A quick Christmas Eve Eve post on a very serious topic.
The list of problems caused by the SARS-CoV-2 pandemic is long and, in some cases, more than a bit surprising. Clearly the death and suffering of millions of people around the world tops that list. You’ll get no argument from me or, I think, anyone else here about that. Then there is the unfortunate economic upheaval that most, if not all, countries have been dealing with.
But I’m a pediatrician, so what about the kids? Won’t anyone think about them? Yes! Unsurprisingly, children have also suffered greatly over the past nearly three years. In the United States alone, there have been roughly 15 million documented pediatric COVID-19 cases, which is undoubtedly a massive underestimate of the true incidence. And in addition to the direct repercussions of infection, with a not-insignificant number of deaths and many more hospitalizations for severe disease, children have also had to deal with a variety of other problems, not all of which could have been predicted. Nobody was expecting MIS-C in early 2020, for example.
Adding to the possibility of that severe and even life-threatening inflammatory condition, even children with only mild COVID-19 are at increased risk of developing diabetes, to give just one of several more examples. There have also been significant increases in ED visits and hospitalizations for mental health crises in our teen and young adult populations. This really is just the tip of the iceberg as there are a number of post-COVID-19 conditions that have been seen in children, with as many as 25% still having symptoms a month after diagnosis. Between 2% and 10% of children diagnosed with COVID-19 will ultimately develop the more disruptive syndrome of post-acute sequelae of COVID (PASC), also known as “long COVID”.
But today I want to discuss a different issue related to the pandemic that is indirectly harming children and has the potential to do so for a very long time. During the peak of the pandemic, when people were trying to stay home and avoid COVID-19, millions of children got behind on their routine immunizations. This was, and is, a worldwide phenomenon. The WHO recently estimated that 40 million children missed a dose of the measles vaccine in 2021 alone, putting them and potentially millions more around them at risk of developing this potentially deadly disease.
In addition to lack of access, the pandemic has also appeared to fuel a wave of anti-vaccine sentiment in the United States. Being against routine childhood immunization, something that has saved countless lives and prevented suffering in so many innocent children, is becoming a plank in the GOP platform. This growing number of people that are wary of vaccines is adding to the number of children who will not be protected from vaccine-preventable illnesses.
I’ll finish up by letting you know what’s going on in central Ohio, where a measles outbreak among children is currently underway. Since late October, more than 70 children have been diagnosed with measles and 26 of them have been sick enough to require hospitalizations. Remember, despite it’s often bland portrayal in sitcoms and cartoons of the past, something that has been wielded as an anti-vaccine talking point, measles is a terrible illness that historically put 25% of infected kids in the hospital and killed 1-2 per 1000.
37% of the infected children in the current Ohio outbreak have been hospitalized so far, which underscores the fact that we don’t have effective treatments. There is no modern medical anti-viral triumph that cures this disease. There is supportive care and correcting vitamin A deficiency, which has been linked to increased risk of death. The modern medical triumph was the vaccine.
All of the 73 children infected with measles in Ohio, at least through last week, were not fully vaccinated against the disease, with 67 of them having not received any doses. 17 of the infected children were too young to have received their first dose. So for most of these kids, their caregivers made a choice to avoid the vaccine.
On that unfortunate note, I hope that everyone out there reading this is happy, healthy, and enjoying the holiday season. Stay warm, stay safe, and see you next year!