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HEALTHFUL HINTS

Frank Bures: COVID shots for tots

From the Collection: Recent Healthful Hints columns by Dr. Frank Bures series
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They are finally here! Vaccinations against COVID-19 were at last approved for the youngest people ages 6 months to 5 years old. Studies in children have been done showing definite protective benefits and no major adverse reactions occurring. The first step was the FDA approval after an advisory panel deliberated the week of June 13 — only 2 days — to vote unanimously to recommend authorization, stating the benefits outweigh any risks for young kids.

The CDC signed off on the vaccines June 18 with another unanimous vote. The two vaccines consist of the Pfizer mRNA version in adults, but a much-reduced dose of 3 micrograms instead of 30 micrograms, given in three doses to induce a high level of antibodies equivalent to young adults. The first two doses are spaced three weeks apart, and the third at least two months later. The study found only 10 COVID cases in the three-dose group and seven in the placebo group for an efficacy of 80%. The study included only a small number of patients. Most of the infectious disease and pediatrician experts cautioned not to lose sight of the fact that the vaccines were saving children’s lives.

The Moderna mRNA vaccine is the same as the adult one but only a quarter of the dose at 25 micrograms in a two-dose series given four weeks apart. Both this and the Pfizer vaccine achieved the same levels of immunity that have protected young adults against severe disease. None of the developed COVID vaccines have achieved the ideal of elimination of the infection. But they have saved many lives.

In children, the risk from COVID is very real, even though hospitalization and deaths are lower than in adults. In children ages 1-4, COVID is the fifth leading cause of death. One source that looked at the period from January 2020 through May 2022 said 202 kids in this age group died from COVID. Another source quoted 480 kids dead from COVID. That’s more deaths per year than hepatitis, meningitis, rotavirus, and other common infectious diseases each caused before routine vaccinations for them were recommended. And the risk wasn’t limited to any particular group. More than half of the youngsters hospitalized due to COVID had no underlying conditions.

These vaccines have proven to be some of the safest of any for adults. In the preliminary studies in this age group the adverse reactions/side effects were mostly mild and short lived, much like those in adults, and similar to those from other vaccines. The main one was pain and redness or tenderness at the injection site. There might be some irritability, fatigue, or sleepiness, loss of appetite, headache, abdominal pain or discomfort, mild diarrhea, vomiting. But everyone got better quickly! Fevers were uncommon and mild in the participants. Those can be treated with acetaminophen.

A pediatric infectious disease specialist at Children’s Hospital, Denver, Colo., said it’s important to keep in mind that COVID-19 is now one of the vaccine-preventable diseases with the highest mortality rate. Hospitalization rates for children with COVID were five times higher during the recent wave than the worst previous points of the pandemic. Katherine Poehling, director of pediatric population health at Wake forest School of Medicine, said, “I am struck by these numbers. I’m also concerned there’s a real underappreciation of the potential severity.” FDA commissioner Robert Califf said, “Any death of a child is tragic, and should be prevented if possible.”

It’s a guarantee that, if a respiratory germ gets into a home, it gets into everyone living there. It may not take hold in each individual to create what we call disease for a host of reasons, but the microbe made the rounds, positive test or not. That includes every kid kissing you or sharing food with you.

The COVID variants currently crawling down our craws are killing fewer Americans daily than during any other period except the summer of 2021. But the country is now recording 10 times as many cases as it was at that time, indicating that a smaller number of cases are causing deaths. But COVID is still killing an average of 314 people a day. These darling little Petri (not “peach tree”) dishes we parents and grandparents love to hug and kiss can be vectors of so many viruses. The vaccines are a tool to help prevent that spread and contagion. It’s an incomplete tool, but it’s part of a larger effort to stop infections, along with hand washing, etc.

Maybe you could liken it to a fork among our eating utensils. We could eat most everything on the plate with that fork, but a knife and spoon sure help us to divide and down the delectables we can’t spear. The vaccines are essentially safe and a valuable tool. One preventable child’s death is one too many. Get your tot shot!

Dr. Bures, a semi-retired dermatologist, since 1978 has worked Winona, La Crosse, Viroqua and Red Wing. He also plays clarinet in the Winona Municipal Band and a couple dixieland groups. And he does enjoy a good pun.

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