Consider This from NPR - Kids Under 5 Still Can't Get Vaccinated. What The Omicron Surge Means For Them

Episode Date: January 5, 2022

New daily cases are at an all-time high. The good news: vaccines and boosters have never been more widely available — but not for everyone. Children five and under still do not have a vaccine available as the omicron surge stretches health care workers thin. For advice on navigating the pandemic in this moment, we turn to Dr. Ibukun Kalu, a pediatric infectious disease doctor at Duke University. Additional reporting in this episode from NPR's Allison Aubrey. In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

This message comes from Indiana University. Indiana University performs breakthrough research every year, making discoveries that improve human health, combat climate change, and move society forward. More at iu.edu slash forward. More than a million new cases of COVID-19. That is how many Johns Hopkins University clocked in the U.S. on Monday of this week alone. And I'll give it to you straight, as I promised you I always would. We're going to see, as you all have been hearing, continued rise in cases. That was President Biden on Tuesday.

Winter weather driving people indoors, holiday gatherings and travel, and of course the Omicron variant, have all created a perfect storm. Case numbers are now far higher than they've ever been in the U.S. But the good news is, with widely available vaccines and boosters, And by the way, we have booster shots for the whole nation. it's never been easier for everyone to have protection against serious illness. Well, at least almost everyone. The fact that Omicron is substantially more transmissible to have protection against serious illness. Well, at least almost everyone.

The fact that Omicron is substantially more transmissible, without a doubt, more children that were going to get infected, you're going to see more children being hospitalized. That was Dr. Anthony Fauci speaking to New York's PIX11. Those hospitalized children will include some kids under five years old, and kids in that age group still do not have a vaccine available. This week, Fauci said one might be ready in the first half of this year. Hopefully in the first half, hopefully towards the earlier part of the first half, we may have some information so that we can vaccinate children of that age. Consider this. In the pandemic's biggest case surge, the nation's youngest kids have no vaccine protection.

And their parents and caretakers, well, they have a lot of questions. Is it safe to take a five-hour flight with an unvaccinated two-year-old? I'm wondering about severity and risk. How much research has been done for the babies who are in utero? Our main concern is that a lot of people are going back to normal, basically, and our daughter is still not protected. We put those concerns and questions to a pediatrician. That's coming up. From NPR, I'm Elsa Chang. It's Wednesday, January 5th. This message comes from Indiana University. Indiana University drives discovery, innovation, and creative endeavors to solve some of society's greatest challenges. Groundbreaking investments in neuroscience, climate change, Alzheimer's research, and cybersecurity mean IU sets new standards to move the world forward, unlocking cures and solutions that lead to a better future for all.

More at iu.edu forward. It's Consider This from NPR. More cases, more infections, more people of all ages in the hospital. That is just the simple math. And while we know that kids face a far lower risk of hospitalization than adults, it's also true that a lot of hospitals right now are struggling. Most ERs are at 200%. Shaquita Bell is a pediatrician at Seattle Children's. She told NPR, like so many hospitals, they are not just dealing with COVID, but with all the other respiratory viruses that

are common this time of year. Like our ER here in Seattle at Seattle Children's is operating at all-time high records of patients seeking care. And we've had record rates of respiratory syncytial virus or RSV infections that are even at a higher rate than COVID, which is overwhelming many of our ERs and urgent cares. That gets at something particular about this moment when it comes to very young, unvaccinated kids. Yeah, their risk of winding up in the hospital is low, but if they do need hospital care, even for a minor thing like an IV, some fluids... That might be a really quick visit in normal times, but when our ERs are seeing 200% of the volumes that they would

have seen a couple of years ago, that ends up being a really long visit, a really long trip to the emergency room because of all the competing limited resources. And those resources are being stretched more and more. The latest CDC data shows about 672 children are being admitted to hospitals each day. That's more than double the week prior. But more patients doesn't mean more staff. In fact, many hospitals are struggling because doctors and nurses are testing positive and have to be off the job for days. It just seems like everybody is getting infected at the same time. And that's why we're just seeing these huge waves. Frank Esper is a pediatric infectious diseases specialist at the Cleveland Clinic. In my personal experience, what I've been seeing, there has been a lot of COVID croup.

That's the barking, cough, and stridor. The big airways get swollen, and they usually show up, cough, cough, cough, bark, bark, bark, cough, cough, cough. And they respond just like with all our other group treatment protocols. They do okay. They do okay, but with effective treatments like steroids or anti-inflammatory medications. And right now, in order to administer care like that, Esper's hospital is getting help from the National Guard. So how should parents and caretakers think about this moment? Well, we put that question, and others that we gathered directly from parents, to Dr. Ibukan Kalu.

