This pandemic is real, of epic magnitude, and is fiercely, unabatedly spreading its wings across the globe. These are uncertain times. A new term called the vaccine passport is now emerging in countries across the world. This will be a temporary fix-it to the ongoing pandemic, allowing travel and mass gatherings amongst people who have built immunity against Covid. This aims to drastically reduce transmission of the virus and provide the luxury of safety – how ironic that safety is now termed a luxury! Various sectors are joining hands to incorporate this provision as a part of the digitalized world. Parents are brimming with questions about the availability and administration of the COVID vaccine for children, in-campus schooling and all that it will entail, and desperately waiting to give back their children the semblance of a normal childhood.
Keeping these issues at the heart of this article, we have unearthed all the questions revolving around children and the pandemic. We had conversations with three leading doctors in the country to make sure we provide authentic answers to the most common questions parents seem to have around vaccines.
Till we find our way to normalcy, we need to do what we know, which is, sanitize our hands frequently, keep our masks on at all times and maintain social distancing.
For this article, we interacted with three doctors:
Dr. Falguni Parikh (MBBS, MD, DNB, FICP, FIDSA, MNAMS ) consultant in Internal Medicine and Infectious Diseases attached to Kokilaben Dhirubhai Ambani hospital, Mumbai; Dr. Samir Parikh (MBBS MD DM DNB) Gastroenterologist, attached to Lilavati Hospital, Balabhai Nanavati Hospital, and Bhartiya Arogya Nidhi Hospital, Mumbai and Dr. Ratna Parikh, (MS FACS FAIS) Oncologist Surgeon at Breach Candy and Bharatiya Arogya Nidhi hospital.
Their views and insights have been highlighted through the course of the article.
What is the status of the COVID vaccine for children?
Vaccinating everyone, including children is the only way to get the pandemic under control. “There is taboo and fear of taking the vaccine (even among educated and uneducated people). This is preventing the development of herd immunity. Recently a double mutant of the virus has been found. This is spreading rapidly infecting younger people, causing more symptoms and increased hospitalization. However, there is no evidence to link the current surge to this strain,” explains Dr. Ratna.
In India, Bharat Biotech has approached the Drug Controller General of India (DCGI) seeking permission to test its COVID-19 vaccine, Covaxin, on children aged between 5 and 18 years.
Clinical trials need to be completed in thousands of young volunteers to assess the vaccine’s safety and efficacy, and the results must be fully reviewed and then authorized. Vaccine trials for children have just begun in America, so the efficacy is yet to be determined. We will get more answers as the studies emerge. Currently, children are not the prioritized population as not many cases have been reported in children and most cases that have been reported, have not proved to be fatal.
“I don’t think children will escape vaccinations. Schools will be opening soon and expecting every child to adhere to the mask norms during play, parties and gatherings are going to be rather difficult. Children need to be vaccinated as well. In some places in Gujarat, they have identified that children are spreading the infection because they play in societies and do not adhere to social distancing or wear a mask. Being asymptomatic, they in fact could be super spreaders,” says Dr. Samir.
What’s different about the Covid vaccine for children specifically?
The composition of the Covid vaccine for children is the same as used in adults, the difference is that the children may require a different dose. The first step in vaccine trials is to figure out the right dose. The pharma companies want to find the lowest possible dose that is safe and produces a target level of antibodies.
What happens when kids get Covid and are hospitalized?
Fortunately, only mild cases of covid have been reported in children so far. These patients have recovered with home care itself.
If a child needs to be hospitalized, Dr. Samir ensures, “Our sisters do a fantastic job of looking after the kids in pediatric ICUs and pediatric wards. If you look at the pediatric wards of many hospitals they are very child-friendly. They are nicely decorated and are equipped with toys and many other kid-friendly items. So the pediatric wards are very different from the adult wards. I don’t think it will be a problem to look after kids who are older than 4 years of age or to keep them in isolation if it is required.”
When will nursery schools reopen in India?
Reopening schools for young children depends on certain factors like the completion of the second wave and the beginning of the third wave. Some of the European countries are already hit with the third wave of Covid-19. We as a society have to weigh the benefits of sending kids to school versus studying at home and the risk that they are exposed to when they go to school.
Also watch: Reopening schools during Covid-19
In that case, shouldn’t teachers, like frontline workers, be given priority for vaccination?
While the protection of teachers is essential for schools to reopen safely, UNESCO and the International Task Force conducted a survey on Teachers for Education 2030 that finds that only 17 countries out of 149 prioritize teachers in the first phase of vaccination efforts. Another 20 countries include teachers as a priority group for the 2nd phase of vaccinations. Meanwhile, 56 countries do not prioritize teachers in national vaccine rollout plans.
An expert panel with the Indian government’s health ministry, the National Expert Group on Vaccine Administration (NEGVAC), has come up with a prioritization list to identify the most vulnerable populations to reduce the mortality rate and burden on the healthcare system.
If we have 130 crores of vials available to vaccinate everybody, then it’s a different story. At present, the vaccine has been passed for emergency use and the vaccine is yet to establish itself, and we don’t have as many vaccines available. The targeted population is the population that is at high risk—high risk to get the infection or develop serious consequences because of the infection. So the people who are at the highest risk of getting the infection are the healthcare workers, the elderly who have fewer reserves and are immunologically compromised, so they are the ones who are being vaccinated first.
