Dr Eric: Should I vaccinate my child against COVID-19?

Dr Eric: Should I vaccinate my child against COVID-19? This is perhaps the greatest current uncertainty circulating the world right now and is especially sensitive to those of us in Thailand who look forward to sending our children back to the classroom.

A question with perhaps the greatest current uncertainty circulating the world right now and is especially sensitive to those of us in Thailand who look forward to sending our children back to the classroom.

Dr Erik's Answer...

This is perhaps the greatest current uncertainty circulating the world right now and is especially sensitive to those of us in Thailand who look forward to sending our children back to the classroom. As there is not what I would call a definitive answer at the date of this blog, I will present the current data on effectiveness and safety. I will present what we know and it is up to each and every parent to make the decision on what is best for their child with the best information available. As we already know, having children is not a dress rehearsal!

For our older children, 12 and above the Pfizer COVID-19 (Biontech) vaccine has been in use in most countries for a number of months. Some of your older children (like mine) may have already received it. So far, the data suggests that children under the age of 18 years represent about 8.5% of reported cases, with relatively few deaths compared to other age groups and usually mild disease. In severe cases, as with other COVID-19 cases, pre-existing conditions and lung issues predominate. This data suggests that children have a much more brisk and effective immune response in fighting off COVID-19 or that there are more asymptomatic cases. Probably both are true and there are ramifications if this is the case.

Studies of antibody production after vaccines show that children under 10 have the best and most effective antibody production in response to COVID-19, be it from getting COVID-19 or getting vaccinated. The next most effective is the adolescents and then adults and elderly. If you look at the rates of recovery from COVID-19, which are far faster in children than adults, this makes sense.

Important Fact:

A COVID-19 infection in a child (or adult) will produce a much higher and longer-lasting antibody production than from the vaccine.

So then the question: If I don’t have much worry about my child getting a severe COVID-19 infection (severe meaning need for hospitalization, ICU care or ventilator use) then...

'Why should my child receive a vaccine with such a short testing history?'

The overall hope toward returning to a state of normalcy at this time is the hope for “herd immunity”- a term that assumes 70% of persons have either been infected against COVID-19 or have been vaccinated against it. Children, being silent, asymptomatic carriers, is likely the most major obstacle toward reaching this number. There is also the fear that leaving COVID-19 unchecked in younger people can increase the chance of viral mutations, which has been the bane of COVID-19 thus far. So the thought is that acting locally will also help us act globally. On the other hand, our children are the most important things in our lives and we do all we can to protect them against possible adversity and harm.

What makes sense next then is to examine the potential harm from these vaccines in order to make as educated a decision as possible. Thus far these are the facts of adverse effects in children currently receiving COVID-19 vaccines. (I would caution everyone to also understand that collecting statistics accurately and quickly in this myriad of different vaccines, cultures and settings is daunting from the start).

Why would a child have an adverse effect from a vaccine?

Vaccine related side effects and illnesses come from the brink and strong reaction of the immune system to the vaccine. This includes both mRNA vaccines and vaccines made from killed viruses. The immune system creates a cascade of intense and rapid inflammation. The result: fever, chills, body ache, brain fog and fatigue. In more severe cases (which are fortunately rare) full-blown allergic reaction or irritation of a vital organ such as the heart or the lining of the heart (Myocarditis and Pericarditis). The Pfizer and Moderna mRNA vaccines have been implicated in such cases. Rates of cardiac inflammation have been quoted between every 25,000 - 1 million cases. This wide range has to do with the ability of a given country to maintain good statistics and must be understood within this context. A good study out of Canada showed that these cases occurred mostly after the second dose of the vaccine and were all treated with an average hospital stay of 4 days, although not all children required hospital admission. There were no deaths and simple treatment resolved the issue. While this is a comforting outcome, none of us wants this experience with our children. But facts are that this is rare and treatable. In the eyes of public health officials, this is an important fact toward moving to herd immunity.