Vaccination rates in the United States are plateauing, and there's one key population that has yet to receive a single shot: children under 12. Particularly with the rise of the Delta variant, those who have been vaccinated against the virus are still vulnerable to infection. Joining GBH’s All Things Considered to talk about COVID-19 and kids is Dr. Annie Murray, a pediatrician at Mass General Hospital who specializes in infectious diseases.
Arun Rath: So, Dr. Murray, I think the worry that many people have boils down to this: we're at this new stage in the pandemic with this very contagious Delta variant now causing havoc — but really causing havoc in the unvaccinated. People who were vaccinated are either protected, or they don't seem to get very sick. But currently, 0% of kids under the age of 12 are vaccinated. So with this stage of the vaccine, with a stage of the pandemic, how vulnerable are those kids?
Annie Murray: So children definitely are vulnerable — especially when unvaccinated — throughout the pandemic. They have been becoming ill with the virus and there is luckily less severe disease than is seen in the adult populations, and overall, the rates of hospitalization and death in pediatrics has remained very, very small and rare events. But they definitely remain susceptible. And I can't wait for the day when we have a vaccine that younger children are eligible for, and that we know that is going to be as safe and effective as the vaccines have been for the adult population, and the older children and adolescents.
Rath: Does the Delta variant change the risk analysis at this point? As you're mentioning, we've known throughout this that — happily — children tend not to be tend not to get as sick as adults. But are things different with a Delta variant, or have things changed in terms of how you assess risk for kids under 12?
Murray: Given that the Delta variant is very infectious and contagious and rapidly creates clusters and increased rates of infection more so than earlier variants in the pandemic, it is a bigger risk to children, and the reason for that is when you have large numbers of infection is when statistically you see those rare, awful outcomes — like hospitalizations and deaths and long term sequelas. So we can keep the infections down, then those rare outcomes remain quite rare. But as soon as infectious variant[s] — like the Delta variant, which is the majority of cases now — it's worrisome because as those rates increase, we are going to see those poor outcomes.
Rath: And are we seeing an increase in COVID cases among children, and does that track with the increase that we're seeing with adults?
Murray: We are seeing an increase in rates in child infections, and I think it largely is that they are a large part of the vulnerable population, because adults have had access in the U.S. to vaccines. And a lot of people have done everything they can to keep themselves protected and get fully vaccinated, so the rates are increasing for children — and they're still much lower than at other, earlier peaks in that pandemic, but it is worrisome.
Rath: One of the things that was — I would call it like a qualified success story, maybe, during the pandemic — was that at least when kids did return to in-person schooling, schools didn't really seem to be a major hotspot for infections, for spreading, even though the kids may have been unvaccinated. Has this changed anything in terms of how we should feel about about kids going back to school in the fall? We know that that masks will be back in school, though.
Murray: Yeah, I think the schools have done an amazing job of all of the strategies for mitigating risks. Of course, when you're in an indoor setting with a large group of unvaccinated people, there is the higher risk of spread. And the fact that statistically we didn't see those increases is a huge, huge thing to be excited about — and to, really, thank all of the people that kept children safe with all of the mitigation efforts.
I think masks for unvaccinated children in school are one of the ways to keep that true and to keep kids from having outbreaks in school. I think staying home when you're sick, and making that OK, and providing accommodations so that children can continue to learn and access the curriculum when they are sick is really important — and something the schools have done a really great job with. So I'm excited for students to go back to the classroom in the fall and expect that they will be safe and that there will be precautions taken. And we've learned a lot over the past several months on how to mitigate risks, and I think if we follow those same advice and same strategies, that kids can safely attend school.
Rath: I wanted to ask you also about the state of mind for young people. I mean, you are a pediatrician specializing in infectious diseases, so I'm sure you talk about things like risk with with young people. It seems to me that kids under 12 — maybe just the world we live in — are a lot more aware of what's going on. Certainly with the pandemic, you know, plenty, I'm sure, are listening to this conversation, that know all the risk we're talking about — all the stuff that's making their parents nervous. So how can we send our kids to school this fall, appropriately prepared but not overly burdening them?
Murray: Yeah, I think what we can do is to do everything possible to to keep them at lower risk, which is making sure they get their routine care and routine vaccines, that they are up to date before they go to school, and that when they become eligible for the COVID vaccine — hopefully in this coming school year — that they do get that vaccine protection.
I think it's also wise to talk with them about what situations are more risky. Like going into inside settings with a lot of unvaccinated people without a mask on is generally just not as safe as if you put your mask on and you make sure to wear it properly. And I know kids have had a lot of practice with wearing their masks and have been quite successful in the clinic — and actually hesitant to take them off for me to look in their their mouth for exam because they they feel a sense of protection from wearing the mask, and they generally are not particularly bothered by wearing it. So I think they do understand a lot.
They have the same anxiety that we all feel about this pandemic and providing reassurance that we've learned ways to keep them safe is helpful, but also I've seen the joy and relief in my adolescent patients who have become fully vaccinated, and I really hope that that will be a possibility for the younger children soon in the coming months. Because just as I felt such relief getting fully vaccinated, I've seen it in my adolescent patients, and I just wish that for the rest of the kids as well.
Rath: Yeah, and that's a good thought that it's one way to talk about this, is that we we've been through this before and, just, we'll go back to what we did before and we'll get through it. Dr. Murray, this is so helpful and I think we'll probably have to get you on again before too long to talk some more. Thank you so much.
Murray: Thank you.
