Like most pediatricians, I like a vaccinated child. While researching my book on the decline in child mortality over the past century and a half, I tried to imagine what child practice and parenting would be like if you had to accept that a whole host of potentially deadly diseases – polio, diphtheria, tetanus, whooping cough – could not be prevented or treated. Some kids just wouldn’t survive. But by the time I was training, we had vaccines to prevent those diseases, as well as antibiotics to treat bacterial infections. Even more progress has been made in the field of vaccines since the 1980s, when I did my residency. Pediatricians at the time were still hospitalizing many children for rotavirus infection and treating their dehydration with IV fluids (and those kids were lucky, because kids all over the world were dying from that infection and from dehydration). Doctors were doing epidural after epidural on children with high fevers and concerned about bacterial meningitis.
We are now vaccinating against rotavirus. We perform far fewer epidurals. And we vaccinate against diseases that are unpleasant, but usually not fatal. I had a pretty miserable case of chickenpox when I was a kid, in the 60’s, and I still have a few scars from it. My youngest got the chickenpox vaccine. He never had to scratch feverishly, never had to risk skin infections, never had to be sick of this disease. Instead, a vaccine activated all of its intricate defenses.
I love vaccines, but I also understand that parents have every right to think critically about decisions for their children, and that the story of COVID-19 vaccination is evolving rapidly. Some parents question whether the risk of serious illness in younger children is high enough to justify the risks of a new vaccine. Other parents worry that their children are vaccinated primarily to protect more vulnerable adults. Some are afraid of the vaccines because they have heard that they are dangerous in some way that is covered up. And others say they just want to wait until more information is available.
Let me address those concerns one by one. Children ages 12 to 15 and even younger are at a lower risk than the elderly for a severe case of COVID-19, that’s right. The vast majority of people requiring intensive care are adults. But more than 300 children in this country have died in the course of the pandemic, according to the American Academy of Pediatrics. In comparison, the CDC reported 188 flu-related deaths in children during the 2019-20 flu season. And the CDC has now registered more than 3,700 cases of childhood multisystem inflammatory syndrome, or MIS-C, a serious condition linked to COVID-19. Children now account for more than 22 percent of all new cases of COVID-19, and even children who are not very ill can face potential long-term complications. At the very least, those who test positive for the virus but are asymptomatic will still have to go through the hassle of quarantine. Compare all of these factors to what a vaccinated child may experience: brief acute reactions, including injection site pain, fatigue, fever, chills and muscle aches – all signs that the immune system is being activated.