Kids vaccine is low risk either way
Parents sense that, and that is why uptake is poor, Exaggerating will ruin trust in medicine
Recently, a study appeared in the New England Journal that reports COVID-19 outcomes among kids who get vaccinated. It is supposed to show the benefit of vaccines, but what it really shows is that the risks to kids are so low, it doesn’t matter. No one needs to stress. If parents want to do it, fine. If they don’t, fine. Not worth pushing it or antagonizing people about it. Moreover, the proof is in the pudding ~3% of parents of kids <5 have gone through with vaccination, and about 1/3 among kids 5 to 11.
Consider the paper:
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First, “Children who had had SARS-CoV-2 infection before the study start date and those who had returned to Singapore after acquiring SARS-CoV-2 infection abroad were excluded from the study.” Already this severely limits generalizability to the USA, where the vast majority of kids already had COVID-19 (75% +++). Risks to kids who had and recovered from COVID from re-infection are lower than immune naive kids.
Second, the study looks at kids who voluntarily took vax vs not. This introduces confounders, specifically socioeconomic status and education. The authors do not adequately adjust for this only doing this, “housing type as a proxy for socioeconomic status (e.g., public housing with one to five rooms, private housing, or other housing)”. That isn’t good enough. Worse it may unlock other problems (perhaps even backdoor pathways) if some of these housing projects were targeted with special messaging.
Third, Singapore uses aggressive asymptomatic testing to test contacts, which will inflate the cases, and, again, is not US standard of care.
Fourth having said all that. Here is the result. Rates of hospitalization, hospitalization requiring oxygen, and death.
That’s not a typo. The risks are so low. You cannot see them. Either way. Now let me blow it up. This is way below 1%. In fact, one quarter of 1%
The difference seen here is likely confounded, likely exaggerated, and would surely be smaller in a group of kids like American kids who mostly had COVID-19 already. But even with all that said. It is low risk.
“Among hospitalized children, only five received supplemental oxygen, four of whom were admitted to the intensive care unit. Of these five children, one was unvaccinated, two were partially vaccinated, and two were fully vaccinated. No deaths attributable to Covid-19 (as determined by the cause of death reported to the Ministry of Health) were observed during the study period.”
On the other side of the ledger
“In Singapore, 22 serious adverse events after vaccination (0.005% of all doses administered) among children 5 to 11 years of age were reported to the Health Sciences Authority as of February 28, 2022”
Bottom line then: Risks to kids are low either way. Putting pressure on parents or making this a major focus of a public health campaign would be a misuse of resources. Exaggerating the importance of the decision is a mistake. Mandates would also be a mistake. Finally, whether this generalizes to the USA is unknown, but if anything the direction of the signal will not go in the positive direction.
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