Imagine there is a new contagious illness spreading among children. More than 400 kids in the United States have died from it. Tens of thousands have been hospitalized. Some who only had mild initial symptoms are afflicted with lasting effects such as headaches, heart palpitations, persistent fatigue and inability to concentrate. Many of the affected children were previously healthy, and it’s impossible to predict who will fall ill and who will be spared.
We don’t have to imagine any of this, of course. The effects of covid-19 on children have been overshadowed by the much greater impacts on adults. But just because older people are more likely to suffer severe consequences doesn’t mean that the coronavirus isn’t a danger to kids.
A common refrain throughout the pandemic has been that kids aren’t at much risk. This argument has been used to justify decisions in Texas and Iowa to ban schools from requiring masks. It is being cited, including by some doctors, as a reason for why vaccines should be directed abroad rather than be given to American children. On Thursday, an adviser to the U.S. Food and Drug Administration questioned whether the agency should be able to use emergency-use authorization to expedite vaccines for children under 12. Even under the emergency designation, vaccines probably won’t be authorized for younger school-age children until this fall, and toddlers and babies not until the end of 2021; waiting for full approval could delay the process well into 2022.
As a mother of two young kids and a physician myself, I strongly disagree with this line of reasoning. Developing safe and effective coronavirus vaccines for young children should be an urgent priority.
To begin with, we need to stop comparing the severity of children’s illness to that of adults; it shouldn’t matter if adults are at greater risk if the illness among kids is itself a problem. That’s why I offer the thought experiment above. Covid-19 is now one of the leading causes of death among children. If the virus only affected children, there’s no doubt we’d clamor to do everything we could to prevent them from getting this disease.
Another fallacy is comparing covid-19 with other respiratory illnesses such as the flu. This coronavirus affects the body differently. According to the Centers for Disease Control and Prevention, there have been at least 4,000 cases of multisystem inflammatory syndrome in children (MIS-C), a condition characterized by inflammation throughout the body, including of the heart, brain, kidneys, eyes and skin. Also, just like with adults, long-haul covid has been reported in kids. One study found that 27 percent of children still had at least one persistent symptom 120 days after diagnosis. The potential for long-term consequences must be considered as part of the cost of illness in children, along with the emotional toll of a child becoming sick and the trauma inflicted on the entire family.
To be clear, I am not saying that the possibility of becoming ill from the coronavirus means that kids should avoid social interactions or stay out of school. I’m arguing that mitigation measures such as indoor masking and surveillance testing must continue for unvaccinated children. These measures will be very important in the fall to allow schools to open safely.
In addition, I take real issue with those who say that declining case counts mean vaccinating children is no longer a priority. First, there are more contagious and virulent variants emerging that could lead to a surge in infections, especially in parts of the country with low vaccination rates. Those unvaccinated, including our children, remain at high risk. As a result, millions of parents are stuck in an in-between place because we are vaccinated but our children are not. Many, like my husband and I, will be reluctant to return to our pre-pandemic lives until our kids are vaccinated, too.
And let’s remember why we vaccinate — to both protect the individual and to quell the disease in the community. Vaccination is, by definition, about prevention, and determining whether to vaccinate isn’t just about how much disease there is. After all, there hasn’t been a case of polio originating in the United States since the 1970s, yet children are inoculated with the polio vaccine because we want to prevent a resurgence.
What will keep covid-19 levels down is widespread vaccination. Can we get there without immunizing younger children? Possibly, but the United States is already having trouble reaching President Biden’s goal of 70 percent of adults inoculated with at least one dose by July 4. Without children being vaccinated, we will probably not come close to 80 to 85 percent of the total population some estimate to be needed for herd immunity. This should be done at the same time that we help other countries with their vaccine supply; one does not have to come at the expense of the other.
Different families have different perceptions of risk as it applies to the virus and the necessity of the vaccine. For our family, it comes down to this: If you have the option to reduce a low risk of something awful happening to your kids to essentially zero, would you take it? I would, and I bet that many parents would too.
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