Transcription:
COVID Vaccines and Kids: What Parents Need to Know

Caitlin Whyte: According to a survey by the Kaiser Family Foundation, 43% of parents with children under five say they will definitely not get them vaccinated against COVID-19. Only 7% of parents say they have had their young children vaccinated and 27% want to wait and see how the vaccine impacts other young children first.

Dr. Deepa Yerram, Chief Medical Officer at International Community Health Services is here to talk about the importance of vaccinating our youngest children against COVID-19.

Welcome to the Together We Rise Wellness Podcast from International Community Health Services. I'm your host, Caitlin Whyte. Well, doctor with the vaccines for children five and under being so new still, you know, there are many parents who are hesitant or they may feel that a vaccine isn't necessary for their young children. So why should parents get their children vaccinated against COVID-19 right now?

Lakshmi Deepa Yerram, MD, MHA: Well, there are multiple different reasons and I will kind of walk through all of them. So the first and foremost thing is that the vaccine helps prevent kids from getting COVID-19, and there are no two ways around that. So although we all know that COVID-19 in children is sometimes milder than what we see in adults, some kids infected with the coronavirus can get severe lung infections, become very sick and require hospitalizations. And we read reports on children, unfortunately, passing away from this infection.

And on top of that, children also have complications such as the multisystem inflammatory syndrome in children, which may require intensive care or long lasting symptoms that can affect their health and wellbeing. And so the virus can cause death in children, although this is rarer than adults and there is great amount of information out there that vaccination decreases these risks.

The second point that I would like to make is that the vaccine helps prevent or reduce the spread of COVID-19. So like adults, children can also transmit the coronavirus to others if they're infected, even if they have no symptoms. So getting the COVID-19 vaccine can protect the child and others, reducing the chance that they transmit the virus, and this includes grandmas and grandpas and all the other family members and friends who may be more susceptible to the severe consequences of this infection.

And the third thing, which kind of has been on all of our minds with all these new variants showing up is that getting vaccinated for COVID-19 can help stop other variants from emerging. So as the cases of COVID-19 are increasing among children, we see that the variants appear to be playing a huge role in that. So reducing viral transmission by getting vaccinated also reduces the virus' chance to mutate into new variants that potentially can be growing more dangerous. So as long as the virus can transmit easily between unvaccinated children and adults, we are giving the new variants a chance to emerge. So the best way to stop that is make sure everyone who can get vaccinated gets vaccinated.

The second last point that I would like to make, which is probably very important for several parents out there, is that having your child vaccinated for COVID-19 can help restore a more normal life for us. So vaccinating the children, as I stated previously, reduces the risk of being infected with COVID-19, which keeps them from getting sick, which also means that they can stay in daycare and schools to continue their education uninterrupted. Older siblings can be more likely to be able to participate in sports and their clubs or we can do all the fun activities like play dates and spending time with friends outside of the house. And more importantly, you're more likely to have uninterrupted travel plans. So per the new CDC guidelines around isolation and quarantine that just came out last week, vaccinated children without symptoms may not be required to quarantine after exposure to someone who tested positive for COVID-19, which also keeps the parents working interrupted.

The most important point that I would like to stress is that COVID-19 vaccines are safe. So the decision by FDA and CDC to recommend Pfizer and the Moderna COVID-19 vaccination for younger kids six to less than five years old, followed an extensive review of safety, immune response and efficacy data. So children can have some mild side effects, very similar to what they would get from routine childhood vaccination. But the likelihood of having a severe side effect from vaccination is very rare. And the governmental agencies continue to monitor these vaccines for safety.

So when you take all of these points into account, we know that this vaccine is safe. We know this is going to make our life better and easier. We know it's going to reduce the variants from emerging, and we know that it is going to keep our kids safe. So I don't see any other way how I can stress of why it is important for every child, including those five and under to get this vaccine.

Caitlin Whyte: Well, you mentioned side effects and I'd love to focus on those for a few moments. Can you tell us about what we're seeing with COVID vaccine side effects in infants and younger children?

