While many children who have tested positive for COVID-19 have shown mild symptoms or none at all, medical experts have voiced concern over the growing number of those with lingering effects months after they contracted the deadly virus.
During a Virtual Town Hall hosted by the Pan-Caribbean Partnership against HIV and AIDS (PANCAP) on Thursday evening to address concerns about COVID-19 vaccination for children between 5 and 11 years, Associate Professor of Pediatrics, at McMaster University, Canada, Dr Narendra Singh was among several physicians who spoke of increasing cases of “long COVID” and its impact on the development of children.
Dr Singh said parents’ best option at this time is to get their children vaccinated. “Kids are starting to have persistence of certain symptoms well in excess of four months and they’re finding that as much as 50% of the kids may have symptoms four months after the fact. Symptoms include headache, confusion, dizziness, difficulty concentrating in school, so I think we really need to take that into consideration from a long-term point of view because we don’t know what’s going to happen in a year, two years, five years down the road in terms of the whether they will develop normally or have learning disabilities”, he said.
As Guyana anticipates the roll-out of the special Pfizer vaccine for children ages 5 to 11, Dr Singh sought to quell skepticism surrounding the move. Dr Singh, who is also the Director for the Pediatrics’ Post Graduate Programme at the University of Guyana, spoke of the development of myocarditis in children. Myocarditis, according to the Mayo Clinic, is an inflammation of the heart muscle that reduces its ability to pump and causes rapid or abnormal heart rhythms.
“I am seeing kids with Multiple Inflammatory Syndrome (MIS-C) which is a syndrome that affects the heart and can get quite severe. I’ve had a number of kids that I’ve had to put on medication to support the heart until such time that the illness goes away. But what’s happened as of the last month or two is that now that kids are back in school, we’re not only seeing an upswing in COVID but we’re also seeing an upswing in other viruses. Some of them are getting multiple viruses so when you add that on top of COVID, clearly you have a situation where kids are getting sicker than they’re used to,” he highlighted.
When children develop myocarditis, they may experience signs and symptoms including fever, fainting, breathing difficulties and chest pain. The Guyanese born Intensive Care physician says this condition occurs after the child would have contracted COVID or within a few days of receiving the second dose of the vaccine. However, Dr Singh says this should not alarm parents since the incidents of myocarditis with COVID-19 is much higher than myocarditis secondary to the vaccine. As a result, he encourages vaccination rather than allowing children to get MIS-C, a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.
“In the last year and a half since the onset of COVID-19 in kids, I’ve seen close to ten kids with MIS-C. I’ve had to put one on a respirator, [and] five of them required medicine to support their blood pressure. None of these patients died, they recovered. I saw one kid with myocarditis secondary to the vaccine. Within two days he went home. He didn’t require any supportive therapy. When you look at the complication rate from the vaccine verses myocarditis from COVID-19 it is much less. COVID myocarditis is much more serious and I’m not saying this because of what I read in a book, this is what I’ve seen in my Intensive Care Unit so you really have to put that into perspective in terms of the complications,” he said.
‘A lot of exposure’
Meanwhile, Dr Tonia Jerrick, a Pediatrician at the Joseph M Sanzari Children Hospital, New Jersey, USA, alluded to the fact that children are exposed to more viruses now that they are returning to school. Sharing her experience, Dr Jerrick said many are coming in with multiple respiratory conditions that require longer hospital stays. As a result, she also urged parents to get their children vaccinated.
“The vaccine has shown to have 91% efficacy and with such a high efficacy it is definitely going to help decrease the number of infections… Things that we’re seeing in our emergency department that are telling us it’s more COVID than the regular flu is if they’re having trouble catching their breath, persistent fever, lack of smell or taste…. we’re having a lot of exposure of asymptomatic cases,” she said.
In adding his voice to the issue, Dr Rajesh Bisnauth, General Pediatrician at Westchester Medical Center, USA, said the number of patients the center has seen for respiratory illnesses during this time is the highest in 22 years.
“I’ve been seeing children who have not been able to concentrate, [who have] constant headaches. And then there’s the physical effects. There’re kids who are athletes that are no longer competitive because the virus causes an inflammatory process in every organ system in your body,” he noted.
As it relates to whether children will be required to take booster shots, Dr Bisnauth expressed the view that while it is too early to determine, it is anticipated that the booster shots could become a regular feature. What is clear, he said, is that hospitals are becoming overwhelmed with unvaccinated patients and that countries with access to the vaccines should capitalise on their availability.
“Disparity in access exists but no parent would want to see their child sick,” he stated.
Safety
In response to concerns that the Pfizer vaccine was developed too quickly, Dr Singh reminded that development of the vaccine to treat the Severe acute respiratory syndrome (SARS) has been 20 years in the making.
“What we have now is like a SARS 2. So in 2001, they started developing a vaccine for SARS and much of the development for that vaccine went into the developing this vaccine so this didn’t just happen in the last year,” he highlighted.
Just over a week ago, Guyana planned to launch a vaccination programme for children in the 5 to 11 age group but postponed it after it became known that Pfizer had developed special doses for children, which have yet to be acquired by the government.
Several parents who spoke with Sunday Stabroek said they are in favour of getting their young children vaccinated. One of the parents, who preferred not to be named, believed that vaccination is the only way to keep their children safe from the virus at this stage, while another, who also did not want to be named, reminded that children have been receiving vaccines from birth and this will be no different. “At some point we have to return to our daily routines, which includes going back to school. For us all to be safe, being vaccinated is important. My 13-year-old has been vaccinated and, luckily for him, he experienced no side-effects. What I believe needs to be done is a more robust public information campaign targeting various sects of society to help persons see the benefits of being vaccinated against the disease”, the parent said.
Another parent, who has two sons under age 11, disclosed that while she has concerns, she will certainly get her children vaccinated.
“I am not against my children being vaccinated. My only concern is if their little bodies can handle it. I just want us all to be safe and return to some kind of normalcy,” she said.
Dr Singh is assuring parents that they have nothing to worry about as the benefits of vaccination far outweigh any risk.
“It is a lower dose… And what’s interesting about it is despite the fact that it’s a lower dose it still amounts to the same immune response,” he explained.
Dr Singh is advising vaccination even in cases where a child has previously contracted COVID-19. He recommended that they get vaccinated after three months of recovering, while noting that those who are immunocompromised should be the first on the list as they are at increased risk.
He says that the misinformation surrounding the effectiveness of the COVID-19 vaccines is one of the issues that parents should be more concerned about.
“I encourage them to get information from reputable sources…WHO, CDC and health officials within Guyana. Unfortunately, what has happened is that there has been a dissemination of misinformation through social media and other such sources that really have no basis and that in itself has become a pandemic where people are resisting it [vaccines] because of misinformation,” he noted. (Onicka Jones)