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Local doctors tout safety, effectiveness of children’s vaccine

Putting their money where their mouth is, the doctors said they were having their own children inoculated with the vaccine.

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Dr. Jill Olson and husband Brad look on as Deb Ferris, RN, walks their son Braden, 9, through the vaccination process and what to expect Thursday, Nov. 4, 2021, at Sanford Health in Bemidji. Contributed / Sanford Health

Area doctors are expressing confidence in the medical science that led to this week’s approval of a COVID-19 vaccine for children aged 5-11.

Dr. Sarah Frenning, a pediatrician at Essentia Health Park Rapids Clinic; Dr. Johnna Nynas, an obstetrician-gynecologist at Sanford Bemidji Medical Center; and Dr. Jill Olson, a family physician at Sanford Family Medicine in Bemidji, all followed the progress of studies on Pfizer’s pediatric vaccine.

In interviews with the Park Rapids Enterprise, the doctors said they would not only recommend the vaccine in their clinical practice, but they plan to have their own children immunized as soon as possible.

Children’s jab goes live

Previously, the Pfizer vaccine was only available for patients aged 12 and older. Approval for a lower dose for ages 5-11 was announced Tuesday by the Centers for Disease Control and Prevention (CDC).

The vaccine will be administered in two doses, three weeks apart. “It’s actually one-third of the dose of the vaccine that we have available now for 12 and up,” said Frenning.

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Meanwhile, Moderna is also running trials of its own pediatric dose. So far, the Food and Drug Administration (FDA) and CDC have only approved the Moderna vaccine for ages 18 and older, the same as the Janssen (Johnson & Johnson) vaccine.

Need for the vaccine

With the Delta strain, Olson said, cases of children with COVID-19 have increased disproportionately. She cited an American Academy of Pediatrics report saying that almost 25% of COVID-19 cases in the last two weeks were pediatric cases.

“That’s a change we’ve seen from earlier waves of COVID-19,” said Olson. “We’re seeing it now more in children, and we are seeing rates of hospitalization increase across the country, and there’s something called multisystem inflammatory syndrome in children (MIS-C) that happens several weeks later, and we’re seeing cases of that rise.”

Viruses mutate to attack a vulnerable part of the population, Olson said, “and right now, that is our children.”

Nynas said the more the virus spreads, the more chances it has to mutate.

“That’s why there’s such a push from the public health sector to try to immunize as many people as we possibly can,” she said, in addition to other prevention measures like masking and social distancing.

COVID-19 is unpredictable, Nynas said. One person may have a mild or asymptomatic case while the next person, with the same preexisting conditions, may end up in intensive care.

“As a physician, that’s extremely terrifying to consider,” she said. “And as a parent, that’s my fear for my kids – the unpredictability.”

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The Pfizer COVID-19 vaccine for ages 5-11 went live Thursday, Nov. 4, 2021, at Sanford Health. Contributed / Sanford Health

Benefits vs. risks

Frenning said the FDA and the CDC’s Advisory Committee on Immunization Practices (ACIP) carefully weighed the efficacy and safety of Pfizer’s juvenile dose.

“The outcome of that is definitely that the benefits outweigh the risks at this point in time,” she said.

Evidence coming out of studies on 5- to 11-year-olds showed that the Pfizer vaccine is 90.7% effective in kids in that age group, Frenning said – even against the Delta variant.

No severe adverse outcomes were traced to the vaccine, she said. The most common side effects were fatigue, headache and muscle pain, all more common after the second dose but, typically, less severe than what adults experienced.

Nynas said the FDA identified only five severe adverse effects in the study, but not one was directly related to the vaccine.

“They had one child who swallowed a penny,” she said. “They had three fractures – one was in a placebo group – and one person who got an infection in a joint, but it had nothing to do with the vaccine.”

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Olson called it “the most studied vaccine that we’ve ever had. Over 3.8 billion people have gotten it. Of that, 247 million were pediatrics, ages 12 and older.”

She noted the FDA asked Pfizer and Moderna to bring several more months of data.

“They’re definitely not rushing this process,” Olson observed. “They’re careful, and they’re asking very pointed questions, and they’re very transparent. So, I have zero concerns with the safety of this vaccine.”

What side effects really are

Nynas said what many people describe as side effects of vaccines are really an immune response the vaccine triggers.

“Most of the types are pretty mild,” she said. “They last less than a couple days.”

In children, Nynas said, the most common symptoms reported in the trials was redness or swelling around the injection site. “There can be some fatigue and tiredness and some muscle aches and occasional fevers,” she added. “They don’t last more than a couple days and they’re pretty mild.”

One concern the FDA committee looked at is the risk of myocarditis induced by the vaccine.

“It’s a concern that a lot of my parents ask me about,” said Nynas.

She said the condition, an inflammation around the heart, is most often reported among older teenage boys after getting the shot. However, she stressed, myocarditis can happen after any vaccine or with any illness.

