Kids under 5 are still waiting on COVID vaccines. What caretakers should know in the meantime.

A pediatrician answers common questions about the risks of long COVID-19 and the mental health challenges of the pandemic.

By Laura RiceApril 25, 2022 7:49 am, , , ,

Kids under age 5 are the last segment of the population awaiting the authorization of a COVID-19 vaccine. The latest projections indicate that could happen in June.

But in the meantime, parents and caretakers are navigating the ongoing pandemic without that extra layer of protection for their kids, and many have questions for their pediatricians.

The Texas Standard posed some of those questions to Dr. Alefiyah Malbari, head of the Division of Ambulatory Pediatrics and an associate professor in the Department of Pediatrics at Dell Medical School at The University of Texas at Austin. Hear the interview with Malbari in the audio player above or read the transcript below.

This transcript has been edited lightly for clarity.

Texas Standard: How are pediatricians currently getting information about COVID-19 and its impact on kids?

Dr. Alefiyah Malbari: For the most part, pediatricians are getting information from their local communities and their local medical societies and governing bodies. Here in Austin, we have the Travis County Medical Society, and that’s where we get our most updated numbers about kids who have been reported positive for COVID, as well as what our vaccination rates are.

Is the data still as good as it once was? Are cases being followed as closely as they were during surges?

Well, I think what has changed significantly in the past several months is that there is a lot more availability of home antigen testing, which is a good thing for kids and for families. But because of that, [though] we are likely not necessarily seeing the true number of COVID-positive cases because the ones that actually get to the county is, for reportable reasons, are the ones that go through labs and offices, etc.

So we are probably not seeing the exact number. But overall, from what we know, we still know that here, at least in Travis County, the transmission remains low, which is good news.

What are some of the common questions you’re hearing from pediatricians?

Pediatricians really want to know exactly where we are in terms of transmission. We also are really wanting to know what are the best ways that we can communicate with patients and families specifically as it relates to vaccines, and know what kind of questions patients and families might have about vaccines and how we can best answer them.

And so those are the conversations that are being had at high levels, especially at the American Academy of Pediatrics. And those are the communications that are being sent out to pediatricians about having those conversations with families.

What do we know about long COVID in kids?

We’re just starting to understand a little bit about what long COVID means in kids. We’ve heard about this a lot, what’s called the “subacute” symptoms of COVID, which was known as MIS-C or multisystem inflammatory symptoms in children. And that was sort of right after an acute COVID infection and two-to-six weeks. But we are now starting to see, especially since many, many kids were infected with the omicron variant, some kids that are falling into this long-COVID category.

And the World Health Organization definition of that are clinical symptoms after an acute COVID infection that lasts for at least two months and can’t be explained by anything else. For the most part, these long-COVID symptoms and kids are tending to be mild things, but they can be annoying for kids. So they include things such as headache, fatigue, sleep disturbance, difficulty in concentration.

So none of them are specifically or significantly very bad, but they can, if they’re lasting for such a long time, impact a child’s daily life. We haven’t been seeing so much of it, but certainly it’s something we’ve been monitoring closely.

There are so many concerns about COVID and treatment options. But how do you balance those concerns with other concerns, the mental health effects of the pandemic?

I think that we’re still, as much as we want to be out of this pandemic, we’re still very much in it. We’re in a better stage of it, I think, but we’re still very much in this pandemic. And you’re absolutely right; I think from the very beginning and until now, we have seen significant mental health issues in the pediatric population. Many, many kids that did not have any previous diagnoses of mental health conditions are now having diagnoses such as anxiety, depression, new diagnoses of attention-deficit/hyperactivity disorder and other things.

There’s also been a lot of catch-up that’s needed to be done in these sort of educational and academic spaces for our kids. And so we definitely do have to think about how we are moving through this pandemic and move our kids to what a normal can be so we can address these mental health issues.

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