by Dr. Debbie-Ann Shirley, Division Head of Pediatric Infectious Disease
The pandemic and children. We are well into our second year of the pandemic and over 3.94 million children to date have tested positive for COVID-19 in the United States, while 3,742 children with MIS-C have been reported, including 71 cases from Virginia. As we watch case rates decline nationwide, about 40,000 new child cases were still reported in the week of May 20th, with children now accounting for as much as 20% of new reported weekly COVID-19 cases.
Variants of concern. The B.1.1.7 variant of concern remains the predominant variant in the US, including in the state of Virginia, currently predicted to account for about 70% of viral lineages. The incidence of the B.1.617 strain and its three subtypes, first identified in India at the end of last year, is being closely monitored as the strain rapidly spreads in other countries, including the United Kingdom. Cases have been reported in the US, but the prevalence at this time is very low. Fortunately, the Pfizer-BioNTech vaccine is reported to be 88% effective at preventing symptomatic disease caused by B. 1.617 in those who are fully vaccinated.
COVID-19 vaccines and children. On May 10, 2021, the FDA authorized the Pfizer-BioNTech COVID-19 mRNA vaccine be given to adolescents ages 12 to 15 years, expanding on the prior emergency use authorization for those 16 years and up. Both the CDC and the AAP followed shortly after with recommendations to vaccinate children 12 years and older, and UVA Health has already administered 1,631 vaccines to adolescents 12-15 years of age over the ensuing 2-week period following authorization. In a press release, Moderna reported that similar to the Pfizer-BioNTech vaccine, its COVID-19 vaccine was also 100% efficacious in adolescents studied byclinical trial. Moderna plans to seek FDA authorization in June. Clinical trials in younger age groups are ongoing by both companies. No safety concerns emerged in either of the two adolescent clinical trials and the most common side effects reported from the vaccine have been local pain at the injection site and non-severe systemic effects such as fatigue or headache. Body aches and chills occurring less frequently, and all side effects appear short lasting. Of the already over 5.2 million adolescents who have received at least one dose of the COVID-19 vaccine the vaccine appears to be overall well tolerated. Rare reports of brief myocarditis and pericarditis have been reported following receipt of the mRNA vaccines, most commonly within a few days of the second dose. It is still not determined whether this is caused by the vaccine. The CDC and AAP continue to recommend use and clinician guidance for evaluation, management and reporting of myocarditis is now available.
Masks and more. The COVID-1 vaccines have been so effective and now with 62% of the US population over the age of 18 years having received at least one dose of COVID-19 vaccine, we are getting closer to resuming activities as normal. The CDC has released new mask guidance that allows fully vaccinated people to stop wearing masks while several additional restrictions on distancing and gathering are being lifted throughout the state. UVA health and safety policies are also changing, but do not apply for healthcare settings where masks are still required. Our patients and families can expect to see easing of UVA visitor restrictions as of June 1st as well. Children over the age of 2 years should also continue to wear masks while participating in childcare, school, and camp activities particularly when indoors or in crowded outdoor settings to help mitigate spread, until more of this population can be vaccinated.
Happy Summer and Keep Safe
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