COVID19 QUICK SCOOPS
(the opinion of W.King, MD, VP-MSEP only) (8/30/21)
The Delta Variant of Covid19 has upended our plans to fully return to normal activities as our school children get ready to return to school. There are four critical layers of protection to protect our children. First, universal mask mandates in all schools are an absolute minimum. The Delta variant is unbelievably more contagious and can be spread even by fully vaccinated individuals, but is well controlled with masking. Second, all children and staff should be temp checked and symptom screened (fever, cough, body aches, fatigue). Third, the schools that have access to rapid Covid testing have an advantage in being able to confirm symptomatic school community members to be sent home, without testing, schools have to return to 10 day quarrantines, which quickly ends in person learning. Finally, the only way any of the protection works is with very high (above 70%) vaccination rates of all adults, and of eligible children. When vaccination rates are high, Covid Delta transmission can be quite low, when vaccination rates are low (below 50%), delta spreads like wildfire. These same procedures can protect faith communities and businesses as well. It will take more aggressive encouragement of vaccination to end the pandemic, only when we all have immunity will the transmission and mutation of Covid19 end.
The Covid19 pandemic is now changing from a single terrible risk to everyone to a very bifurcated (split in two) problem. Vaccinated citizens have almost complete protection from the original Sars-CoV-2 virus, and the variants, since vaccination provides very close to 100% protection against hospitalization, severe illness, or death (>99.9%). Unfortunately, unvaccinated citizens in all countries are facing even greater risk this summer than they were last summer, because with each population that is infected, Covid19 coronaviruses mutate and have created variants that are much more infectious (sometimes twice as easily spread) and more dangerous (often 50% more invasive). Neighborhoods, Counties, States or Countries with low vaccination rate are now facing a virus that can infect them more easily, put them in the hospital more often, and infect them again. Many people who already were infected last year by Covid19 appear to be able to get reinfected and ill from the variants. Fortunately, the vaccines appear to provide protective immunity, meaning they stop the variants from causing bad illness, for at least a year.
The current variant circulating is called Delta. Remember, originally when Covid changed the variants were named by their first location...UK, Brazil, South Africa, NYC, India. Well that wasn't well received, people from those places were rightly offended. Now they are naming them like hurricanes, using the Greek alphabet...the UK variant is now Alpha, the India variant is now Delta, then next one will be Epsilon (alpha, beta, gamma, delta, epsilon...right?). The variants are only named when they are found to be more infectious or deadly than the original . We are just praying a variant will not emerge that gets around the vaccines, before we can get vaccines out to the world. In the US, both the Pfizer and Moderna vaccines can be modified in weeks, and manufactured in months to provide a Covid19 (maybe called Covid21!?) booster. This quick ability to protect Americans won't help the rest of the world, they don't even have access to the first vaccine yet.
The Pfizer vaccine has finished the clinical studies for children down to age 12 (it is already approved for teens 16 and up). The studies on more than 2200 kids showed 100% effectiveness in preventing COVID19 infection, no severe adverse events, and minimal side effects (sore arm, fatigue...). The FDA and CDC have authorized the Pfizer vaccine for children 12 and up. Pediatricians and other children's doctors are administering the Pfizer vaccine to their 12 and older patients starting May 17th. Data reviewed by the CDC shows that Covid19 has been more dangerous to teens that prior flu seasons, and that the vaccine is protective. Reports of cases of a heart inflammation called cardiomyositis after vaccination do not appear to be directly associated, and doctors are aware to supervise teens for this side effect, but the benefits of vaccination are clearly protective from the heart injury from Covid infection.
Vaccinated teens will be able to participate in close contact sports and activities and in person learning without needing constant testing and quarantine procedures. Masks and distance will still be needed until more children and parents are vaccinated.
Moderna and Pfizer are both very safe - more than 100 million doses, no major dangers.
J&J - appears to have a real and predictable risk of 1 major blood clotting event per million doses. The FDA and CDC invenstigation concluded in late March 2021. The "hold vaccinations" order has been lifted...and is distributing the J&J vaccine again, the federal agencies concluded the benefits of preventing covid19 deaths outweighed the 1/million risk of blood clots. The blood clots (more than 20 events, about 10 million doses) have almost exclusively occured in women under 50. The estimated risk of a severe event in women under 50 is 7-10 per million. This is a high risk for a population vaccine.
Astra/Zeneca - is not approved in the US, and uses the same technology as the J&J vaccines, there have been even more blood clotting event for this vaccine, at least 10 major events per million doses. This is a very high risk for a population vaccine.
I would recommend women only get the Moderna or Pfizer for now. If you got a J&J vaccine - talk to your doctor and watch together for side effects. The J&J vaccine has not revealed other predictable severe side effects, but there is no need to take this specific risk from the adenovirus vector vaccines (J&J, Astra Zeneca).
Vaccine appointments are available everywhere, but many families who have hesitated getting a vaccine are struggling with the endless repetition of Covid nasal swab testing and 7-10 day quarantine each time a family member is exposed to Covid19. Once fully vaccinated, family members are not required to quarantine or get testing after Covid exposures or travel, according to CDC guidelines!