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Why, you may ask, are we now vaccinating children ages 5 to 11 against the COVID-19 virus? You’ve probably heard that serious effects of the virus in young children are rare, and you have heard correctly. So why vaccinate?
I will answer by broadening the question: Why do we vaccinate children at all? The answer is twofold: first, to protect children from disease, and second, to prevent children from spreading disease to others.
To protect young children we vaccinate them against a number of diseases that were once very common, and were capable of causing severe illness, disability, or death. While they are now extremely rare, they haven’t been wiped out, and we don’t want them back. Two examples:
Polio. In the 1950s there were between 10,000 and 20,000 cases per year of paralytic polio. This disease could leave a person requiring leg braces, or a wheelchair (as in the case of FDR), or an iron lung. Widespread vaccination eradicated it from the Western Hemisphere, but it still exists in parts of Asia and Africa. We vaccinate because we don’t want it back.
Diphtheria. This is a respiratory infection that can damage the heart as well. My grandmother’s sister died from it in the 1890s. It caused over 100,000 infections and 13,000 deaths each year in the 1920s. It is now extremely rare in the U.S., but more common in other parts of the world, including Africa, southern Asia, and more recently it has made a comeback in Venezuela. We vaccinate because we don’t want it back, either.
To prevent children from spreading disease, we vaccinate against other formerly common conditions. One example:
Rubella. Also called German measles, it is usually a mild, self-limiting disease in children, with little fever and a mild rash. But if a woman in the first three months of pregnancy is infected, her baby can miscarry, or be born dead or with severe defects of the heart, brain, eyes, ears, and bones. In 1964-65, there were 12.5 million cases of rubella in the US, with 11,000 miscarriages, 2100 stillbirths, and 20,000 babies with birth defects. In the 1970s, rubella was nearly eradicated by vaccination. We vaccinate children for rubella, because we definitely don’t want this one back.
What does this have to do with COVID? Both reasons apply. In the last 20 months in Virginia, 555 children under age 10 have been hospitalized with COVID-19, and six have died. Much less common than in adults, but very bad outcomes if it’s your child. Second, young children are able to spread COVID to others, and this is especially of concern during the holiday season where visits to elderly relatives are common. Adults suffer long-term effects from COVID, and in those over 80 who are unvaccinated, infection carries roughly a 20% fatality rate. Even vaccinated elderly are not without risk.
We offer vaccination against COVID to children for the same two reasons we offer them for other diseases: to protect the children from rare but serious disease effects, and to prevent them from spreading a highly contagious and dangerous disease to elderly and infirm relatives and contacts.
With the holidays approaching, now is the time to give serious consideration to vaccinating your children against COVID-19. Discuss concerns with your child’s physician. Vaccines are available from certain primary care offices; several local pharmacies are offering them as well; they can be located at vaccines.gov. The Rappahannock-Rapidan Health District is collaborating with the local school districts to offer vaccination clinics at selected schools; call your child’s school for more information. Finally, RRHD is offering a variety of COVID vaccines, including those for 5-11 year-olds, out of our clinic at the Reva Fire Department. For dates and times, please visit rrhd.org, or call 540.308.6072.
Dr. Greene is a retired Army family physician, and is serving as the acting director of the Rappahannock-Rapidan Health District, serving Rappahannock, Culpeper, Fauquier, Madison and Orange Counties.