CHILDREN, COVID-19 AND VACCINES

EXPERTS DISCUSS THE RISKS AND BENEFITS OF INOCULATING CHILDREN

With an accelerated vaccine drive ongoing, Sri Lanka is well on its way to achieve its vaccination goals ahead of the September target set out by the World Health Organization. With the Delta variant of Covid-19 essentially bringing down the country’s hospital and care system to its knees, the mass vaccination of vulnerable groups have provided a sense of relief for many.

Children would be the next group to be vaccinated once the population of 30 years and above are inoculated

Globally the Pfizer vaccine has been recommended to inoculate children against Covid-19

When the asymptotic viral load is very high among adults, leaving children unvaccinated may make them vulnerable

Children with underlying risks have been suggested to be included in stage two of the vaccination roadmap

An estimated 25,000 children with underlying risks or comobidities need to prioritized

Concerns emerge over vaccine causing inflammation of the heart muscle and tissue

If all goes as planned, and if Sri Lanka somehow survives the impending wave of the Delta spread, the next target group for vaccinations would soon include children. State Minister of Production, Supply and Regulation of Pharmaceuticals Prof. Channa Jayasumana claimed that Sri Lanka is exploring the possibility of administering the vaccine to children between the ages of 12 to 18. This is following a request made by the

Education Ministry to vaccinate school children in order to reopen schools as soon as possible.

Minister Sudarshani Fernandopulle meanwhile speaking to the Daily Mirror said that the government has not reached a final decision in this regard. “There’s been no final decisions in this regard. The Vaccine Committee must first make approvals. As far as I’m aware there has been no decision about which vaccine would be used. Although internationally, the Pfizer vaccine has been recommended to inoculate children against Covid-19. In Sri Lanka, children would be our focus once the 30 and above population is vaccinated,” the State Minister of Primary Health Care, Epidemics and Covid Disease Control said.

At a recent webinar discussing the vaccination of children against Covid-19 organized by the

Sri Lanka Medical Association, several expert medical professionals discussed the possibilities, risks and challenges of inoculating children in Sri Lanka against this deadly virus. Consultant Pediatrician and Neonatologist Dr. Surantha Perera speaking at the forum said that in the United States an estimated 191, 641 individuals under the age of 23 years were hospitalized due to the illness, highlighting the vulnerability of this group.

He added that when the asymptotic viral load is very high among individuals, leaving children unvaccinated may be a cause for concern. “Children with underlying risks have been suggested to be included in stage two of the roadmap for prioritizing target vaccine groups,” Dr. Perera said. According to the experts, the US Centre for Disease Control recommends the Pfizer vaccine for children over 12 years of age, where the second jab should be administered within a period of three weeks.

CONCERNS OVER RISKS OF HEART INFLAMMATION

Meanwhile Emeritus Professor of Paediatrics Sanath Lamabadusuriya queried if children with existing heart conditions should be administered the vaccine. The professor is not alone in sharing this concern. Globally parents have shown some hesitation in administering the vaccine to their children in response to several reports that kids could develop conditions called myocarditis and pericarditis after COVID-19 vaccination.

According to Harvard Health Myocarditis is inflammation of the muscle of the heart, and pericarditis is inflammation of the tissue that forms a sac around the heart. While there are a number of possible causes for these conditions — infections, especially viruses are known to be a common cause. While in some cases

myocarditis and pericarditis have been caused by autoimmune conditions such as rheumatoid arthritis, heavy metals and radiation are also probable causes. In rare cases it has also been caused by vaccines.

Senior Faculty Editor of Harvard Health Publishing Dr. Claire Mccarthy writes that in the US about 1,000 cases of these conditions have been reported after vaccination against Covid-19. According to the numbers, this is considered as a low risk. The cases have been most common in male adolescents and young adults, occurring most often after the second dose, and usually within several days of receiving the vaccine. The majority of cases have been mild. Experts are still gathering information, but as of this writing, 79% of teens and young adults who experienced this had recovered, she wrote.

The Sri Lankan experts discussing this issue debated that the benefits of vaccination outweigh the risks of inoculation against Covid-19. Dr. Surantha Perera stressed that in the event approval is granted to vaccinate children, those with underlying conditions would need to be examined by paediatricians at hospitals, where they will be filtered for possible inoculation. “If vaccinated, complications are rare, but the children would need to be monitored nevertheless. There would be a need for surveillance for side effects for at least 6 weeks,” he said. Therefore medical bodies are currently looking at the possibility of developing a mobile app and a web-based query service for parents who wish to have their questions and concerns answered by medical professionals.

The experts also discussed that children would most likely be vaccinated in September this year, while children with comorbidities (simultaneous presence of two or more diseases or medical conditions) would be included the immunization plan. “If the government approval is granted these children with comorbidities would be prioritized. We have a rough estimate that this would include about 25,000 children comorbidities.