A pediatric critical care nurse prepares discharge paperwork for a child admitted to the ICU after a surgical procedure. She asks the parent the question highlighted in red – “Do you wish to have a COVID vaccine prior to discharge? The mother responds: “Let my child get vaccinated for COVID? I can’t justify that – there’s too much we don’t know.”
Actually, there is a lot more that we do know.
Nearly 4.2 million (16%) of U.S. children have been infected with COVID-19 as of July 29, with 72,000 cases added in the past week. While a vaccine for children age 12+ years was made available this past spring, only 38% of children age 12-17 are fully vaccinated – the lowest rate of any age group authorized to receive the vaccine.
It’s true that pediatric ICU admissions for COVID over the past year were relatively rare, but the stories were profound – a 17-year-old preparing to play collegiate baseball ending his career due to chronic implications of COVID-related multisystem inflammatory syndrome in children (MIS-C), a 12-year old spending his birthday in the hospital with COVID-induced heart inflammation requiring intravenous medication support, a new mom unable to hold her infant peering helplessly through an isolette. For these young people, days and weeks in an ICU bed became a tangible definition of social isolation.
As of last month, upwards of 4,200 children have met criteria for MIS-C, 99% of which tested positive for COVID-19. In a study led by researchers at Boston Children’s Hospital, 80% of patients with MIS-C required intensive care and 20% required mechanical ventilation. The takeaway? Kids get COVID, and they do get sick – some for the long haul.
Even more concerning is the fact that once sporadic admissions have been replaced with winter-level patient volumes of acutely ill infants, children, and teens with Delta variant infections and respiratory syncytial virus (RSV). During the last week in July, 38,654 new pediatric COVID cases were reported. At the same time beds are becoming scarce, schools are preparing to reopen their doors. With flu and RSV season around the corner, it’s time we recognize that pediatric COVID-19 and its associated long-term health sequelae are urgent public health crises. It’s time we stop trusting that children are safe simply because they have a less severe experience with COVID. Rather, we must consider that vaccination is an effective measure in sparing children from the worst manifestations of COVID-19.
In children ages 12-17 years, the CDC estimates that every 1 million second vaccine doses could prevent nearly 8,500 infections and 200 hospitalizations. However, if vaccination rates among adults and adolescents continue to lag behind, the youngest, most vulnerable members of our population will pay the price. The uptick in cases and hospitalizations in several states suggests we are on the front end of a pediatric COVID-surge. Only this time, we will face in influx of admissions within a system already burdened by health care personnel burnout. What’s going to happen if COVID, flu, and RSV all surge at once this winter? It’s a burning question, and one that I don’t want to have to answer.
The majority of these recent ICU admissions are in children under 12 who are not yet eligible for a vaccine. So, if you or your child is eligible to receive a vaccine before the start to the school year, I urge you to do so. In addition to your bolstering your own protection and acknowledging your contribution to herd immunity, you could preserve the lives of infants, toddlers, and young children who are unable to advocate for themselves.
Getting our youngest children back in schools and activities means we stop allowing them to be victimized by a pandemic with an available solution.
Kayla Johnson is a registered nurse from Somers.