She's a pediatric infectious disease doctor at Duke University, and she spoke to Mary Louise Kelly. Thanks for being with us. Thank you for having me. It's nice to speak with you, Mary Louise. Yeah, and you. Before we get to the parents' questions, may I ask you just how things are going at your hospital? Are you seeing a lot of kids hospitalized with COVID-19? Yes, we are seeing a few more than we saw both with the Alpha and Delta surges in the past spring and summer of 2021. And what ages are you seeing? And I suppose part B of that question is, are they vaccinated? So we've seen across all age groups, we're seeing a couple of small infants, and that may be partially because they have other viral infections spreading in the

winter, for example, influenza. And then we're seeing some older kids, older than the age of five, that should be eligible for one of the vaccines out there. Unfortunately, more of the children that are in the hospital are unvaccinated. However, we have younger children that are not eligible for vaccination and also end up in the hospital with COVID. Yeah. And the ones who are hospitalized, what symptoms do they have? Are the symptoms kids are demonstrating tracking along with adult symptoms or any differences you can see? For the most part, they track along with adult symptoms. So they may have fevers, some issues with breathing, such as shortness of breath.

However, our youngest kids, those that are infants, tend to have more gastrointestinal symptoms. They may have vomiting or diarrhea or have issues just maintaining their fluid intake, and they end up in the hospital for some support. Yeah. We have a question along these lines. This is our first parent, Alex McCarty. He has a four-year-old and an 18-month-old. I'm wondering about the severity and risk of the Omicron variant to children. Does it seem to be more dangerous than previous variants, or is it about the same or less so?

So Dr. Kalu, this is a question adults have been asking. How do the symptoms compare? How does the severity of Omicron compare? What do we know specific to children? So what we know so far is that Omicron is milder than Delta in both children and adults, but it's still pretty severe. And it can cause significant symptoms in a small group of children, not across the board, but the small subset that do end up with more severe symptoms end up in the hospital. If we see more cases, we'll likely see a higher number of kids end up in the hospital just by sheer numbers. Do we know yet how the risk compares to something like the flu? And again, specifically for kids? In kids, partly because COVID seems to cause the

initial infection, and then just track through the body and cause post COVID syndromes. It is worse than influenza. And currently, we are seeing influenza spread in our community, but COVID is just outpacing that across the board. Okay, next question. This is on vaccines, and it comes from Oriana Perez, who has a three-year-old daughter. What was the reason why the vaccine trial for children under five failed. Our main concern here in Texas is that a lot of people are going back to normal, basically not wearing masks in public, and our daughter is still not protected. So I think she may be referring to the Pfizer vaccine trial for kids under five. What more can you tell her about that? What I understand about the process so far is that

the trial was conducted to ensure that the vaccine is safe and it actually works in children that are younger than five. And the dose that was chosen did not necessarily trigger a high enough protective response. They were advised and they chose to go back and adjust the dose to ensure that when they have a viable vaccine option, the dose that's authorized will likely lead to a protective response in kids. So I didn't see it as a failure. I think this is a helpful process for getting a safe and effective vaccine. Let me turn us to a question about even younger children. This comes from Mandy McCaslin, who has a six-month-old. How much research has been done for the babies who were in utero when moms were vaccinated or babies who were breastfeeding when moms are vaccinated?

This is a really fascinating one. If a mom who is vaccinated is breastfeeding or was carrying a baby when she was vaccinated, might those babies be protected? Yes. The CDC has summarized some of the more recent research, and I will refer to the data they've shared publicly as just a source of information that might be helpful here. But there are also multiple published studies from 2021 that help to address the question she's asking. Specifically, when they look at mothers that had babies recently, mothers that were vaccinated, or those that may have been unvaccinated but got an infection just by nature of having COVID spreading everywhere, they saw that those that were vaccinated were able to pass antibodies or pass protection to their infants and pass it in such a way that it was both in the blood, but also

within the mouth and noses of the babies. And this is huge. This is great because if babies get exposed just inadvertently by leaving in community, they have a layer of protection since they can't mount their own protection. Some of those that were infected passed some antibodies as well, but it was slightly less than those that were vaccinated. So I think vaccines were safe and effective in pregnant women and they were able to pass it on, which is hugely helpful. Okay. One last question. This is from a family that is looking to escape all of this for a little while. Ryan McGee says his two-year-old son is great about wearing his mask, wears his mask like a champ, but he is worried about taking a planned vacation to Hawaii. Is it safe to take

a five-hour flight with an unvaccinated two-year-old? Would it be more prudent to postpone our trip? And once we get to our hotel, how safe is it to go to the beach or to the pools? Should we try to encourage mask wearing while playing in the water? Dr. Kalu, I'm trying to imagine trying to keep a two-year-old in a mask on the beach in Hawaii. But what advice do you have for this family or others trying to figure out if they can travel with really young kids? I share the sentiment. It would be nice to find more sun somewhere. But during the current surge, I'm assuming the questions regarding this period we're in, it may be advisable to defer travel since we're seeing such high rates of community spread. If you can do it, if it's feasible, push it out a few weeks. If you're

already on the way there or it's just not feasible for you to move that around, encouraging masking will be great. I think the two-year-olds may struggle a little bit, but also ensure that everyone within your party is vaccinated and has received a booster shot if they're eligible for vaccines. Finally, play outdoors as much as you can. Masks don't necessarily work when you're submerged in water. So I would not expect masking in that setting. That was pediatrician Ibakan Kalu at Duke University. You also heard reporting in this episode from NPR's Alison Aubrey.

It's Consider This from NPR. I'm Elsa Chang.