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Don’t panic about unvaccinated kids It's time to get back to normal

Take off the masks. Johannes Eisele/AFP via Getty


May 3, 2022   4 mins

In the United States, some parents — and more than a few physicians — are still panicking about unvaccinated children.

Last week, Politico reported that the US Food and Drug Administration might wait until this summer to consider authorising a vaccine for children under five years old. Only a few days earlier, a judge had struck down the nationwide mask mandate on airplanes, prompting angry reactions from some who claimed that the ruling would result in dead children. Some parents have loudly proclaimed that they will continue to shield their kids from social interactions until a vaccine is available. And in New York City, children aged between two and four are still required to mask in schools because they are too young to be vaccinated.

As Covid restrictions and mandates have been dropped across the America and the Western world, unvaccinated kids have become a rallying cause for Americans unable or unwilling to leave the pandemic behind. But the truth is that children under five don’t need to wear masks and don’t need to have their lives put on hold pending vaccination. Hysteria about the risk to them is not just unhelpful but harmful. It deprives them of a normal childhood without any countervailing justification.

A decision on vaccines for young children is probably a few months away, given that U.S. public health authorities want to consider the Pfizer and Moderna vaccine data together. While some parents are understandably angry and frustrated with delay, the FDA is right to be cautious here. Young children are at low risk from the virus and the benefits of vaccinating them are uncertain. Even if the vaccines are approved, it is not clear that they will make a big enough difference to justify placing restrictions on children in the interim.

First, consider that the FDA has not tasked the vaccine makers with proving that their vaccine lowers rates of hospitalisation in kids. Nor do they have to show that the vaccines reduce MIS-C (an inflammatory condition that may arise after infection) or even rates of Covid infection. Rather, the FDA has asked Pfizer and Moderna to prove that their vaccines, at the dose given to kids, generate levels of antibodies that are comparable (or “non-inferior”) to levels of antibodies generated among older, fully vaccinated people. This is a low benchmark, and means that, in practice, the trials being run to clear it are very small. Indeed, they may be too small to detect reliable signals for the most important benefit — reduction in severe Covid — and for harms.

Yet so far, Pfizer has failed to clear even this very low bar. Two doses of three micrograms of the Pfizer vaccine (1/10th the adult dose) fell short in December of 2020, to the disappointment of many. The FDA allowed the company to take another shot at it, literally, by adding a third dose. In late January of this year, there was buzz that the FDA would take the unprecedented step of authorising the vaccine despite the failed trial because it looked like it might reduce infections, but just a week later, Pfizer announced they would wait for the results of the 3rd dose before seeking approval. The flip-flop generated national news and outrage from some parents and doctors.

Then, on March 23, 2022, Moderna announced that its children’s vaccine — two doses of 25 micrograms, or 1/4 the adult dose — did generate sufficient antibody levels, again raising hopes that FDA approval would be forthcoming. But only limited results have been released so far. We don’t know the full spectrum of adverse effects, nor the impact on the outcomes we really care about: cases, severe disease, hospitalisations, MISC-C, and deaths. These outcomes are especially important for conducting a cost-benefit analysis for Moderna, which has clearly been linked to higher rates of myocarditis in young men than has the Pfizer vaccine.

As the clinical trials have dragged on, moreover, the landscape of kids and Covid has changed. Children have always been at relatively low risk, but newer variants appear to be even less risky for them. A recent preprint from the UK suggests that children infected with Omicron were less likely to be hospitalised with severe disease than children infected with the alpha or delta variants. We have also learned that MIS-C is less common often with the newer variants. Delta was less likely to trigger the condition than alpha, and CDC data suggests that omicron was less likely to trigger it than delta.

More generally, it makes no sense to be overly cautious about low-risk children at a time when the United States is dropping most restrictions for adults. The risk to an unvaccinated healthy child under five is often lower than the risk to their vaccinated or even boosted parent. Natural immunity is also powerful and prevalent. It protects strongly against reinfection and even hospitalisation after reinfection. Not that the data here is from adults — naturally immune children are so rarely hospitalised that it is difficult to conduct studies on them.

