Kids are less likely to acquire SARS-CoV-2. Most kids already had COVID-19.
Dr. Vinay Prasad is very good at coming up with very bad reasons as to why unvaccinated children should contract COVID. In his essay Should We Let Children Catch Omicron?, published when COVID was sending nearly 1,000 children to the hospital every day, Dr. Prasad argued that infected children should be used as human shields to protect more vulnerable adults. He said it was “natural and healthy” for children to get sick, and that we should accept that COVID will kill some of them “as a matter of course“. Elsewhere, he treated theoretical vaccine harms, even abnormal lab values, more seriously than actual COVID harms.
In a previous article, I discussed how he used two opposite data points to reach the same conclusion. In winter 2021, before there was any data about the pediatric COVID vaccine, he argued against it because:
Kids are less likely to acquire SARS-CoV-2, the virus that causes Covid-19, than adults.
In 2022, however, argued against the vaccine because:
Most kids already had COVID-19.
Whether cases were going up, down, left or right, Dr. Prasad’s conclusion was always going to be the same: unvaccinated children should get COVID.
Doctors’ time is limited
At times, Dr. Prasad got very creative and simply invented reasons to support his predetermined beliefs. In a “debate” on his monetized Substack, Dr. Prasad argued that vaccinating children against COVID would lower measles vaccination rates. He said:
Third, and finally, doctors’ time is limited. Routine childhood vaccine rates are slipping. Contrary to COVID-19 shots, the measles vaccine is sterilizing and high rates are needed to halt spread. Doctors must realize that pro-vax does not mean zealotry, but evidence first… To the proposition: Should doctors encourage healthy kids (11 and under) to be vaccinated against COVID-19?
I say, “No, Save your breath for routine vaccination”
Though he obviously didn’t intend for anyone to do so, it’s worthwhile to seriously think about his concern, as it shows how doctors who claim to value “data and evidence” were willing to make just make stuff up to advance their anti-vaccine agenda.
Even though babies, who have the highest COVID risk of all children, can be vaccinated against COVID at 6-months and they don’t receive the MMR until they are 12-months, Dr. Prasad imagined a scenario where pediatricians will be unable to vaccinate them against measles because their discussions on the COVID vaccine will run out the clock. In his dystopian vision, time will expire, pediatricians will walk out the door, and children will leave the office without any vaccines. Moreover, he suspects this won’t be a rare occurrence. He implies it will happen so often that we will lose herd immunity for measles. That’s how powerful and dangerous the pediatric COVID vaccine is, according to Dr. Prasad.
Dr. Prasad is right that routine vaccination rates are slipping, but he did not provide any evidence that time limitations imposed by the COVID vaccine are to blame. He just conjured it out of thin air. I queried several pediatricians and they all agreed- the COVID vaccine does not impair their ability to vaccinate children against measles. Pediatrician Dr. Christopher Hickie told me this about Dr. Prasad’s hypothesis:
Pediatricians can and routinely do promote all approved vaccines–it’s not the time crunch he baselessly imagines it to be, and I don’t know of anyone in pediatrics who thinks time is an excuse not to encourage COVID-19 vaccination.
While Dr. Prasad claims that only enormous RCTs for every variant can demonstrate the COVID vaccine’s benefits, he was fine just casually inventing reasons not to use it. Ho hum, I’ll just say pediatricians don’t have the time and we’ll lose herd immunity to measles.
Unfortunately, this was just one example of a larger trend where doctors required impossible standards of evidence for things they didn’t want to be true and no standards at all for things they wanted to be true. Whether they were extolling the The Triumph of Natural Immunity or declaring that COVID was mild for people under age 70, doctors were very comfortable just making things up. It happened all the time.
The agenda-driven disinformation that has been pushed out relative to Covid vaccines fed the fire of distrust and skepticism that is really sort of the new pandemic of hesitancy for routine vaccines.
