CHAMPAIGN – As school physiotherapy kicks off for the fall, some parents remain undecided about whether or not to vaccinate their children against COVID-19.
On the one hand, children infected with the virus — even if they had no symptoms — may be at risk for the rare and potentially dangerous childhood multisystem inflammatory syndrome associated with COVID-19.
On the other hand, a small number of children who have been vaccinated may end up with cases of the inflammatory heart disease myocarditis or pericarditis that have been reported – although very rarely – after the second dose of an mRNA COVID-19 vaccine.
What should a parent do?
One Parent in the Area – Carle Pediatrician Dr. Brent Reifsteck – chose to have his kids vaccinated, and he’s urging others to do the same before fall, when school starts and the more contagious Delta strain could become the dominant virus strain in Illinois.
His children were vaccinated once they reached the minimum age of 12, he said, and if he had an 11-year-old child on the verge of being eligible for the COVID-19 vaccines, that child would be “first in line.”
“The studies done so far and the results we have tell us that vaccination is much better than getting the disease,” said Reifsteck, head of Carle’s pediatric services.
Contrary to the potential for long-term side effects of the disease, any side effects from the vaccine would manifest themselves quickly, Reifsteck said. And most of the 3.04 billion doses administered worldwide were given 30 to 45 days ago, he said.
“If we were seeing a long-term effect from a vaccine, we would have seen it,” he said.
Reifsteck said he hears concerns that the mRNA vaccines aren’t around long enough for parents to feel comfortable with for their children. But while mRNA vaccines may be new to the public, they’re not really new, he said.
“It’s been studied and experimented with for decades,” he said.
As a co-parent, Reifsteck said he understands that the decisions parents make for themselves don’t weigh as much on them as the decisions they make for their children.
“Every parent should hear reassurance that these fears are normal,” Reifsteck said.
So here are some things he said parents should consider:
What is the risk of MIS-C for unvaccinated children?
As of June 2, there were 4,000 cases of childhood multisystem inflammatory syndrome (MIS-C) in the US, according to the Centers for Disease Control and Prevention.
Carle Foundation Hospital had an adolescent hospitalized with MIS-C this week, and has had a handful of MIS-C cases over the course of the pandemic, according to Reifsteck.
While COVID-19 is typically not serious in most children and cannot even be diagnosed due to the absence of symptoms, children can still get MIS-C two or three months later, “and that can be really, really dangerous,” he said. .
Symptoms of MIS-C for parents to watch out for — and call their doctors — include a rash, red eyes, enlarged lymph nodes, peeling on hands and feet and a “dilapidated” feeling, Reifsteck said.
Depending on the severity of the illness, children may only need pain and fever control. More severe cases will need to be treated with steroids and recovery will take a little longer, but most children will recover, Reifsteck said.
What is the risk of myocarditis for vaccinated children?
Parents should be aware that myocarditis was rare before the pandemic and still is, Reifsteck said. Cases after receiving an mRNA COVID-19 vaccine are 0.0004 percent across all ages among 300 million vaccinations, he said.
There are 323 confirmed cases of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the outer layer of the heart) in people under the age of 30 – mainly in men – of which 309 were hospitalized and 295 discharged, the American Academy of Pediatrics reported in late June.
After the CDC’s Advisory Committee on Immunization Practices recently met and reviewed myocarditis/pericarditis following the COVID-19 vaccine, federal health officials and physician organizations continued to push for childhood vaccination.
“The facts are clear. This is an extremely rare side effect and only an extremely small number of people will experience it after vaccination,” they said in a joint statement dated June 23. “Importantly, for the youth who do, most cases are mild and individuals often recover on their own or with minimal treatment. In addition, we know that myocarditis and pericarditis are much more common when you get COVID-19, and the risks for the heart of a COVID-19 infection could be more serious.”
Signs of myocarditis/pericarditis that parents should watch out for, Reifsteck said, include chest pain, chest pressure, shortness of breath and palpitations.
For parents who are still undecided about vaccinating their children, Reifsteck said it’s important to understand what can happen if unvaccinated children go back to school.
When COVID-19 first broke out, it had a general population reproductive number of 3 — meaning one infected person would pass the virus on to three people. On cruise ships, the reproduction number was more like 14, Reifsteck said.
Further into the pandemic, as more people have been vaccinated, the reproduction number for COVID-19 dropped to between 1.05 and 1.10, he said, but has risen again with the arrival of the Delta variant to between 2.5 and 1. 4.
Although schools are not cruise ships, Reifsteck warned that the reproduction number will always be inflated if a number of people are in a confined space.
And while current vaccines are believed to protect against the Delta variant, it’s scary to think they might not work on a future mutation, Reifsteck said. The more people vaccinated, the smaller the chance that those mutations will develop.
“The only way for us to get to the other side is vaccination,” he said.
Carle offers COVID-19 shots at school so parents can care for both in one visit, Reifsteck said.
Christie Clinic will also provide school-based COVID-19 vaccinations and sports physical therapy if vaccine supply allows, according to Christie pediatrician Dr. Maria Louisa Maranon.
“The Christie Clinic Department of Pediatrics is urging parents of patients 12 years and older who have not yet received their vaccination to make an appointment by sending a MyChristie patient portal message or by calling their pediatrician,” said they.