@DrJenner I am going to ask you a question and would like to know what your thoughts are. Last year when this virus hit, our young people were not getting sick for the most part, but of coarse there was a few exceptions with ones that already had health issues. This year, we have seen more and more younger people getting infected, that is a fact, but we have also been vaccinating more of our young people and then also seeing more health issues popping up after the vaccine, like an enlarged heart. Do you think there is a link? Are we doing more harm trying to vaccinate the younger generations?
The CDC just published a paper
using data from the Coronavirus Disease 2019–Associated Hospitalization Surveillance Network (COVID-NET).
https://www.cdc.gov/mmwr/volumes/70...tember 3, 2021&deliveryName=USCDC_921-DM65137
This is a database of COVID-19–associated hospitalizations in 99 counties across 14 states. Scientists looked at pediatric hospitalizations from March 1, 2020–August 14, 2021. What did they find?
- The cumulative number of COVID19 hospitalization was 49.7 per 100,000 kids
- Rates were highest among children aged 0–4 years (69.2 per 100,000) and adolescents aged 12–17 years (63.7 per 100,000)
- Rates were lowest among children aged 5–11 years (24.0 per 100,000)
- Among pediatric COVID19 hospitalizations, 26.5% were admitted to an ICU, 6.1% required ventilation, and 0.7% of the children died
The rate of hospitalizations has dramatically increased in the past month
- Pediatric hospitalization rates are 5 times higher in August compared to June
- The biggest increase was among 0–4 year olds, with a COVID-19 hospitalization rate 10 times higher in August compared to June
- The hospitalization rate among unvaccinated adolescents (aged 12–17 years) was 10 times higher than that among fully vaccinated adolescents
COVID-19–associated weekly hospitalizations per 100,000 children and adolescents,* by age group — COVID-NET, 14 states,† March 1, 2020–August 14, 2021 (3-week smoothed running averages)§
But, this isn’t necessarily because Delta is more severe
To assess severity of Delta compared to previous variants, hospitalizations were split up into two time periods: before Delta (March 1, 2020–June 19, 2021) and after Delta (June 20–July 31, 2021).
- The rate in which kids died, were admitted to the ICU, needed oxygen, or ventilation was not statistically different during Delta compared to before Delta:
- Before Delta: 26.5% were admitted to an ICU, 6.1% required ventilation, and 0.7% died
- After Delta: 23.2% were admitted to an ICU, 9.8% required ventilation, and 1.8% died
So, Delta is not likely more severe for kids. Increasing pediatric hospitalization rates are due to high transmission in the community.
The CDC also published a second paper
recently, but it’s less surprising. This study looked at hospital records across states to see whether state-level vaccination rates impacted pediatric hospitalizations. In other words, does the vaccine immunity wall help kids?
https://www.cdc.gov/mmwr/volumes/70...tember 3, 2021&deliveryName=USCDC_921-DM65137
- Emergency department visits and hospital admissions are higher in states with lower population vaccination coverage
- Emergency department visits and hospital admissions are lower in states with higher vaccination coverage
Bottom Line: Pediatric hospitalizations have dramatically increased in the past month. Yes, the media is accurately portraying the situation on the ground. And, hospitalizations have increased the most for 0-4 year olds. Importantly, this isn’t because Delta is likely more severe, it’s because we are transmitting Delta in the community and our kids aren’t protected.
It’s been more than 8 months since 16-17 year olds have been vaccinated in the “real world” (i.e. after clinical trials) and more than 2 months since 12-15 year olds have been vaccinated in the real world. This is a critical time period because in the history of vaccines side effects have only ever popped up 8 weeks post vaccination.
Last week, the CDC published an update on the safety of vaccines among adolescents. Specifically, scientists published data from two surveillance systems: V-safe and VAERS.
***V-Safe Results***
V-safe is an active surveillance program in which the CDC proactively texts people to check up on them after vaccination. If someone reports a concerning or severe side effect, public health workers call that person to gather more contextual information.
Since December, 129,059 adolescents enrolled in the v-safe program (66,350 aged 16–17; 62,709 aged 12-15). What are the numbers telling us?
-49-56% of adolescents experience a side effect after dose 1. 63-70% report side effects after dose 2.
—-24% of adolescents were unable to perform normal daily activities the day after dose 2.
—-The most commonly reported side effect was fatigue, followed by headaches, muscle pain, and fever.
-0.5-0.8% of adolescents required medical care in the week after receipt of either dose
-0.02-0.04% adolescents were hospitalized (although, v-safe does not record reason for hospitalization, so we don’t know if it was related to the vaccine or not)
***VAERS Results***
The publication also highlighted VAERS data. This is a passive surveillance program in which people (or more commonly physicians) voluntarily report symptoms.
Take VAERS with a grain of salt. Anyone can post anything to this site leading to a number of biases. But, nonetheless, it’s been a useful tool to use throughout the pandemic to find safety signals.
From December to July 2021, there were 9,246 reports of adverse events for adolescents aged 12–17 years after vaccination.
-90.7% of the reports were for non-serious events like dizziness (20.1%), headache (11.1%), and fainting (6%; majority due to anxiety of needles)
-9.3% of the reports were for serious events, like chest pain (56.4%). Myocarditis was listed among 4.3% (397) of all reports
-CDC investigated 14 reports of death after vaccination, none of which have been causally linked to the vaccine. Cause of deaths were pulmonary embolism (2), suicide (2), head injury (2), heart failure (1), and bacterial infection (1). Six deaths are currently under investigation.
What are the latest myocarditis numbers? Other than the VAERS data above, the latest data we (the public) have on myocarditis is from the June 11, 2021 at an ACIP meeting. For adolescents aged 12-17 years old, there were 147 cases of myocarditis investigated by the CDC. This rate was higher among males compared to females:
-Females: 8 myocarditis cases per 1M. As a reminder, we expect 2 per 1M to happen in the background.
-Males: 63 myocarditis cases per 1M. As a reminder, we expect 4 per 1M to happen in the background. Observed is much higher than expected, signaling a link to vaccines
-No deaths linked to myocarditis
