The Covid-19 response team of the national government has already announced that the inoculation of children five to 11 years old will start on February 4, 2022 as the vaccine supply for this age group is set to arrive last week of January.
But is the government really ready? Even the kids? The Food and Drug Administration (FDA) already approved Pfizer BioNTech for use to vaccinate the five to 11 age bracket and is awaiting the arrival of the vaccines while vaccinators are already being trained on how to administer the doses to kids.
What do we know about Covid-19 in children?
During the latest episode of the TV UP webinar series “Covid-19 Pediatric Vaccination: Ready na ba Tayo?,” organized by the University of the Philippines together with UP Manila National Telehealth Center and in cooperation with UP Philippine General Hospital, Dr. Enrique “Eric” Tayag, Epidemiologist and Public Health Expert Director IV, Department of Health – Knowledge Management and Information Technology Service (DOH-KMITS) said that children, just like adults, are susceptible to Covid-19.
Incidence is also similar to adults despite the low risk of exposure, and testing is infrequent to confirm diagnosis. “Many parents don’t suspect if it is Covid-19 because many of them are already used to the usual cough and cold,” he said.
Also, Dr. Tayag said up to 18 percent of laboratory-confirmed Covid-19 cases are children though the actual number of cases are deemed underestimated since symptoms are mild and most likely were not tested. The incidence of Covid-19 in children also increases as age increases based on studies.
Infections occur in children when they are exposed to an adult who is an Index Case while secondary attack rates were noted at over 75 percent, and transmission from asymptomatic kids were reported as well, while reinfections can also occur.
The risk factors for Covid-19 in children, he said, can be from an infected household member, visitors at home, and gatherings with non-household members present. With regard to face-to-face classes, Dr. Tayag reported that children get infected not because of attending the classes but due to the inconsistent use of masks, while asymptomatic infections can range from 15 percent to 42 percent.
Children also have similar symptoms as adults but frequency may vary and typically includes, fever or chills and cough. Children with underlying conditions have higher rates of hospital and ICU admissions. Fortunately, most children with Covid-19 recover in about four weeks, while SARS-CoV-2-related deaths in children are rare, but may also be susceptible to long Covid, or its after-effects.
The Global Advisory Committee on Vaccine Safety (GACVS) concluded that in all age groups, the benefits of the mRNA Covid-19 vaccines in reducing hospitalization and Covid-19 deaths still outweigh the risks.
Considerations
The World Health Organization Prioritization Roadmap, according to Dr. Tayag, said that focus should be to protect sub-populations with highest risk of hospitalization and deaths. “So are the children in this age bracket considered as sub-population?”
He also said that countries with few or no vaccine supply constraints should consider issues like global equity when making policy decisions about vaccinating children and adolescents.
“Many countries have not even started their first doses, or simply marginal if they did. Many are still ramping up to achieve the 40-percent vaccination target. And although safety and effectiveness of vaccines have been proven, the stringent regulations should be followed, and maintaining education for school-aged children should be an important priority during this pandemic,” he said.
Many countries have already started vaccinating this age group, Dr. Tayag said, which include the USA, Canada, Spain, Italy, France, Bahrain, China, Venezuela, Argentina, Costa Rica, Israel, Saudi Arabia, UAE, Oman.
The Philippines targets to vaccinate at least 12.5 million five to 11 year-olds by the first quarter of this year, plus booster shots by the third quarter of 2022.
How are we getting ready?
The FDA already provided an Emergency Use Authorization (EUA) to Pfizer last December 23, 2021 for use on five to 11 years old. The Philippine Pediatric Society (PPS) and the Pediatric Infectious Disease Society of the Philippines (PIDSP) already issued a joint position statement, which said that priority should be in areas with reported high local transmission, children in the A3 (or children with co-morbidities) category, the A1 or children of medical frontliners. “The groups also cautioned implementing agencies that due diligence should be applied to ensure vaccine equity and access.”
Guidelines from the Health Technology Assessment (HTA) Council, the National Immunization Technical Advisory Groups (NITAG), and the National Vaccination Operations Center (NVOC), however, are still pending.
“The procurement of the appropriate Pfizer vaccines is also pending since they will come in a different formulation, but the townhall meetings for healthcare workers are scheduled next month, while social mobilizations are already being planned so I hope the local government units are being implemented it already,” he said.
He said pre-registration is now ongoing at least in the City of Manila, while vaccine team volunteers are already being signed up, and awareness building via social media and other forms of publicity are being prepared.
Preparing for the jabs
How do we prepare kids for vaccination? Dr. Tayag suggests to prepare them days ahead so the experience will be less upsetting, that they understand how the vaccines will protect them and those around them, including playmates, and explain that there may be unpleasant experiences on the first jab to help encourage them to go back for a second one.
Parents should not be in a hurry and allot enough time to explain to their kids what to expect in the vaccination process and alleviate their fears and concerns. “Perhaps it would be best if the explanation is accompanied by photos and other visuals for them to better understand, or substitute words like using Pisil [pinch] instead of Turok [injection].”
On vaccination day, they can be distracted unexpectedly when about to be injected, to close their eyes and learn how to handle crying, or sitting beside them or holding their hands during the ordeal can be of help to take away their fears. Putting ice packs on the injection site can also be of help, or even a gift/reward after injection to provide comfort and joy and take their mind off the pain.
And remember to tell them to keep their masks on. “Let’s all pursue to make children’s future safe and brighter each day,” Dr. Tayag said.
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