We are writing to you as a group of individuals who care for the youth of this community every day. We are nurse practitioners, physician assistants, family physicians and pediatricians who have dedicated our careers to the health of kids. Our primary goal, every day, is to support the health and well-being of your children.
There has been an active dialogue on this opinion page about the potential benefits and potential risks of how we care for children during the COVID19 pandemic. This issue has consumed your lives and our lives for the last 20 months. The answers are not always clear or easy. We know that it is challenging to navigate the amount of information available in this era of social media and seemingly unlimited conflicting news reports. On Tuesday the Pfizer-BioNTech vaccine was approved by the CDC for emergency use in children aged 5-11. To us, the medical research clearly shows the benefit of vaccinating all eligible youth from age 5 to 18. In the most recent study of children 5-11, the vaccine was 90% effective at preventing symptomatic COVID illness and no serious adverse outcomes were seen in the over 3000 vaccinated participants. This has been reviewed by primary care providers, medical specialists (like cardiologists and infectious disease experts), scientists, statisticians and public health specialists.
Many of our patients have expressed concern about the newness of the vaccine and the fact that it could be considered “experimental.” While the specific mRNA vaccines offered in the United States are newly available, they are arguably one of the most rigorously studied medical interventions in human history. Immense amounts of time, money and scientific expertise have gone into their development and testing. The initial studies on the mRNA vaccines, offered in the United States, were tested on tens of thousands of participants.
Worldwide, we are approaching 7 billion doses of COVID19 vaccines given. In the United States 13.6 million children under the age of 18 have had one vaccine and 11.3 million are fully vaccinated. The benefits and potential risks of vaccination have been followed closely. We know that being vaccinated decreases the risk of getting COVID19 in all age groups. We know that it reduces the risk of spreading the disease in adolescents and adults (this was not studied in the recent 5-11 year-old data). We also know that it decreases the risk of severe illness and hospitalization. For example, in data collected by the CDC, youth 12-18 who received the vaccine were 10 times less likely to be admitted to the hospital compared with their unvaccinated peers.
The mRNA vaccines that have been studied are a remarkable scientific breakthrough. The vaccine cannot give us the virus and it does not change our DNA. mRNA is like a recipe that our cells use to make important building blocks and other useful molecules. Our body does this all the time, every second of the day. The mRNA vaccine gives our body the recipe to make the spike protein from the surface of SARS-CoV-2 (the virus that causes COVID19). The mRNA from the vaccine is then quickly broken down. The vaccine helps the body’s immune system learn what SARS-CoV-2 looks like so our immune system can be prepared to fight a COVID19 infection and prevent illness.
Much attention has been placed on the risk of possible myocarditis after getting a COVID19 mRNA vaccine. In peer reviewed research, the risk of getting myocarditis (inflammation of the heart muscle) after vaccine does exist but the risk is very low. The risk is seen in males under the age of 30 and cases have been identified in youth 12-18. This is being monitored very closely. Importantly, the risk of myocarditis is far greater in people who become infected with COVID19 and the severity of myocarditis from the illness is worse.
Another question often asked in our offices is whether the mRNA COVID vaccine poses a risk to fertility or has an effect on puberty. This has also been monitored closely and studied. There has been no effect on fertility in recipients of the vaccine and there has been no observed effect on pubertal development. However, women who get the illness of COVID19 during pregnancy are at higher risk of complications. This risk includes pregnancy loss, premature delivery and death.
Many people ask us if vaccination is necessary when children do not get as sick from COVID19 compared with adults. There have been 6,295,648 cases in children in the U.S since the start of the pandemic. In Vermont we are approaching 10,000 cases in 0-19 year olds. Sadly, many of these cases could likely have been prevented if more adults were vaccinated and we were better at using preventative measure such as mask wearing in indoor spaces. Pediatric COVID19 illness in Vermont and New Hampshire has contributed to missed well care, many clinic and ER visits, missed days of work for adults and teens, thousands of missed school days for children and the unfortunate transmission of illness to people with high-risk medical conditions. COVID19 has had a higher impact on children living in lower income households and on children of color.
Nationally, there have been more than 8300 children hospitalized due to COVID19. During the Delta variant surge, hospitalizations have risen sharply. CDC shows that just over 30% have no chronic medical conditions but children with underlying medical issues are more likely to need hospitalization. Those with chronic lung disease, obesity, neurologic disorders and immune problems are at the highest risk. One third of all patients admitted to the hospital for COVID have needed care in the intensive care unit.
As of 10/27/2021, according to data from the CDC, there have been 657 deaths in children 0-18 in the United States. 455 of these deaths have been in children 5-18. 94 of those deaths have been in kids 5-11. Dr. Lee Savio Beers, the president of the American Academy of Pediatrics, wrote last week, “There is simply not an acceptable number of child deaths when such effective and safe preventive treatments are available.” We, the members of your medical community, agree.
It is always important to remember that the health of children is closely linked to the health of their family and loved ones. For every anecdotal story you hear about the possible risks of vaccines, there are many more documented stories of children living with the death of parents, caregivers and grandparents. Covid has killed over 700,000 Americans and the numbers climb daily. Children account for ¼ of the COVID cases in Vermont and the current rate of illness is highest in children 0-10. While vaccinating children helps prevent illness for them it may also prevent spread to the people they love and who care for them.
National data shows that young patients and their families trust their medical home to provide reliable information. We work hard to do this every day. We want to be your partners in raising healthy children. That is our singular goal. We have chosen to get the COVID vaccine for ourselves and, after weighing the evidence, have chosen to vaccinate our eligible children. Our community thrives when the youth in our community are well.
There are local vaccination sites available Monday through Saturday. Find detailed information on the Vermont Department of Health and The New Hampshire Department of Health and Human Resources websites. Please contact your primary care office if you have further questions or concerns.
Sources: CDC, Vermont Department of Health, American Academy of Pediatrics, VRBPAC/FDA hearing 10/26/21.
The following health care providers endorsed the above submission:
From Northern Counties Health Care: Emily Alfano FNP , Patrick Anderson, PA-C, Katie Burnell FNP, Jay Dege MD, Tina Heck FNP, Dana Kraus MD, Sarah Morgan MD, Logan Dege Pearl, FNP, John Raser MD, Elise Rozendaal FNP, Kelsey Skillin PA-C, Tim Tanner MD, Rebecca Tatel FNP, Martha Whitefield FNP, Jeri Wohlberg FNP, Abby Young FNP;
From North Country Pediatrics and Primary Care – Littleton: Jessica Jacobs MD, Kate Noel APRN, Sunit Patel MD;
From Weeks Medical Center: Jayne Tarkelson DO;
From St. Johnsbury Pediatrics: Josh Kantrowitz MD, Marin Katz DNP, Moriah Krason MD, Brenda Stewart PNP, Meghan Swinehart MD, Janet Wilson FNP, Marjel Zaldivar DO.