What questions have I not answered? You asked about boosters …

Comment on Why Vaccinate Kids Against COVID-19? by Sean Pitman.

What questions have I not answered? You asked about boosters for children, and I answered that question as best as I know how at this point in time. Again, I don’t know for sure, but I am hopeful that boosters might not be needed for children since I believe that we might be nearing the end of the COVID-19 pandemic – that we might soon be reaching “herd immunity”.

As far as “not caring”, you’re mistaken. I have two young sons (10 and 12 years old). So, I do care very much as to the correct decision as to what to do for my own two boys here. And yes, my oldest son has had his first Pfizer vaccine two weeks ago… without any ill effects except for a mildly sore arm for a couple of days.

Sean Pitman Also Commented

Why Vaccinate Kids Against COVID-19?
Assuming the 90% efficacy figure for the Pfizer vaccine holds up, vaccinating one million 5- to 12-year-old children would prevent 33,600 cases and 170 hospitalizations over 120 days. The CDC puts the figure about 58,000 cases and 226 hospitalizations prevented. During the same period of time, there would be around 21 cases of myocarditis or pericarditis (Link, Link). There is also the argument that the significant majority completely recover from vaccine-related myocarditis/pericarditis without any long-term effects. Recovering from a COVID-19 infection requiring hospitalization, however, often results in long-term injuries.


Why Vaccinate Kids Against COVID-19?
While vaccinating children is certainly more of a gray area as compared to vaccinating adults and those with pre-existing medical conditions, there are benefits to vaccinating children that Dr. Martin Kulldorff failed to mention – such as injuries that happen even if a child doesn’t die. These injuries and longer-term problems aren’t exactly rare either – as described in my article above. There is also the issue of children spreading the virus to others who are more susceptible.

Even death, while relatively uncommon among children compared to older adults, is still a problem. Almost 700 children have died from COVID-19 in the US so far. While this might seem to be similar to a normal flu season where between 34-200 children die during a given year, keep in mind that these numbers are affected by flu vaccinations that are given to children every year. Flu shots are widely available to all kids, while no COVID vaccines have been authorized for children under 12. More than half of children, around 60%, get their flu shot each year. This significantly reduces the death rate for children who are vaccinated since the vast majority (~90%) of kids who die from the flu each year are unvaccinated. That means, if you compare apples to apples, the flu death rate for children would be much higher without the annual flu vaccine – which is the reason why a flu vaccine for children has been made available. Why then should we not make a COVID vaccine available for children as well?

“Among children age 1-14, COVID-19 was in the top 10 leading causes of death through August and September 2021. Among children age 5-14, COVID-19 ranked as the number 6 leading cause of death in August and September. Among children ages 1-4, COVID-19’s rank rose from number 13 to number 7 among leading causes of death in August 2021 and held there in September.” (Link)

As far as the known risks of vaccines for children, these risks are still far less than the risks of getting infected by the live virus – for every significant risk one can list.

It is for this reason that the FDA advisory panel unanimously voted, yesterday, to approve the reduced dose Pfizer vaccine for children ages 5-11 (Link).


Why Vaccinate Kids Against COVID-19?
Although rare, it is thought that the production of the spike protein, from cells translating the mRNA vaccine, can trigger the same inflammatory cascade as a COVID-19 infection, resulting in these neurotrophic effects such as seizures (Link, Link). In children, seizures following various kinds of vaccinations may be related to the development of fevers (Link). Such febrile seizures do not end up affecting a child’s development or behavior (Link). It may also be that certain individuals are more prone to this side effect.

It is also interesting to note here that seizures may be the first and main manifestation of COVID-19 in children. “Seizures may occur even in children with no history of epilepsy and in the absence of fever or severe COVID-19 illness, necessitating a ‘high index’ of suspicion for the virus to make an early diagnosis and allow for appropriate infection control measures… Among 175 children diagnosed with acute SARS-CoV-2 infection in the emergency department over 10 months in 2020, 11 (6%) presented with seizures. Studies in adults with COVID-19 have reported seizures in 0% to 2% of cases, the investigators note. The 11 children with seizures (seven boys) ranged in age from 6 months to 17 years (median age, 11.5 years). All of them had seizures as the presenting sign of infection and none had severe COVID-19 requiring ventilatory or hemodynamic support. Six of the 11 children presented with fever.(Link).


Recent Comments by Sean Pitman

Natural vs. Vaccine-derived Immunity
Toby Rogers is a political economist who is also strongly anti-vax. He is not a medical scientist or physician.

In any case, this particular article, by Rogers, distorts the data regarding vaccines and the position of Dr. Peter Aaby – who is a strong supporter of vaccines in general (although, when it comes to COVID-19 vaccines, he seems to favor the adenovirus-based vaccines, such as Johnson and Johnson, AstraZeneca/Oxford or the one produced by China’s CanSino Biologics, over the mRNA-based vaccines – since the adenovirus-based vaccines may have more benefit on reducing “overall mortality – Link). Note, however, that this study found that of the 31 deaths that occured in mRNA-vaccinated individuals, only two were from COVID-19. The rest were due to other causes. For the adenovirus-vaccinated group, two of the 16 deaths were from COVID-19. It’s very difficult, then, to determine a clear relationship here between the different types of vaccines and deaths not related to COVID-19.

“The study isn’t about the effectiveness of mRNA vaccines against COVID,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health and Security. “The study is aimed to determine if COVID vaccines have non-specific mortality impacts that extend beyond the incontrovertible mortality benefit they confer with COVID-19. Certain vaccines have effects that extend beyond the target infection and decrease mortality from other causes (e.g. measles vaccine).”