Lakshmi Deepa Yerram, MD, MHA: It is pretty much similar to the other routine vaccines that are out there. So you and your child might notice pain at the injection site and the kids might feel a little bit more tired than usual. And all the side effects are usually temporary and generally clear up within 48 hours. And because we are talking about infants now, and infants are unable to express achiness for the most part, so we should expect to see the children to seem a little fuzzy or tired and maybe experience a fever after the COVID-19 vaccine. And mind you, this is all very similar to what you or they might experience after other routine vaccines. And these types of side effects are the result of your child's immune system responding to the vaccine and mounting a strong defense against COVID-19.

So talking about side effects, we should definitely talk about myocarditis and pericarditis. And since April 2021, there have been more than a thousand reported cases of myocarditis, which is the inflammation of the heart muscles and pericarditis, which is the inflammation of the lining outside the heart, which can occur after some COVID-19 vaccination. But considering that hundreds and million of COVID-19 vaccines have been administered, having a thousand cases kind of make it a very rare side effect. This problem occurs more often in teens and young adults, particularly in males. And myocarditis or pericarditis in most cases is mild and resolves quickly. And myocarditis is actually a much more common complication of having COVID-19, rather than from getting vaccinated. So I wanted to talk about myocarditis and pericarditis because we see reports of this very often and kind of majority of the patients have been citing this as a reason for not getting vaccines. And believe it or not, even the most severe complications such as myocarditis and pericarditis is, A, very rare and, as I said, you are more likely to get it from an infection rather than from the vaccine.

Caitlin Whyte: So then, what is your advice to parents who are still very worried about the side effects even with this information?

Lakshmi Deepa Yerram, MD, MHA: So both the Moderna and Pfizer clinical trials, and we all know from news media reports that this extended for months and months, and both these trials actually included thousands of children aged six months to two years, and several more thousands of children aged two to five years. And within each age group, most children received the COVID-19 vaccine and a smaller number received a placebo. So it is important to understand that absolutely no steps were skipped during the clinical trials for these vaccines. The vaccines went through extensive reviews and safety monitoring, and then the final trial data shows that the vaccine is just as safe in young children, as it has been in the older kids and adults.

And we can get more into the whole process of how the Federal Drug Administration and CDC kind of actually looked through the data around vaccine trials and how they approved, but what I can tell you all in short is that it is a multifaceted multistep process. And even if one step doesn't seem to be clicking in the way it should, the clinical trial is either thrown off or you have to repeat it all over.

So all this information kind of makes me assured, assured enough to get both of my young children vaccinated, that the vaccines that we have for kids, be it at any age, is perfectly safe. And I would also like to stress that food allergies or any other allergies in general have been found not to be a contraindication to receive the COVID-19 vaccine.

Caitlin Whyte: Well, it's of course back to school season, so we have to talk about heading back into those buildings. Does back to school increase the risk of children catching or transmitting the coronavirus?

Lakshmi Deepa Yerram, MD, MHA: Yes, it does. So transmission of the coronavirus can occur in schools and the clusters have been reported in all types of school setting, be it the preschools, the primary or the secondary schools, or even daycares. But I have to say that the transmission of the coronavirus in schools definitely appears to be affected by how widespread the virus is in the broader community. And we have previously talked about how children who do not develop symptoms when infected, especially the kids with the milder versions of COVID-19, they can still transmit the virus, correct? And we have to imagine schools and daycares as being these confined spaces. And schools have been putting important measures in place to prevent the spread of infections such as physical distancing and improved ventilation. There are stay-at-home-when-sick policies around. All the schools have been stressing, proper hand hygiene and regular hand-washing. And we as parents should definitely consider the use of masks when feasible, when the kid is amenable to kind of wearing this mask. So all these steps are being taken at the school's end to kind of prevent the spread of virus in their settings. And as these reduce the transmission of the virus, we have to remember that vaccination also plays a key role by reducing the risk of transmission and infection.

