Throttle Back

Family Practice News headlined their May issue with the typically breathless “COVID-19 – Twelve percent of diagnosed children end up hospitalized.”  (You’re welcome to try the link, but I didn’t feel like registering “for free”).  The meat of it:

–       “12% of U.S. children with COVID-19 were hospitalized in 2020, and nearly a third of those had severe disease” that required a vent and/or ICU.  That sounds pretty awful.

–       This was based on discharge data on 20,700 patients “with COVID-19” from 869 facilities.  Of those, 2,430 were hospitalized “with COVID-19” (but were all of those “due to…”?  Our acceptance of horribly inaccurate numbers early on continues to haunt).  Of those, “756 had severe COVID-19.”  That means that of the total children seen in a hospital setting that were COVID-19 positive, 3.7% were seriously ill.  

–       “As of April 8, more than 3.54 million U.S. children had tested positive (and we know that is an erroneously low figure to describe the infection fatality rate, as well as the estimated number of who have recovered and developed natural immunity).  This article winds up with “less than 2% of all child COVID-19 cases resulted in hospitalization,” which sounds a lot less scary than the numbers above.

Last month also saw CDC director Rochelle Walensky, MD (who shares the same high degree of credibility with that pristine organization) enthusiastically endorse the “Pfizer-BioNTech COVID-19 vaccine in adolescents aged 12-15 years.”  She gave the usual hedge boilerplate of “Understandably, some parents want more information before their children receive a vaccine.  I encourage parents with questions to talk to your child’s healthcare provider or your family doctor…” Those same primary care docs will be further, um, leveraged by the ever-compliant American Academy of Pediatrics, whose president Lee Savio Beers, MD said:   “As a pediatrician and a parent, I have looked forward to getting my own children and patients vaccinated, and I am thrilled that those ages 12 and older can now be protected.  The data continue to show that this vaccine is safe and effective. I urge all parents to call their pediatrician to learn more about how to get their children and teens vaccinated.” 

So we have a couple of government and media approved sources telling everyone to get all kids vaccinated.  That might be persuasive pressure on the average primary care doc.  It certainly has been persuasive to the hysterically risk averse  teachers’ unions and universities. 

Nicole Saphier, MD, has a different take on pediatric COVID-19 vaccination.  To be fair, she is a radiologist with a specialty in breast imaging, so she treats only a few more children than do Dr. Walensky or The Fauci.  And full disclosure, I have not been a particular fan of hers over the past year-plus, as she fell in line with her Fox News corporate mantra supporting mass social distancing and masking, which I think have been ridiculous (let the screaming resume).  My point is that for all of my gleefully embraced confirmation bias, I’m no sycophant.   But unlike the average celebrity, she is an actual physician who treats patients and can interpret studies.  So I was interested to read her growing skepticism regarding mass pediatric COVID-19 vaccination.

She is fully in favor of vaccinating adults, particularly those at risk, and has repeatedly said so, so she passes the tinfoil hat test.  Nor is she anti-pediatric vaccine: “The infection fatality rate in young children from COVID-19 is less than 0.008%, likely lower due to undertesting. This number is less than flu (0.01%) and markedly less than measles (up to 3% in nonimmune populations), which is why pediatric vaccines for these other illness-causing viruses are crucial.”  Again, she’ll never get the Annual Jenny McCarthy Award for Vaccine Opposition with that sort of attitude.  She cites the numbers for COVID-19 associated Multisystem inflammatory syndrome:  “More than 65% of MIS-C cases have arisen in children less than 12 years, with 58% under 10.”  Then she properly asks, “If the vaccine successfully induces an immune response, which some studies suggest may be more robust than natural exposure to the virus, then could the vaccine incite the inflammatory reaction resulting in MIS-C?”  (This is a serious question, for which we simply do not yet have the data.)   “If so, would it be more frequent or severe if the immune response is greater? Couldn’t this place healthy children at risk of a severe outcome from the vaccine who had an extremely low likelihood of getting sick at all?”  And that is the everlovin’, freaking point.  Moreover, we definitely do not have good numbers on those who have already been infected and recovered, and what if any complications that may predispose vaccine-takers to. 

“Universal vaccination campaigns should be halted in adolescents and even young adults until more safety information becomes available… An expedited vaccine intended for HEALTHY kids, who have a near zero risk of severe illness and dying from COVID-19, can seem like a solution in search of a problem.”

The milquetoast weasels on the Fox website added “Editor’s note: Dr. Nicole Saphier’s views on this topic are her own.”  Yeah, well they’re mine too.  Were I still in my family practice clinic, I would probably generate a complaint to the state medical board for non-uniformity, but I would not presently recommend pediatric COVID-19 vaccines, nor would I give them.

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