Most kids have already had Covid, even if they and their parents don’t know it. Prior to the omicron wave, up to half of American children had been infected, and the virologist Trevor Bedford estimates that omicron might have since infected 40% of Americans. Although there is surely some overlap between the two numbers, most kids have probably already had Covid at least once, and it would be difficult for a vaccine to offer them any significant further protection. Finally, we have learned that vaccination has rapidly waning protection against symptomatic infection. Some studies report that vaccine effectiveness in those aged 5-11 for symptomatic Covid is less than 20%.

If you put all this together, the story becomes clear. The vaccine trials have been inconclusive. Most children have had Covid already, and the ability for a vaccine to further improve their health is limited. Finally, they are at extremely low risk to begin with. Parents may encourage their offspring to get vaccinated if and when vaccines become available, but they should not be consumed with fear pending FDA approval. Nor should they prevent their children from living a normal life.


Vinay Prasad is Associate Professor of Epidemiology and Biostatistics at the University of California, San Francisco. He is a practising hematologist and oncologist, and author of more than 300 peer-reviewed publications.

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Marius Clore
Marius Clore
2 years ago

Agree with everything that Vinay Prasad says in the article. A refreshing dose of common sense.

Last edited 2 years ago by Marius Clore
Elizabeth Hart
Elizabeth Hart
2 years ago

If you put all this together, the story becomes clear. The vaccine trials have been inconclusive. Most children have had Covid already, and the ability for a vaccine to further improve their health is limited. Finally, they are at extremely low risk to begin with. 

So why on earth was there ever a plan to jab children…or most people for that matter?!
This entire situation is beyond INSANE!
In regard to jabbing of children, see my email questioning this, forwarded to the chair of the Australian Technical Advisory Group on Immunisation (ATAGI): Why does ATAGI recommend COVID-19 mRNA injections for all children aged 5 to 11 years? 22 April 2022.

Jeremy Sansom
Jeremy Sansom
2 years ago
Reply to  Elizabeth Hart

Thank you for sharing this, Elizabeth. I hope we will get to hear the outcome.

Elizabeth Hart
Elizabeth Hart
2 years ago
Reply to  Elizabeth Hart

Last edited 2 years ago by Elizabeth Hart
Elizabeth Hart
Elizabeth Hart
2 years ago
Reply to  Elizabeth Hart

Last edited 2 years ago by Elizabeth Hart
Elizabeth Hart
Elizabeth Hart
2 years ago
Reply to  Elizabeth Hart

Vinay Prasad says:

Children have always been at relatively low risk, but newer variants appear to be even less risky for them. A recent preprint from the UK suggests that children infected with Omicron were less likely to be hospitalised with severe disease than children infected with the alpha or delta variants. We have also learned that MIS-C is less common often with the newer variants. Delta was less likely to trigger the condition than alpha, and CDC data suggests that omicron was less likely to trigger it than delta. 

Why are children being jabbed?!
As I said in my previous comment, this is INSANE!
Children obviously have a very effective natural immune response. What will it mean for them to be deliberately given defective Covid-19 ‘leaky vaccines’ that don’t prevent infection nor transmission?
What happens now – will they be jabbed every few months in this mad off-the-cuff experiment, where the protagonists don’t seem to have a clue what they’re doing…or do they?
How did this even happen, how did an ethics committee approve the trials in children, in individuals who it was already known weren’t at risk of the SARS-CoV-2 virus, and weren’t at risk of disease, i.e. Covid-19. 
In this regard, see my email to Andrew Pollard, Chief Investigator of the Oxford/AstraZeneca vaccine trials: Who initiated the plan to vaccinate the entire global population against SARS-CoV-2? 30 June 2021.

Joff Brown
Joff Brown
2 years ago

I simply cannot understand how this insanity about covid in kids seems to have taken hold in the US. And it seems to be the type of people most likely to say “follow the science” who refuse to believe that covid presents a minuscule risk to children.

Philippe W
Philippe W
2 years ago

Nobody’s panicking. In fact, turns out 19 in every 20 British parents were asking the right questions all along.
From last week:
One in 20 eligible children have Covid jabs amid lacklustre take-up
Just 262,000 children have received their vaccinations as centres use therapy dogs and games to make the experience more ‘child-friendly’
https://www.telegraph.co.uk/news/2022/04/28/one-20-eligible-children-have-covid-jabs-amid-lacklustre-take/

Martin Smith
Martin Smith
2 years ago

Is it hysteria caused by relentless official propaganda about Covid, or performative virtue pretending to a higher level of morality to ordinary folk? I certainly suspect it is most prevalent among prosperous white middle-class (in UK terms) college graduate types.

