Sunday, December 5, 2021

How Doctors Give COVID Vaccinations to Children 5-11 Years

With the pandemic disrupting their daily lives, families have been waiting for this moment and hope the healthcare system is ready: 28 million children aged 5 to 11 in the United States are now eligible for two Pfizer medicines. -Dose the COVID-19 vaccine and healthcare providers and public health workers are working behind the scenes to meet the surge in demand from parents looking to vaccinate their school-aged children.

Caitlin Givens pushed a wheelchair with her daughter, 6-year-old Penelope Porter, into an examination room Wednesday morning at the Children’s National Research Institute in Washington, DC. Dr. Nicola Brody was waiting for them with alcohol wipes and a dose of COVID-19 vaccine. Penelope, who lives with cerebral palsy and feeds through the G-tube, was one of the first children aged 5-11 to receive the vaccine in the capital.

“I know you’re smiling down there,” Givens said as she knelt next to her daughter, who was wearing a mask. Givens rolled the gray shirt sleeve over Porter’s left arm, and Brodie wiped the disinfectant around before injecting the dose.

Givens said she followed closely the discussions on the vaccine at the Centers for Disease Control and Prevention. Givens said that whenever Porter develops a fever or chills, seizures often follow. “Even a cold can get it for weeks.”

Now, in the doctor’s office, she was thrilled that her medically fragile daughter would be vaccinated against the virus, which could be particularly devastating.

Gilberto Tully, 11 (center), listens as pediatrician Dr. Nicola Brody describes the COVID-19 vaccine Tully and his brother, Damonta Richardson-Talley, 9, will receive at the Children’s National Research Institute in Washington DC on Wednesday … Talley is awaiting heart and liver transplants and has been homeschooled throughout the pandemic. His mother, Caroline Tully, said that after being fully vaccinated, he would be able to return to school in person. Photo by Laura Santhanam

Although children in this age group are less likely to suffer from severe coronavirus disease, there are many reasons for parents to be relieved now that their children may get their pokes. According to federal estimates released on Tuesday, four in 10 are infected with the coronavirus. Of these children, about 150 have died from COVID-19 and over 8,000 have been hospitalized. One third of these patients had no previous medical complications. When schools opened for full-time education this fall, millions of parents are concerned that their children may come home sick, infect someone else, or be forced to stay home for several days in quarantine.

Dr. Kurt Newman, president and chief executive officer of Children’s National Hospital, which recruited volunteers for clinical trials of the Pfizer vaccine between the ages of 5 and 11, said he sees more hope and excitement this week among pediatric workers at the forefront. with a vaccine available to young children and patients. Throughout the pandemic, he and his staff monitored children with ventilators “choking” and wondered how the virus would affect the long-term development of their brains and hearts. “You didn’t see what I saw,” he said.

Yet polls show that most parents are not ready to vaccinate their school-age children – many are waiting to see how things go during this initial implementation. According to a poll published Oct. 28 by the Kaiser Family Foundation, only three in 10 parents with children aged 5 to 11 said they want to vaccinate their children against COVID-19 as soon as doses are allowed.

Thus, pediatricians, who are among the most trusted people in healthcare, should focus “not only on making vaccines available, but also on providing access to information,” said Amy Wimpy Knight, president of the Children’s Hospital Association. “This is what a lot of people are focusing on right now.”

How is the implementation in the country

Before the CDC approved the vaccine, batches of age-appropriate doses began arriving at hospitals and health departments in some parts of the country. In Washington on Monday, trucks delivered packages filled with 10 microgram doses of the vaccine, a third of the adult dose, so staff can prepare to administer them to young children. The ability to squeeze more doses out of the vaccine stock is one of the benefits of this deployment. In late October, the Biden administration said it had already procured sufficient doses of the vaccine for all children in this age group, and committed itself to “quickly distributing these doses and making them available to families across the country in a convenient and fair manner.”

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But this does not mean that you will not have to wait. “It’s important to know that not all locations will have vaccines delivered on day one,” said Patrick Ashley, senior deputy director of the DC’s Emergency Preparedness and Response Office, noting that several more doses are on the way. to Washington.

