The children should definitely be vaccinated

By Abhigyan/Abhinav

In an interview with Double Helical, Dr. Neelam Mohan, Director, Department of Paediatric Gastroenterology, Hepatology and Liver transplantation, Medanta, The Medicity, Gurgaon. says that though the morbidity and the mortality of Covid-19 is low in children. There is increasing recognition of Covid associated multisystem inflammatory syndrome in children (MIS-C). Children with co morbidities (chronic lung /heart /kidney /liver disease) are at highest risk. Therefore as the vaccine trials confirm safety and efficacy in children, they should definitely be vaccinated as we should try to prevent even the smallest number of tragic events among children.

Every Covid patient is a potential source of infection to others. Since children stay close to parents and especially grandparents, they can be a potential threat for the elderly at home.The advent of corona vaccine in the beginning of the new year led to dramatic conquest over prevalent infectious Covid-19, followed by emergence of Covid vaccine for relief from Corona Virus.

Today especially the children tend do what they see and not what they are told to do so its duty of parents to wash hands often and cover mouth while sneezing so that our little champs copy them automatically. Hands should be washed with soap and water for at least 20 seconds before children eat, after they use the bathroom, come inside from outdoors or touch something dirty like garbage.

Excerpts from interview

How is Covid-19 infection in children different from adults?
Children and adolescents account for only 2-7 percent of all cases reported worldwide. Most of the infections in children have been mild and non-fatal. Reported mortality is as low as 0.06 percent as per American academy of Paediatrics.
However, in the last 6 months, there have been increasing reports from UK, America and India describing children with Covid-19 associated multisystem inflammatory syndrome, which seem to develop after the infection rather than the acute stage of the disease.

What is Multisystem inflammatory syndrome (MIS-C)?
Clinically MIS-C is recognised as an illness similar to Kawasaki disease (rash, conjunctivitis, oral/ mucosal inflammation) or signs of shock mimicking toxic shock syndrome or significant diarrhoea, vomiting /abdominal pain in a child with initial resolution of known/highly suspected Covid-19 infection or history of recent Covid-19 exposure in last 4 weeks. It is supported by laboratory evidence of inflammation (low albumin, high CRP, high ESR, raised D –dimers, High ferritin, high LDH ) and Covid PCR or antibody positivity. Most cases are managed with IVIG and /or steroids along with appropriate anticoagulants.The long-term outcomes remain unknown and close follow-up is important in such children.

Can children be a source of infection too?
Yes, every Covid patient is a potential source of infection to others. Since children stay close to parents and especially grandparents, they can be a potential threat for the elderly at home. Therefore, schools have been shut for almost a year now in India and other countries.

Is it safe to send the child back to school?
Some schools are planning complete in person learning while others are planning a hybrid mix of in person and online classes. Personally I feel that younger children and kids with special needs learn best in school while older children can handle online classes better. However at the same time, making young ones practice social distancing and wearing mask above the nose is a bigger task compared to older kids.
Schools teachers and health experts are all working hard to make schools as safe as possible like proper disinfection measures, limiting class size, stagger schedules, hybrid learning. Parents should play their part and train their kids to follow basic safety rules and also be flexible in their approach as per needs of the school.

How to make children practice hand washing and social distancing?
Children tend do what they see and not what they are told to do so its duty of parents to wash hands often and cover mouth while sneezing so that our little champs copy them automatically. Hands should be washed with soap and water for at least 20 seconds before children eat, after they use the bathroom, come inside from outdoors or touch something dirty like garbage.
We should practice social distancing in front of them and count 3 feet back every time we stand and talk to anyone or stand in a queue. This will reinforce social distancing among them.

How to react when a young child asks: “Why can’t I go to school or malls?”
Avoid negative reactions like “coronavirus is dangerous; it can kill us all ’’. Reassure children by saying “We all are warriors fighting the evil virus and if we follow basic rules of hand washing, social distancing and masks, it will not be able find us and we shall win!” It is very important as a parentto remaincalm and not show panic in front of the young ones.

Should children get Covid vaccine?
Though the morbidity and the mortality of Covid-19 is low in children. There is increasing recognition of Covid associated multisystem inflammatory syndromes in children (MIS-C).Children with comorbidities (chronic lung /heart /kidney /liver disease) are at highest risk. Therefore as the vaccine trials confirm safety and efficacy in children, they should definitely be vaccinated as we should try to prevent even the smallest number of tragic events among children. There is no reason to believe that if the vaccine works in less than 16 years, why it should not work in the younger children as they have a more robust immune response. Only safety data needs to be collected before vaccinating our young ones. Many vaccines are under trial in children above 12 years of age and soon trials will begin in 6- 11 years group as well.

Should one take the vaccine if she is breastfeeding his/her child?
As of now, WHO does not recommend vaccination in pregnant and nursing women. However FDA (USA) has left it on the individual’s choice. Trials have begun on pregnant women as well.

Are masks safe for kids?
All Kids more than two years should wear a triple layer mask which fits them nicely above the nose.

Which sanitizer is best for kids?
Hand sanitizer with at least 60 percent alcohol can kill germs like Covid-19. Parents should supervise children less than five years of age when using sanitizers as they can spill it in their eyes or try tasting it which can be very harmful.

As they say after every difficulty, there is always ease….This too shall pass and our little ones shall bloom!

 

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