Do the Right Thing for Children: Stop Piling on Unnecessary Risk

by Robert Nelson, MD

November 9, 2021

 

It is with dismay and disappointment that I witness the enthusiastic rollout of COVID vaccine for children 5 – 11. 

Please consider, at the time of this writing:

• The recovery rate for documented COVID in this age group is 99.995+%. 
  • CRF of about 0.005% based on DOCUMENTED CASES.  So, 1.9 million documented positive tests and 94 deaths. (CDC data)
• This doesn’t count the asymptomatic cases that were not documented nor those with home exposure and mild symptoms that weren’t tested.  Some estimates put the likely number of infections at nearly 3 million.
  • So adjusted IRF is even lower than 0.005%. 
• The symptoms of COVID in this age group are often milder than the common cold virus and usually milder than the circulating seasonal Coronaviruses (no vaccine for those) and certainly milder than Influenza for ages 5 – 11.
• There is no vaccine stratification for severely at risk for COVID such as children with CF, severe asthma, organ transplants, heart disease or cancer Tx. 
  • These are the children who would surely benefit from vaccine.
• m-RNA vaccines are associated (likely causal) with pericarditis and myocarditis in teens and young adults.  This occurs mostly after 2^nd dose. 
  • Why take that chance in younger kids?
• The vaccine is a disease-modifying vaccine, it does not prevent future infections or transmission. Effectiveness wanes significantly after 6 – 8 months. 
• The two studies submitted by Pfizer included fewer than 5,000 children.  This is hardly an adequate sample, nor adequate time to follow for long-term consequences. 

Exactly how does one measure the benefit of a vaccine when the recipients have nearly a 100% recovery rate?  The only way is to cite RELATIVE risk reduction without regard to absolute risk reduction.  It is a statistical gimmick. 

Say, for example purposes, that the vaccine reduces virus-associated mortality from 0.005% down to 0.0025%.  That is a 50% relative reduction! Yet, it is an absolute risk reduction of 0.0025.  So, with vaccine the full recovery rate is 99.9975% but only a mere 99.995% without vaccine.

I often hear that vaccinating healthy children will protect the elderly; that is an odd defense if we really believe the vaccine provides individual protection against hospitalization and death.  Everyone at risk for complications and death has had ample opportunity to receive the vaccine and now a booster for those 65 or older, or who has certain medical conditions.  So, with the vaccine readily available (most have received it) to at-risk adults, when did it become the responsibility of children to protect adults?

An uncommon but serious complication of SARS-CoV-2 infection in children is Multi-system Inflammatory Syndrome (MIS-C).  It is s very real, yes, but rare.  Given that the over-all low risk of complications from COVID in children ages 5 – 11, why would we take any risk of serious harm by a using a vaccine lacking long-term safety data which is indicated for an illness that behaves much like the common cold virus in most children?

Has anyone calculated the number needed to vaccinate to avert one adverse outcome?  With such as low mortality/morbidity rate to begin with, we may never get to a point where benefit outweighs risk; especially considering the efficacy wanes over time and these children will likely become infected in the future.

This issue is very much on parent’s minds.  Even in the urgent care setting, I have been asked for my opinion several times by parents who want to make the right decision for their families.  I am committed to always affirming to the parents that it is ultimately their choice, which I have certainly done every time I’m asked about it.  I will never push them one direction or the other, but if asked I am obliged to give them my honest opinion. 

I will certainly not promote this endeavor.  I can only hope the vaccine remains voluntary for school and athletics/activities for children and that parents will use caution and utmost discretion when deciding on whether to vaccinate their children. 

In my view, it is a public policy mistake and an intervention that will put children at greater over-all risk compared to the yet unsubstantiated, at best meager, benefit that vaccine may provide to healthy children.  Given the decision to endorse COVID vaccination of healthy children ages 5 – 11, and acquiescence to the vaccine mandates, I have lost great deal of confidence in healthcare systems around the country to make decisions in the best interest of patients and providers.