I was deeply familiar with the anti-vaccine movement before the pandemic. I know that parents don’t refuse vaccines because pediatricians run out of time. Rather, they don’t trust what the pediatrician has to say. The anti-vaccine movement is fueled entirely by mistrust, and doctors who told the public You’re Right Not To Trust Public Health poured fuel on that fire. That’s why Dr. Prasad became a hero to anti-vaccine luminaries like American Loon #204 Robert Kennedy Jr. and American Loon #131 Barbara Loe Fisher. He speaks their language.
Unsurprisingly, Dr. Prasad has never advocated for the MMR outside of dunking on the COVID vaccine. His concern about children missing this vaccine is entirely vacuous and performative. He’s only ever been concerned that a child might receive the COVID vaccine. He wanted to prevent that at all costs.
In contrast, I advocated for vaccines long before the pandemic. Based on my experience, I have argued that confidence in the COVID vaccine will go hand in hand with confidence in other vaccines. To understand why, one only needs to read the very article that Dr. Prasad linked to- Routine Childhood Vaccinations in the U.S. Slipped During the Pandemic. It said that experts attribute falling vaccination rates to a “groundswell of resistance to Covid-19 shots spilling into unease about other vaccines.” It said:
Pediatricians said in interviews that those issues had also collided with growing levels of anti-vaccine misinformation aimed at the coronavirus shots, which they said had prompted more resistance to ordinary vaccines, too.
“There’s a greater proportion of parents who are questioning routine vaccines,” said Dr. Jason V. Terk, a pediatrician practicing in a suburb of Dallas who also acts as a spokesman for the American Academy of Pediatrics.
“The experience of the pandemic, and the agenda-driven disinformation that has been pushed out relative to Covid vaccines,” he added, had “fed the fire of distrust and skepticism that is really sort of the new pandemic of hesitancy for routine vaccines.”
The article also quoted a pediatrician who said:
All the rumblings about vaccines for kids and the misinformation that was going on at the time — that sort of amplified that particular segment of families, where ‘I’m distrustful of the flu vaccine and then I’m also distrustful of the Covid vaccine and maybe I’m starting to be distrustful of vaccines in general.’
In other words, pediatricians on the ground blame people like Dr. Prasad, an adult oncologist, for making their job more difficult and their patients more vulnerable.
Indeed, the available data supports the intuitive notion that confidence in the COVID vaccine is linked to confidence in all vaccines. Areas that discouraged the pediatric COVID vaccine are seeing their overall vaccination rates decline. There have been large measles and pertussis outbreaks in the the UK, for example, which was slow to vaccinate children against COVID.
More children died per year in the first three years of COVID-19 than died per year from measles in the years right before measles vaccination
Dr. Hickie also told me this:
And since he brought measles into his side of the debate, Prasad should realize more children died per year in the first three years of COVID-19 than died per year from measles in the years right before measles vaccination. I am glad Prasad wasn’t around in the early 1960’s to cast doubt on the measles vaccine rollout since several hundred children a year dying because they went unvaccinated against COVID-19 during the pandemic doesn’t seem to bother him one bit.
He’s right. COVID hospitalized 234,000 children during the first 4 years of pandemic. During that time, there were just 338 measles cases in the entire country. COVID killed 179 children the first 2 months of 2022. Measles last killed American children in 1990-1991, when 9 children died. Dr. Prasad is only concerned about the virus that killed 0 children the past 30 years.
However, like Dr. Prasad, I also want you to use your imagination and envision a world where the COVID and MMR vaccines aren’t in competition, but rather where pediatricians can make the case for both vaccines simultaneously. Here’s what they might say:
Measles and COVID are different, as are the vaccines against them. However, the underlying logic as to why children should receive them is identical. Most children with COVID do well. Most children with measles do well. However, for a small number of children, these viruses will be devastating, even fatal. It’s not healthy for developing children to be infected with either virus, and we can’t always predict which children are at risk.
The vaccines aren’t perfect. No vaccine is perfectly safe or perfectly effective. However, they are much safer than the virus for both COVID and measles. There is no logical reason to be for one of these vaccines, yet against the other. My children are vaccinated against COVID, measles, and any pathogen that threatens them. Here’s a handout I made with the studies that back up these comments. I’ll be happy to answer any questions you may have.
See, that didn’t take any time at all.