Caitlin Whyte: And I know ICHS serves highly diverse communities, including immigrants, refugees, and communities of color. Can you tell us what you've seen with vaccine hesitancy among these populations and how you're addressing any concerns within them?

Lakshmi Deepa Yerram, MD, MHA: Yes. Amongst our several patient populations that we serve, Asian-American population tends to be the dominant. But we do service black, Pacific Islander, Latinx and other communities of color. And all of these groups have been disproportionately impacted by the COVID-19 pandemic, especially in terms of the number of cases and fatalities. The factors rooted in inequities such as the social drivers of health and how they intersect have played a very large role in the heightened risk faced by these communities. And we have to remember that all these populations, these diverse communities, come from a place where there has been distress. And there has been issues with lack of access to healthcare and stigmas and stereotypes around poor hygiene and carrying disease.

All of the populations that we serve, they have been overrepresented in high risk jobs, such as the food and the service industry. And they have greater burden of chronic disease, which are associated with worse COVID-19-related outcomes. Several of our patients live in multigenerational households or crowded living condition. They deal with risks associated with immigration status and definitely there are barriers to healthcare.

So all these factors make a person. And the general distrust that comes with the governmental organizations and structured medicine leads to the hesitancy among the populations that we serve. And these are all our patients. And so we had to sit down and develop tactics to ensure that our patients got the latest information on infections and vaccines and thereby increasing vaccination rates and reducing complications from the infection.

So there were two key tactics that was employed by ICHS and one was circled around communication. And the other was around the ease of vaccines. So talking more about communication, what we decided really early on and have continued to do so is to provide outreach in their spoken language. And this could be over phone or in person and the community health workers, which is a subgroup of our organization, they are out in the community talking and providing information and vaccination to the patients when they're ready. And we have been organizing several in-person outreach events in the form of fairs and popups. And then, popups are also where the patients can get vaccinated.

We kind of developed communication strategies and including the marketing team in the whole process, hence making sure that we are regularly passing up-to-date information to the patients in various languages. Our patients speak 70 plus languages. So all of those linguistic differences have to be included when we are passing the information. And we have been utilizing various channels to pass that information such as social media, radio networks, and podcasts, such as this one and short videos, films, and interviews. So we have been everywhere where we could be trying to pass the correct information out to our patients and ensuring that they are getting the latest and the most evidence-based information that is available around this vaccine.

We have been also trying to pass on tailored messaging to audience segments, such as our youth groups. And what is it that youth like most? Minecraft. And we had utilized Minecraft-based messaging to this particular subgroup. And of course, the most important of it all is the personal conversation that the patients can have with their trusted providers, be it their primary care providers, the dental, the behavioral health or the pharmacy providers.

So once we have communicated to the tilt and we have ensured that they understand the importance of vaccination and they're ready to get the vaccine, we had to make sure that there was ease of vaccination. And we did that, and we are doing that by making sure that they can get vaccinated during their clinic visits, hence sparing a separate visit for this particular service. We have and have been running high-volume vaccination sites at almost all of our clinic sites. Our pharmacy has continued to provide walk-in services to both our patients and non-patients, and they can get vaccinations at demand. As previously kind of alluded to, we have continued to organize popup clinics, which are kind of structured by our community health worker teams at various community gathering places where patients live, such as the grocery stores or religious institutions and social community centers, schools, et cetera. And so by making sure that proper information gets out and by ensuring that they can get vaccines, as they get ready for the vaccines, we have continued to make sure that our patients can reap the benefits of the vaccines that are currently available for COVID-19.

Caitlin Whyte: Well, such important information, doctor, especially heading into this new school year. Thank you so much for your time. Check out our website, ichs.com, for more information, and remember to subscribe and share this show with your loved ones. And thank you for listening. This has been the Together We Rise Wellness Podcast from International Community Health Services. I'm Caitlin Whyte. Be well.