Teachers are present in the group, but it isn’t clear at what stage they will be vaccinated.
What is the recommended number of children in a classroom during the Covid-19 pandemic?
CDC (Centers for Disease Control and Prevention) has revised the physical distancing recommendations to reflect at least 3 feet between students in classrooms and provide clearer guidance when a greater distance (such as 6 feet) is recommended. To know more, click here for authentic information from the CDC.
The number of children in a classroom will depend upon the size of the classroom and its ventilation system. The required distance between 2 children is 3 feet. Most schools don’t have the luxury of having big classrooms, so it may be worthwhile to reduce the classroom size to half. So if you were educating 40 kids, maybe we can have 20 kids come to school in the morning and 20 kids in the afternoon.
How do you see schools preparing for reopening?
Dr. Falguni explains that when schools do reopen the following prevention strategies need to be implemented: wearing a mask that covers the nose, mouth, and chin; physical distancing of a minimum of 3 feet; frequent washing of hands; respiratory etiquettes like covering mouth and nose against a sleeve/shoulder during a cough or sneeze; cleaning of school properties and proper ventilation in classrooms; reduced sharing among students; disinfecting the surfaces that the students are in constant contact with; conduct contact tracing and thereafter follow isolation and quarantine guidelines and cancellation of the playground and extracurricular activities.
Schools will have to cut down the strength of the class and the duration of school hours drastically. Parents need to ensure they monitor their children daily for any symptoms.
What precautions should parents take when they send their children to school?
We are aware of the precautions that need to be taken when we send a child to school. What needs to be highlighted is the protocol that should be followed when the child comes back from school. For example, the school uniform needs to be washed immediately, the child will have to take a shower and get into fresh clothes. Everything that the child has taken to school will need to be sanitized every day.
Will school buses be safe for transportation for children?
School buses will have to be sanitized regularly throughout the day. The school bus attendant will have to ensure kids are masked at all times and social distancing in the school bus is followed strictly to reduce the risk of transmission.
A lot of parents will be skeptical to send their kids to school. What would your advice be for them?
“We have to understand that it has been over a year that children have been at home and are not attending school. Children need to stay socially connected so we have to reassure children about their safety and follow a normal routine. Talk to your child and listen to all his apprehensions. Be honest and clear with older children and ensure there is no ambiguity in regards to the precautions that need to be taken,” says Dr. Falguni.
Currently, 2 doses of the vaccine are given in a month. Will the gap be the same for the younger generation, in particular young children?
Vaccine trials have been conducted on people who are 18 years old and above. The clinical trials for the Pfizer vaccine have only recently begun in America. The gap between the two doses will be determined based on the findings of this trial.
Since the Pfizer vaccine is authorized for ages 16 and older, when can we expect the COVID vaccine for children younger than 16?
Vaccinating children of all ages will be critical in controlling the pandemic. The roll-out of the Covid vaccine for children younger than 16 will depend upon the clinical trials that are currently underway. The youngest children will probably be the last to be vaccinated.
What preventive measures can parents take to protect their children?
Frequently sanitize hands, ensure your child wears a mask at all times when he is out of the house, and strictly maintain social distancing. Practice the same protocols diligently and your kids will follow them too.
Pfizer’s vaccine for kids
In the most recent development, Pfizer has announced this COVID-19 vaccine is safe and strongly protective in kids as young as 12 years of age. Click here to read more.
FAQs on Covid-19 in children -The Second Wave of Covid-19
The pediatric Covid cases have been on the rise in the last 15days. This has stirred up panic in parents. Below are the most commonly asked questions that are flooding pediatricians off-late, and we have answered all these questions with the intent to curb the rising parental anxiety.
How is Covid-19 in children different this time than in the first wave?
During the first wave of Coronavirus in March 2020 majority of pediatric patients were asymptomatic and most cases that had been reported did not prove to be fatal. This time there is an increase in the number of infected children and there are symptomatic presentations in children of all age groups from neonates to adolescents. A reverse trend has also been observed where the child develops symptoms first and then the adult gets infected from the child.
Why are children getting affected more this time?
The double mutant strain of the virus is showing a higher propensity to affect children. We could attribute this to the exposure children have while playing outdoors, traveling, and non-compliance with the issued protocols.
What are common symptoms of Covid in kids?
These are the common symptoms that have been seen in children – fever, cold, dry cough, loose motions, vomiting, and fatigue. Few may have breathing difficulties, rash, etc.
If my child has a fever, how soon should I get him tested for Covid?
A symptomatic child should be tested at the earliest – day 1 or day 2 Covid RT PCR test should be done. Parents should not be scared or apprehensive to get the child tested. Early diagnosis helps in early treatment. If a child is asymptomatic, and both parents have tested positive for Covid, a covid diagnosis test is not required for the child, 14 days of home quarantine is adequate.
Do I need to admit my child if he has a fever and the RT PCR test is positive?
No, you can monitor your child at home after consulting your pediatrician. You need to watch for red flag signs of breathlessness, fever beyond 5 days, poor oral intake, rash, etc.
If the parents are Covid positive, should they send their child to a relative’s house?
Your child could still be a carrier of the virus so all of you need to be home quarantined in the same house. Also if there are grandparents in the house they need to be quarantined as well.