Pediatric COVID-19 case counts likely ‘tip of the iceberg,’ expert says

Nov 21, 2021

3 minutes reading

Source/Revelations

Source:

Oliver, S. Covid vaccines for children. Presented at: Symposium Infectious Diseases in Children; Nov 20-21, 2021; New York (hybrid meeting).

disclosures:
Oliver does not report any relevant financial disclosures.

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NEW YORK — A CDC official said pediatric COVID-19 cases are likely underreported and reassured health care providers about the safety of vaccination during a keynote address at this year’s Infectious Diseases in Children Symposium.

Sara Oliver MD, MSPH, An Epidemic Intelligence officer in the CDC’s Division of Viral Diseases leads the Advisory Committee on Immunization Practices Working Group on COVID-19 and delivered the presentation on the first day of the conference. She cited CDC data indicating that COVID-19 cases have increased.

Sara Oliver

“At the end of October we were at around 60,000 cases per day and now we are back at about 80,000 cases per day,” Oliver says. “We need to look a little bit and see what happens when different other parts of the country experience that delta wave. But we do know that kids are a big part of that.”

Oliver said more than 2 million cases have occurred in children ages 5 to 11, and more than 2.5 million cases have occurred in teenagers. About 20% of the new cases were found in children, she added.

“At the beginning of the pandemic, this was [thought to be] a pandemic affecting the elderly or the elderly population,” said Oliver. “Because that population was vaccinated early, we’ve really seen the shift in this pandemic among younger populations.”

In addition, COVID-19 was not the only illness to hit children during the pandemic, she added.

“We have seen double the number of hospitalizations for type 2 diabetes during the pandemic than we normally see,” Oliver said. “So it’s not just COVID-19 that affects these kids. They are being hospitalized for a number of other things directly caused by the pandemic. [There is the] decline in the use of health care and routine vaccinations, increase in childhood negative experiences and loss of caregivers, with thousands of children now having lost one or both parents.”

“So when we think about what the epidemic is in children and adolescents, we know that they are at least as likely to get infected as adults — again, more than 4.9 million cases in this 5- to 17-year-old age group, with their prevalence somewhere between 38% and 39%,” Oliver continued. “But we know that might just be the tip of the iceberg.”

She added that cases are likely under-reported.

“For every case we hear about, how many infections are possible?” said Oliver. “Over the general population, we think that’s about two to one, so for every case we hear about, there might be two cases where we don’t. For pediatrics, that’s six to one. So for every diagnosed case we Seeing there, there may be six cases that may go undiagnosed and reported.”

Risk of myocarditis associated with mRNA vaccines

While reports of cases of myocarditis following vaccination with messenger RNA technology are a concern, these cases are rare – mainly occurring in young males. Oliver said it was something the ACIP needed to “think about” before recommending approving the Pfizer-BioNTech vaccine for children for emergency use.

“It’s a rare occurrence, mainly in men under the age of 30, especially after the second dose,” Oliver said. “ACIP has thought this through carefully as it relates to adolescents and young adults, continuing to think that the benefits outweigh the risks and still recommend the vaccine.”

Oliver ended her comments by saying that health care providers and pediatricians played a bigger role than they might realize in increasing vaccination rates.

“We know that if a pediatrician recommends a COVID-19 vaccine, the parents [and children] were more likely to get it,” Oliver said. “So I think the biggest thing that [providers] can do is just keep talking about it. And it may not be on the first visit, it may not be on the second visit, but having a counselor in that parent’s life who really has a conversation with them about the vaccine is what the impact will be [people], more than anything I can do at the CDC.”

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