“I have actually seen it myself, in my practice,” she said, “and it was not from the vaccine; it was from the influenza virus.”

Nynas said it can be treated with anti-inflammatory drugs and usually lasts less than a week.

Frenning said cases of myocarditis following the jab tend to be relatively mild, while the risk of myocarditis is higher with COVID-19 and cases are more severe.

“If I had to play my cards on if I was gonna get myocarditis from the shot vs. myocarditis from COVID itself, it’s actually a much scarier prospect getting it from COVID,” she said.

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Dr. Jill Olson, Dr. Johnna Nynas and Dr. Sarah Frenning Contributed / Sanford Health; Essentia Health

Money where their mouth is

Olson tried to enroll her three children, aged 4, 7 and 9, in the Pfizer and Moderna trials. They weren’t accepted, perhaps because so many other families volunteered.

Nevertheless, Olson said her 7- and 9-year-olds would receive the vaccine as soon as it is available. Regarding her youngest daughter, she has hopes for a similar study of 2- to 4-year-olds, “and I have no doubt I will gladly vaccinate her as soon as she’s able.”

“I definitely plan to vaccinate my two children,” Nynas agreed. She has a daughter, 6, and a son, 4. “As soon as I have a vaccine available for his age group, he will be vaccinated as well.”

Weighing vaccine risks against potential consequences of her child being exposed at school, Nynas said even a mild COVID case would result in missed school, separation from friends, social impacts, academic impacts, and the risk of long-term complications like persistent cough, brain fog and fatigue lasting more than four weeks, sometimes indefinitely.

“We’re seeing that in about 8% of cases amongst children,” she said.

Frenning has kids aged 2, 7 and 9. She said the older two will be vaccinated at the first available appointment – showing her confidence as both a practicing doctor and a parent.

“In the exam room, the strongest thing I can say is, I will be putting it in my children’s arms,” she said.

The road back to normal

“I want my daughter to start to see what life is really like,” said Nynas. “I feel like she hasn’t seen a normal world yet. She’s only 6 years old. I’m really looking forward to the day when we can get this behind us, and she can be a normal elementary school kid again.”

But this can’t happen unless a large portion of the population is vaccinated, she said.

“Immunity after a COVID-19 infection does not last as long as immunity following an immunization,” Nynas said. “To get us to the point where we can see a normal society again is gonna take vaccination.”

“To get out of this pandemic, the transmissions in general need to lower,” Frenning agreed.

She said it’s understandable for parents in her exam room to focus on the child in front of them, but she urges looking at the bigger picture – like the chances of a child with COVID-19 passing it to someone at higher risk of severe illness.

“This is a bigger thing than just each individual child’s death,” she said, citing a recent article saying that 140,000 children have lost their caregivers to COVID-19.

“Some people question – ‘Well, kids don’t get that sick; is this really necessary?’” she said. “In pediatrics, we’re thankful that most kids do not get seriously ill with COVID. But they’re not spared. … In pediatrics, we feel like kids aren’t supposed to die.”

More than 600 children have died from COVID-19, she said, many of them since the Delta variant came along. It’s now the sixth leading cause of death for ages 5-11.

“Sure, there’s not as many deaths as in adults,” said Frenning. “Thank God! But one kid, in my opinion, is too many kids to die.”

A word to the skeptics

Frenning said there’s a lot of misinformation about COVID-19 and the vaccine. However, it’s also important to adapt to new data. She noted that earlier in the pandemic, data showed kids weren’t transmitting the coronavirus.

“But then, they were in school wearing masks and socially isolated,” she said. “Since that’s been done away with, there’s very good data that kids transmit the virus.”

Olson responded to skeptics who cite the approval of booster shots as evidence the vaccines don’t work.

“We’ve changed the schedule of most of the vaccines since whenever they came out,” she said. “The great thing about the CDC and the FDA is, they don’t sit on the data. They look at population health and they say, ‘They don’t seem to have a great lasting immune response to tetanus, so we’re gonna give them a booster. And pneumonia, and hepatitis B.’

“We’ve changed vaccination schedules all the time. Will the COVID-19 vaccine change up? Probably. Do we need another booster in 10 years? I don’t know. But it’s nice to know we’re always looking at the data.”

Recalling that her grandmother died from COVID-19, Olson has a picture of herself getting the jab, holding a sign saying, “For you, grandma.”

“It’ll be a year ago on Saturday,” she said. “So, if my kids get their vaccine by Saturday, it’ll be pretty significant.”

“It’s hard to have a public health-minded decision making process,” Frenning admitted, especially regarding worried parents. “But this is safe for kids, and this is effective against this horrible virus, and it’s also the right thing to do for our community and our loved ones.”

Bottom line, Olson said, “As a physician, I completely recommend it. As a parent, I completely recommend it.”

Related Topics: CORONAVIRUSCOVID-19 VACCINE
Robin Fish is a staff reporter at the Park Rapids Enterprise. Contact him at rfish@parkrapidsenterprise.com or 218-252-3053.
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