 1,518 recipients and 750 placebos.  1,591 recipients were added later in the expanded group, and the data ended 2.5 weeks after the expanded group finished vaccination.

Vaccine was found to be 99% effective in producing antibodies, 90.7% effective in preventing symptomatic disease.

Side effects were similar to those in adults and adolescents, pain at site, fatigue, headache, mostly from the 2nd dose. There were only 2 serious adverse effects in the vaccine group but they were related to accidents (broken arm and abdominal injury with pancreatitis).

 

There were rare ( only one each) unusual adverse effects that may or may not be related – joint swelling, lower extremity tingling, tic development and blood in the stool, all of these resolved within a 1-3 week period.  Specifically there were no incidences of myocarditis or blood clots.  Myocarditis seen in mostly adolescent males after vaccination is considerably less than after COVID infection and is hypothesized to be less in the younger groups especially with the lower dose.

 

There were no deaths in this study.  The VAERS data for COVID Vaccination deaths thus far in adolescents and adults is .0022%

So what do we do with this information?  Like all things in life you have to look at risk versus benefit, not only for the individual but also for the greater community. 

Benefits/Pros:

- Excellent response to vaccine.

- Low side effects

- Less time out of school for the individual child

- Excellent protection for high-risk kids and their high-risk family members and contacts. ( chronic illness, obesity etc.)

- Less disruption in the schools, sports and other activities.

Risks/Cons:

- Low sample size, unclear whether other problems may surface after larger population doses are given

- Side effects, though transient, of vaccine itself

- Low prevalence in our community at present.  We currently have 3% positivity – 3.5% for the 5-12 age group, it was a different story a few weeks ago and may be again soon – no one knows. 

The recommendation from the AAP/CDC/FDA is that we should vaccinate.  I have discussed it with a friend who is a pediatric infectious disease doctor I trained with in Tampa.  She said she has immersed herself in the data the past few weeks and feels comfortable recommending it.  We support vaccination especially in high risk children but understand if you decide, with the current information, to wait.  We submitted our information to the state database in order to be considered for vaccine distribution but we haven’t heard anything yet.  We may never get it if it continues to be distributed in very large dose batches that have to be used quickly since we have a small practice.   If more data comes out or if we end up having the vaccine in our office we will share this information with you. 

 

Please let us know if you have further questions or concerns. 

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