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Q: Will children need to be vaccinated against COVID-19 to reach herd immunity?

A: As of last month, 3.4 million children in the U.S. tested positive for COVID-19, according to the American Academy of Pediatrics. After a slight decline in cases over the past two months, an increase in cases has been reported.

Children represent 13% of total cumulative cases in the U.S., approximately 3% of hospitalizations and 0.2% of COVID-related deaths. In Hamilton County, 19% of COVID cases have been in people less than 20 years of age; 6% of those are in people less than 10 years of age.

For effective herd immunity to be achieved, vaccinating efforts will need to include a significant percentage of people 18 and younger. Fortunately, trials are ongoing to evaluate the safety and efficacy of COVID vaccines in the younger age groups.

Pfizer recently released data on its vaccine trial in adolescents 12 to 15 years of age. More than 2,000 participants were randomly assigned to get two doses of the vaccine or placebo. Participants who became COVID-positive during the study were all in the placebo group. This study proved that the vaccine was 100% effective in protecting adolescents ages 12 to 15. Also noted was that the antibody levels exceeded the levels of those observed in studies of the older age group. No significant side effects were seen. Monitoring for long-term efficacy will continue for two years.

Children and adolescents make up about 25% of the U.S. population. As vaccines become available for young adolescents and clinical trials for children as young as 6 months of age ramp up, the discussion of vaccine acceptance, vaccine hesitancy and vaccine refusal will focus on parents. Parents' acceptance will be important, as their consent is needed for vaccine administration. A recent survey by the family advocacy group Parents Together showed that only 58% of parents would probably or definitely vaccinate their children when a vaccine becomes available.

Understanding parental concerns about vaccines will be necessary for vaccination efforts to succeed. Examining trends in general vaccine hesitancy among parents, such as their willingness to allow their child's measles-mumps-rubella (MMR) vaccine, could predict whether parents will vaccinate their children with the COVID vaccine.

Such comparison, however, may not be generalizable to all vaccines, according to Kaiser Health News. Some parents, for example, may choose to delay some childhood vaccines but choose to vaccinate their child with the COVID vaccine to protect their grandparents or other vulnerable family members. Discussions of the benefits of the vaccine with parents will be key in getting children vaccinated and reaching herd immunity.

Fernando Urrego, M.D., is the interim health officer at the Hamilton County Health Department and a member of the Chattanooga-Hamilton County Medical Society.

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Contributed Photo / Dr. Fernando Urrego
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