Dr. Farber’s COVID-19 Update 35

I will be giving my thoughts on the vaccine’s use in younger children (regular readers should not have any problems predicting my views), but will first cover some other virus items.

The virus has certainly caused major damage in this country.  By comparison, we can look at the three major wars we have fought, all of them four-five years long.  World War I was felt to have cost around 115,000 American lives, World War II 400,000, and the Civil War 650,000.  COVID, in less than two years, has led to over 740,000 deaths, and the number will of course continue to rise.   There is, however, good news lately.  The number of cases of COVID in the DMV has been dropping every week since September 14.  Fairfax County is now classified as having ‘mild activity’, and Prince William County should be there soon.  Vaccines clearly work, as do masks.  For the latter, the most recent quality study I found on the subject indicates that mask-wearing in schools cuts COVID rates by around 50%.  However, this is not a time for complacency.  For example, slacking off on masks and vaccines at this time would be expected to lead to a rise in rates once again.

The FDA has just approved vaccination for children age 5-12.  This may seem to have been rushed, but the data are quite solid, unfortunately due to the large number of cases.   To understand this concept, suppose I developed a vaccine for tularemia, a rare infection.  I could show that the vaccine raised antibody levels, suggesting it was effective, but then to prove it actually worked in practice, I might take 5,000 people and give half of them the vaccine and half not.  I would find no cases of tularemia in either group, given the rarity of the infection, so I would be unable to prove the vaccine worked.  With COVID, when thousands of children are given/not given the vaccine, there are more than enough cases to show the vaccine is effective in real-life as well as in the lab.

Children continue to be relatively spared from the illness, although as more adults become immune from vaccine or disease, children start to make up a larger percentage of cases.  The death rate remains low, but real, with around 700 deaths of children in the United States so far.  I see three main reasons to vaccinate children.  One of them is obviously reducing the risk of illness, hospitalization, and death in children, and adults they may in turn infect.  Another is helping to wipe out COVID in this country, which will best be accomplished with high vaccination rates.   The third is practical, and a scenario I have seen played out a few times in our practice:  a parent comes down with COVID, so the unvaccinated children have to go into quarantine.  Then, when the quarantine is about to end, one of the children comes down with COVID, and the quarantine for the others continues.

Is the vaccine 100% safe and effective?  Of course not; nothing in medicine is.  It’s a question of reducing risks.  You can still die in a car crash with a seat belt, but the chance of that happening goes way down if you are belted in.  Conversely, some smokers do live long lives.  However, if you want to maximize your chances of living into your 80’s, wearing a seat belt and not smoking is clearly the way to go.

With the approval of the vaccine, anti-vaxxers will be out in full force again.  As Garry Trudeau has pointed out in Doonesbury, some anti-vaxxers such as Bob Enyart, Marc Bernier, Phil Valentine, Jimmy DeYoung and Dick Farrel are no longer broadcasting anti-vax screeds – because they have died from COVID.  These were preventable deaths, and tragic no matter how you look at it, but it will not stop others from sprouting lies about the vaccine, opining without evidence to back up their claims, and even making up material with no plausible scientific backing.  An early example of this was seen when the swine flu vaccine came out.  A cheerleader ambassador for the Washington football team got her 15 minutes of fame by showing how the vaccine made it so that the only way she could walk smoothly was by walking backwards.  It turns out that this could go away if she did not realize she was being filmed.

As a more current example, the COVID vaccines are not live vaccines, and cannot cause COVID.  This has not stopped the Centner Academy in Florida (no surprise where the school is located) from ordering those teachers and student who are vaccinated will need to stay out of school for 30 days because the Academy has heard that the vaccine causes COVID.  I can only assume that students there are taught about Sasquatch in science class, and how the earth is flat in geography, other ‘truths’ which can easily be verified with an internet search.  (By the way, a very useful site for exploring whether there may be any truth to a rumor is snopes.com).

(Digressing briefly, to another subject I feel passionate about, related to the power of the media, I saw an advertisement this week for a satellite TV company and video streaming service.  In it, grandparents are wondering how to entertain their infant grandchild, and are so pleased with themselves when they figure out how to find a program for him to watch.  See this and similar content often enough, and you will begin to question your parenting skills if you aren’t plopping your child down in front of a screen).

Bottom line, get the vaccine for everyone in your family who is eligible.  I am not yet sure how we will handle the demand in our office; check our webpage for this.  However, I am also fine with having it given at a local pharmacy.  I don’t much care where it is done, as long as it gets done.

Lastly, on the subject of vaccination, there will be significant cases of the flu this year, now that schools are open and workers are back at work.  We expect there will be several unvaccinated children in our practice who wind up in the hospital.  Make sure to get everyone in your family vaccinated for this as well.  Early on, before we had enough data, it was recommended that no other vaccines be given within a few weeks of the COVID vaccine but further studies have shown this is not a concern, so don’t let a recent COVID vaccine keep you from getting other immunizations, and vice-versa.

Stay healthy.

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