Editor’s Note: Megan Ranney, MD, MPH, is a professor of Emergency Medicine and associate dean at the School of Public Health at Brown University. The views expressed in this commentary are her own. Read more opinion on CNN.
A few years ago, I visited a cemetery in an old mining town in Utah. My husband and I were struck by the rows of little tombstones. Each tombstone’s death date was within a few weeks of each other in the early 1900s. They were all children who had died of diphtheria. As a parent and a physician, it was an all-too-concrete reminder of the toll that infectious diseases used to take on US families and children.
Luckily, we rarely see these kinds of little tombstones any longer. Thanks to pediatric vaccination, one of the greatest public health successes of the 20th century, we have all but eliminated diphtheria – along with polio, measles, Haemophilus influenzae type b and more – from the United States.
It is no longer common for American kids to experience death or disability from infections. Instead, injuries (particularly firearm injuries) are typically the top causes of death among kids in the US.
The new guidelines put out by the Florida surgeon general on Tuesday, that “healthy children from ages 5 to 17 may not benefit from receiving the currently available COVID-19 vaccine” therefore flummoxes those of us in the public health and medical communities.
Covid-19 is certainly not as lethal as diphtheria. And it is true that the death and hospitalization rates from Covid-19 are lower in kids than they are in adults. Still, the lower absolute number of deaths among kids than adults doesn’t mean that these kids’ deaths don’t matter.
Indeed, in 2021, Covid was among the top 10 causes of death for American children and young adults every month (except June, for 5 to 14-year-olds, when it dropped to the 11th spot but remained in the top 10 for adolescents). As of this month, almost 40,000 Covid-19 associated hospitalizations were registered in 25 states (data is not available from the other states). We are just beginning to learn about the nature and frequency of the long-term consequences of Covid among children.
This is why the development, testing and eventual distribution of a pediatric vaccine against Covid-19 – with the goal of preventing severe illness, long-term symptoms and deaths – was so welcomed by parents, physicians and public health professionals alike. Here was a chance to offer our kids a way back toward normal. And this illustrates why Florida’s guidance is so misguided.
Let me be clear about the facts. The Covid-19 vaccine currently under emergency use authorization in the US for kids 5 and up – a two-dose Pfizer/BioNTech series – is effective at preventing the worst outcomes: severe illness, hospitalization and death.
Study after study shows that the kids who get hospitalized for Covid-19 are, by and large, those who are unvaccinated. Even during the Omicron wave, when the vaccines became somewhat less effective in preventing a SARS-CoV-2 infection, preliminary analyses supported that vaccinated kids were still much less likely to have these most severe outcomes.
Equally important, these vaccines are safe for kids. Almost 20 million doses of the Pfizer Covid-19 vaccine have been given to 5 to 11-year-olds, and another 30 million ages 12 to 17. Of these, only a handful have had allergic reactions. Very few children ages 12 to 17, and even fewer 5 to 11, have been reported to experience the rare side effect of myocarditis; these cases were generally mild and self-resolving.
Compare that to the known effects of Covid-19, which the vaccine can prevent: the tens of thousands of children hospitalized, the over 1,000 children dead, the unknown numbers who will struggle with long Covid – and severe, life-changing myocarditis and other heart disorders. Some studies estimate that the risk of myocarditis among youth after a Covid-19 infection is 100 times higher than the risk after vaccination.
Finally, the Florida Department of Health claims that only “children with underlying conditions are the best candidates for COVID-19 vaccination.” But, aside from the ableism of this claim, it’s important to remember all the reasons that this is silly. Almost 20% of American children are obese – a leading risk factor for poor outcomes after an infection; never mind the untold more with diabetes, cancer and the multitude of other risk factors. Moreover, even healthy children get sick: One study last summer reported that a third of pediatric Covid-19 hospitalizations were among youth with no pre-existing high-risk conditions.
All of these reasons are why I enthusiastically vaccinated my own children against Covid-19. (P.S. They’re both fine.) It’s also why countries across the world – including the UK, which was initially reluctant to vaccinate kids – are urging all children 5 or older to get their Covid-19 shots.
Here in the US, at a time when we are asking the public to take an increasingly individualistic role in the control of Covid-19, let’s not undermine these effective protections available to our children. We should celebrate, not denigrate, vaccines. Let’s let common sense, compassion and respect for the data prevail.