COVID-19 Children’s Corner: Updates on Epidemiology, Variants, Vaccines, Immunity, and More

COVID-19 Children’s Corner

by Dr. Debbie-Ann Shirley, Division Head of Pediatric Infectious Disease

The pandemic and children. Does it feel like you have been noticing more mental health problems in your pediatric patients lately? Well, you are not alone. The results of a large survey of nearly 1,300 parents of school-aged children conducted over the fall were released in an MMWR report last week. Children in full or partial virtual school reported lower levels of physical activity, less in-person time socializing with friends, and worse mental or emotional health compared to those receiving full in-person schooling. Virtual school parents were also more likely to report their own emotional stress, too. Students in virtual school were more likely to be black, Hispanic, or other racial minority than white, revealing yet another health disparity highlighted by the pandemic. The study concludes that “children not receiving full-time, in-person schooling and their parents might need additional support to mitigate pandemic impacts” and adds to our growing awareness that children are experiencing unprecedented increases in indirect adverse health consequences related to pandemic. In case you missed it, you can still watch the VA-AAP virtual town hall on school re-opening held last week on March 23^rd to learn more about how you can get involved to help.

Variants of concern and variants of high consequence. A SARS-CoV-2 variant of concern is one that is associated with mutations that have the potential to alter the ease of transmissibility, severity of disease, or ability to escape immune protection and hence impact COVID-related therapeutics, and/ or vaccines. A variant of high consequence is one that has clear evidence that prevention measures or medical countermeasures have significantly reduced effectiveness relative to previously circulating variants. The CDC has recently added the B.1.427 and B.1.429 strains, first detected in California, to the list of variants of concern, joining the B.1.1.7, B.1.351 and P.1 variants. The B.1.427 and B.1.429 variants are said to be about 20% more transmissible, have significant impact on neutralization by at least some therapeutics, and have moderate reduction in neutralization using convalescent and post-vaccination sera.

As of March 31st, the CDC reports at least 190 cases of the B.1.1.7 variant in Virginia, and 30 cases of the B.1.351 variant. In a press release last week, the VDH announced our first cases of B.1.427 and B.1.429 in the state. None of the emerging variants currently meet the variant of high consequence criteria. As these variants of concern continue to spread and we watch other new variants emerge, it remains critical to continue to practice the public health measures that we know help, including wearing masks and other personnel protective equipment, hand hygiene, social distancing, and vaccination.

COVID-19 vaccines and children. The Pfizer/BioNTech, Moderna and Johnson &Johnson COVID-19 vaccines are currently available for use in those ≥ 16-18 years of age under an FDA Emergency Use Authorization. Vaccine makers have expanded age eligibility in vaccine trials and Pfizer/BioNTech began testing the safety and immunogenicity of their mRNA vaccine in children ages 6-months to 11-years last week. They state that results should be out in the second half of 2021 and subsequently plan to seek authorization for this age group by early 2022. Moderna and J&J are set to follow testing in these younger age groups soon, as well. All three companies have already begun clinical trials in children 12 years and older, and we can look forward to seeing some of these results trickle out in the next few weeks. Here are the latest results from Prizer/BioNTech.