Chris DeButt (left) kneels next to his 6-year-old son Daniel as pediatrician Dr. Nicola Brodie injects Pfizer-BioNTech's COVID-19 vaccine in Washington, DC.  DeBatt and his son were the first family to attend Children's National Research Institute on Wednesday.  in the morning for Daniel to receive his first shot of coronavirus protection.  Photo by Laura Santhanam

Chris DeButt (left) kneels next to his 6-year-old son Daniel as pediatrician Dr. Nicola Brodie injects Pfizer-BioNTech’s COVID-19 vaccine in Washington, DC. DeBatt and his son were the first family to attend Children’s National Research Institute on Wednesday. in the morning for Daniel to receive his first shot of coronavirus protection. Photo by Laura Santhanam

When Pfizer’s vaccine first became available to adults, it was very sensitive to temperature and required ultra-low storage, which many healthcare providers lacked. Doses had to be thrown away if they were refrigerated but not used after a month. These conditions made the distribution work difficult in some parts of the country. For ages 5-11, Pfizer has changed the formula so that doses can be stored in a regular refrigerator for much longer – up to 10 weeks – before the expiration date.

In Milwaukee, Dr. Smriti Khare, president of Children’s Wisconsin-Primary Care, said pediatricians and nurses worked with the city’s Department of Public Health to make this “science” a process they have worked for educators and children as young as 12 years old. and older at the start of a pandemic. To reach up to 49,000 children in the service area, Kara said they are distributing the vaccine through mass vaccination sites, clinics, pharmacies, school gyms and cafeterias.

And as health experts say children can safely receive COVID-19 and influenza vaccines at the same time, Khare expressed hope that these visits will give children and families a chance to get back on track of preventive care, something millions of households neglected during the pandemic and “All the difficulties that happen in life,” said Kare.

In Little Rock, Arkansas, Dr. Rick Barr said pediatricians there and across the state are awaiting vaccine delivery and plan to offer children doses through their primary care physicians this week. Barr said Tuesday that he was looking forward to a vaccine for young children because “it will help children get back to their normal lives.”

Registered Nurse Jennifer Deerman of the University of California San Francisco Children’s Hospital Benioff said doses arrived Tuesday at her Bay Area hospital system and staff plan to use travel lanes to help distribute pediatric doses starting Friday in some locations. Deerman said the hospital system will have a separate alley and a nurse who will distribute COVID vaccines to young children as quickly as possible. To manage vaccine supplies, hospital staff prefer meetings, but allow rounds, Deerman said.

“We understand that it is not easy for some people to access an electronic portal or even get a phone,” Deerman said. “The one who approaches will not turn away.”

Image from iOS-8

Pediatrician Dr. Nicola Brody (right) injects the Pfizer-BioNTech COVID-19 vaccine for 6-year-old Penelope Porter as the mother of the baby, assures her daughter Caitlin Givens on Wednesday at the Children’s National Research Institute. Porter was one of the first children aged 5-11 to be vaccinated against the coronavirus in the nation’s capital just hours after the Centers for Disease Control and Prevention approved its use in young children. Photo by Laura Santanam / PBS NewsHour

Answering questions, calming fears

While some aspects of distribution have become easier, many pediatricians and health care providers report that they receive more questions from parents about this younger cohort than about children aged 12 and older, said Knight of the Children’s Hospital Association.

Childhood immunization schedules are food for pediatricians, Knight said. But with the COVID-19 vaccine, Knight said “there is doubt about that.”

Some parents have raised concerns about reports of myocarditis – or inflammation of the heart muscle that can cause shortness of breath and chest pains – in children who receive the vaccines, especially boys, Barr said. But he noted, “With the vaccine, it’s not about what we’re seeing with COVID infections.”

These infections were more likely to contribute to myocarditis than the vaccine in any age group, according to data provided Tuesday by experts from the CDC’s Advisory Committee on Immunization Practices. When COVID-related cases did occur, they caused more severe cases of myocarditis than were reported from participants vaccinated during a clinical trial of the vaccine or after millions of doses were administered to the public.

So far, the most common side effects associated with the COVID-19 vaccine in the 5-11 age group include initial pain and swelling at the injection site, followed by fever, fatigue, headache, and chills, according to data released Tuesday. … These side effects are very similar to those seen after other childhood vaccines.

Givens, a healthcare professional, is one of those parents who didn’t want to wait to see how the vaccine worked. Along with 6-year-old Penelope, she also has a toddler who is almost 3 years old and a 6-month-old infant, and after vaccination, she gave all three babies breast milk, hoping that they could acquire her antibodies. For several months, the family lived in voluntary isolation to protect Porter.

“We’ve been living with bated breath for the past two years,” Givens said. Now, relief.

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