Last edited 2 years ago by Martin Smith
Peter Imeson
Peter Imeson
2 years ago

At first I assumed you were joking, but maybe not. Firstly, it’s clear the vaccines are doing nothing to halt the spread. Also the thought that we should give children a vaccine which is not fully tested and provides them with no benefit ‘to set the social tone’ seems beyond insane.

Andrea 0
Andrea 0
2 years ago

Godsthruth!
Said that, even here (UK) I keep seeing some masked younger kids. They have always been few in number, but they are still around.

Marius Clore
Marius Clore
2 years ago
Reply to  Andrea 0

Even more so in the US. Indeed, more mask kids than old people as far as I can tell.

Andrew Horsman
Andrew Horsman
2 years ago
Reply to  Andrea 0

Masking kids is child abuse. It’s as simple as that. The photo accompanying this story is a profoundly disturbing depiction of child abuse. Unherd are within their rights to publish it because it is important that this child abuse is recorded and reported upon. But it is child abuse and the perpetrators of this need to take a long hard look in the mirror and come to terms with what they are doing to their kids, and stop it, now. The attempt in New York to mandate masks for the under fives epitomises just far psychotic adults are prepared to go to perpetuate the lies that they are telling to themselves and others. Sick.

Susan
Susan
2 years ago

No, don’t panic about unvaccinated kids. Panic about VACCINATED kids. A new study of the Pfizer injections demonstrates that they do indeed alter our DNA. Is this what we want for our children? Come on people – wake up!!!

Will Bash
Will Bash
1 year ago
Reply to  Susan

Dr. Vinay Prasad knows that his antivax-lite message encourages hard-core science-deniers like Susan and others here. He just doesn’t care. And really, why should he? After all, his employer, UCSF, has just awarded him with promotion to Full Professor, which means big bucks in his pocket. Meanwhile he insults concerned parents by calling them “panicking,” “angry,” “unwilling to leave the pandemic behind,” & “hysterical.” Shameful.

Last edited 1 year ago by Will Bash
Howard Gleave
Howard Gleave
2 years ago

Good article. But the statement “Young children are at low risk from the virus” is a huge understatement.

Perry de Havilland
Perry de Havilland
2 years ago

I worry far more about the future of the vaccinated ones.

Elizabeth Hart
Elizabeth Hart
2 years ago

Further to my previous comments, which note the defective Covid-19 ‘leaky vaccines’ don’t prevent infection nor transmission, i.e. don’t provide sterilising immunity.
The monkey trial with the Oxford/AstraZeneca vaccine demonstrated the ‘vaccine’ didn’t prevent infection nor transmission…so why did it go on to human trials? Was this considered?
In this regard, see my email to Boris Johnson: Were ‘leaky vaccines’ deliberately spread round the world? Considering the monkey trial… 22 March 2022.

Lesley van Reenen
Lesley van Reenen
2 years ago

Plenty of people need to be locked up.

Elizabeth Hart
Elizabeth Hart
2 years ago

Are you being sarcastic Thomas Hutcheson?
You say “It helps prevent their inadvertently spreading he disease to others”.
Really? Using Covid-19 ‘leaky vaccines’ that don’t prevent infection nor transmission?
It’s crazy, the children should have been left alone to deal with the virus with their own natural immune response. Who knows what lies ahead for children now with this unnecessary and unethical medical intervention?
Has children’s natural immune response been sacrificed to purportedly protect others? The elderly for instance? In this regard, see my BMJ rapid response published in August 2020: Is it ethical to vaccinate children to protect the elderly?

Elizabeth Hart
Elizabeth Hart
2 years ago

Also see my email to Fiona Godlee, former editor in chief of The BMJ, which also discusses ‘informed consent’: Why should people not at risk of covid-19 be pressed to have covid-19 injections? 30 May 2021.

ARNAUD ALMARIC
ARNAUD ALMARIC
2 years ago

What happened to that ‘agent provocateur’ and Elizabeth Hart’s erudite reply?

16.18: BST.

Jürg Gassmann
Jürg Gassmann
2 years ago

Thank you