Dr. Monica Gandhi, an infectious disease specialist at the University of California, San Francisco, also said the question of the paper isn’t about COVID-19, but whether the vaccines had a beneficial effect on other causes of mortality. The research reinforced that both types of vaccines significantly prevented COVID-19 deaths, “which is not surprising as both types of vaccines generate cellular immunity against SARS-CoV-2, protecting us against severe disease.”

“However, to be fair,” Gandhi said, “the number of non-COVID and COVID deaths were rare in all of the pooled analyses and the causes of non-COVID deaths not well adjudicated, so this analysis needs to be taken as preliminary and hypothesis generating at best.”

(Link)

What’s interesting here is that studies have shown that the “all cause” mortality rate is also reduced for those who have been vaccinated against COVID-19 – to include those who’ve been vaccinated via the mRNA-based vaccines (Link).

Anyway, here’s a more balanced view of Dr. Aaby’s position on vaccines (Link). Note also that Dr. Aaby supported the vaccines against COVID-19 for adults (Link), but not necessarily for children since children have significantly reduced risk (compared to adults) for COVID-19 infections (Link). Dr. Aaby did publish some interesting results, however, suggesting that the polio vaccine, as well as the BCG and MMR vaccines, may also reduce childhood risk from COVID-19 as well (Link, Link).

“We would not be surprised if MMR could provide some protection against severe COVID-19,” said researcher Peter Aaby, of Bandim Health Project in Guinea-Bissau and Research Centre for Vitamins and Vaccines (CVIVA), Statens Serum Institut, a governmental public health and research institution under the Danish Ministry of Health in Copenhagen, Denmark and a pioneer in the field. “Together with my partner Dr. Christine Stabell Benn, we’ve been reporting on mortality reductions from live-attenuated vaccines such as polio, BCG and measles vaccine/MMR for multiple decades now, and arguing for optimized vaccine schedules. With the COVID-19 crisis adding urgency, it’s good to see the potential of non-specific immune effects being taken seriously.” (Link)

Overall, I do find Dr. Aaby’s main concern to be well-supported that vaccines may produce unforseen beneficial as well as detrimental side effects. In the case of COVID-19, however, it was very clear to me that the potential unknown risks were clearly outweighed when compared to the known risks of getting infected by COVID-19 as well as the very clear known benefits of being vaccinated – particularly for adults over the age of 50 and those with various medical conditions that put them at great risk. Even healthy children seemed to be far more at risk from a live COVID-19 infection than from the vaccines – particularly regarding long-term effects. Of course, this was all before the current less severe Omicron variant took over and the predominant variant worldwide. At this current point in time, vaccines against COVID-19 don’t seem to me to have as significant of an advantage compared to earlier on in the pandemic.

Hope this helps,

Sean


Back to Square One…
I’m not sure what “teachings” you have in mind here that need amending?


Mandates vs. Religious Exemptions
I’m just saying is that if you think that what you say on blog sites like this one doesn’t really affect people, especially when you present yourself as an MD, you’re mistaken. I know that people have been influenced against taking the mRNA vaccines by what you’ve said here in this forum. You’re not simply being neutral in what you’ve posted. You do, in fact, come across as being opposed to the mRNA vaccines – also noting that you didn’t get vaccinated yourself and chose to get infected by the live COVID-19 virus without pre-established vaccine-based immunity. You’ve also come across as being strongly against any response by me to the articles that you’ve referenced where I point out how these papers really do not actually undermine the efficacy and/or the relative safety of the mRNA vaccines. Clearly, you don’t come across as being neutral on the topic.

And, such comments have an effect on people – they really do. While that upsets me, again, it’s more important to me to allow for those who disagree with me to also post their comments rather than to only allow what I personally think is true to be posted.

Beyond this, no one is twisting your arm to post our comments here. You can post or not post as you wish. That’s entirely up to you. But, don’t expect that I won’t push back when you post comments that I think will increase the risk of those who read what you have to say…


Mandates vs. Religious Exemptions
The difference between us is that I see people in the ICU, as does my brother-in-law Dr. Roger Seheult (a pulmonologist in S. Cal.). You might see the occasional person die from COVID-19, but those who work ICUs in larger medical centers see far too many people die from COVID-19 – to include young people (not just those in nursing homes). You might offer the vaccine to those whom you see, but if you present arguments to them like the ones you’ve presented here, such advice most certainly does result in increased injuries and even death. For me, that’s a big deal. You might call it “weird and overly dramatic” if you want, but for me the effort to save lives and reduce injuries is neither “weird” nor “overly dramatic”. I mean, that’s why I do what I do…

Now, you say, “The discussions that I have on blogs like this are my personal thoughts and concerns. They don’t reflect the way that I actually practice primary care medicine on a daily basis.”

That would be great if this were a private conversation, but it isn’t. It is a public conversation and your words have an impact on the hundreds who read this blog every day. I mean, in a very real sense, especially given that you include your title “MD” with your name, and often point out that you are a medical doctor when you post to this blog, you are, in fact, practicing medicine when you post public comments like you do. You cannot simply say, “I don’t actually follow my own advice that I post in blogs when I practice primary care medicine on a daily basis.” Your influence simply isn’t limited to what you do face-to-face with patients in your clinic. Your influence also extends to what you say and do in front of people outside of your daily medical practice.


Mandates vs. Religious Exemptions
Well, I’m glad you go at least this far… although I still think that the kinds of arguments you present here really do put people’s lives and health at increased risk. I know you don’t agree, but that’s how I see things from my own perspective.

Now, I’m fine with you, and those who think like you, having the ability to freely share your opinions – despite how mistaken and damaging I personally think these opinions may be. That’s just the nature of living in a free society – which I think is far more important than restricting the freedom of speech.