Editor’s note: Dr. William Miller, chief of staff at the Adventist Health Mendocino Coast Hospital, is writing weekly reports concerning the COVID-19 situation on the Mendocino Coast. We are pleased to be running his health column, with details on the medical fight against the pandemic. The views shared in this weekly column are those of the author, Dr. William Miller, and do not necessarily represent those of The Mendocino Voice or of Adventist Health.
Editor’s note: this column has been updated for clarity.
On October 29th, the FDA gave Emergency Use Authorization that expands the use of the Pfizer COVID vaccine to children ages 5 to 11. This was done after Pfizer provided data from a study involving 4,700 children from the US, Finland, Poland and Spain.
In the study, half received a placebo and the other half received the actual vaccine which was given at 1/3 the adult dose. The vaccination protocol involved giving one dose followed 3 weeks later with a second dose. Effectiveness was measured both in terms of antibody levels in the blood as well as looking at actual COVID infection and illness rates. The two groups, vaccinated and placebo, were then compared. While this is an ongoing study, the data thus far shows that the effectiveness is 90.7% at 7 days following the second dose and showed no significant sign of waning at 2 months. These results are consistent with the results seen in both the age 12-18 group and in adults. As in adults, it is likely that the effectiveness will start to wane around the 6th month, but remain quite effective in preventing serious illness even after that.
Children, especially those before puberty, are much less likely to develop high viral loads when they get infected and as a result are therefore much less likely to get seriously ill or transmit it to others. However, both can still occur and that is the basis of approving the vaccine for this age group. According to the CDC, since the pandemic began about 8,300 children between age 5 to 11 have required hospitalization in the US. The vast majority of these have done well with only 146 deaths occurring. An additional 400 deaths in kids age 12-18 have also been reported. By far, the most COVID hospitalizations and deaths have been in adults. Of the 45 million Americans who have tested positive for COVID since March, 2020, five million were in children.
One potential side effect of the vaccine that is getting a lot of press is also complication of getting COVID itself and that is myocarditis. Myocarditis is an inflammation of the heart and pericarditis is inflammation of the sack surrounding the heart. Myocarditis and pericarditis are rare events that can occur in many different viral infections, COVID being one of them. Since the vaccines are designed to imitate an infection, then it is not surprising that some effects of the vaccine are similar to that of the infection. For example, that is why some people get achiness, feel tired or even have fevers after the vaccine.
While myocarditis is rare in both situations, it appears to occur three times more commonly in the actual COVID infection than with vaccination. It is primarily seen in males over the age of puberty and most significantly between ages 24 and 30. COVID related myocarditis also tends to be more severe than vaccine induced myocarditis. In vaccine related myocarditis, the symptoms are usually mild achiness in the chest and sometimes palpitations (ie., feeling your heartbeat). The resolve in a few days without any treatment or damage to the heart. COVIID related myocarditis can be much more severe and has been reported to potentially cause long term damage. Because of the fact that COVID related myocarditis carries much greater risks, it is felt that the risk of actually getting COVID and all the other bad things that can go along with it greatly outweigh the risk of the vaccine.
To help put things in perspective, there have been 400 million doses of Pfizer and Moderna COVID vaccines given in the US making 175 million Americans fully vaccinated. The total cases of myocarditis/pericarditis following vaccination is 1,226. That is 1,226 out of 175 million which equals 0.0007%. Even when you look at the group at highest risk, males between puberty and 30, the incidence is 40 per million or 0.004%. This data is from the CDC.
Meanwhile, the risk of getting myocarditis/pericarditis from a COVID infection is 2.3% in young, college age men according to a recent article published in the Journal of the American Medical Association (JAMA). I think we would all agree that there is a big difference between 0.004% and 2.3% as levels of risk.
“While it is true that the vaccine is both safe and effective for protect the child from COVID, the real reason for vaccinating younger children is to protect the older members of the family, especially grandparents,” said Dr. Chris Robshaw, pediatrician at Mendocino Coast Clinics (MCC) in Ft. Bragg. “The pattern of spread of COVID in the household is the same as we see with influenza. While it is the teenager that brings it home from hanging out with friends, it is the youngster who then picks it up and spreads it to the rest of the family.”
“Our school district will be partnering with MCC to offer a drive-through, after-school vaccination event for parents who wish to have their child vaccinated,” says Beck Walker, Superintendent of the Ft. Bragg Unified School District. “Our number one priority is always the safety of our students,” she added.
Part 2 of the reporting on nursing homes in America with a look at local experience will be postponed to a future week since this topic seemed more timely.
You can access previous Miller Reports by visiting www.WMillerMD.com.
The views shared in this weekly column are those of the author, Dr. William Miller, and do not necessarily represent those of the publisher or of Adventist Health.