“Please involve your child in the decision making. Speak to your paediatrician and do not rely on Google doctor for your information.”

That was the advice to parents coming from Dr Jose Nunez with regards to them making informed decisions on having their children vaccinated against the Covid-19 virus.

“We advise for the parents to have healthy discussions with your doctor, your healthcare provider. Don’t forget the child especially those between 12 and 18. In fact, looking at the statements on TV by some of these teenagers, I’m quite impressed by the statement that they made, some of them caring and protecting their grandparents and so on. Sometimes I wonder if some of these children are actually smarter than their parents.”

Nunez, the Head of Paediatrics at the San Fernando General Hospital, who was speaking during Wednesday Covid-19 press conference hosted by the Ministry of Health, urged parents to get vaccinated and to have their children vaccinated as well.

“As a paediatrician we say vaccination is our bread and butter. We live and breathe vaccines. We start giving vaccines to children from the age of two months, so it is something that we’re very well aware of the benefits of vaccination.

Benefits of vaccinating children

“The obvious benefit of having your child vaccinated is so that your child doesn’t get Covid. That is what everybody wants.”

He said the argument people would put forward is that children are less likely to get serious illness, which is true, less hospitalisation and less death.

He noted however, that children can get Covid and they can get it very, very seriously, developing a condition called the Multi-Inflammatory Syndrome in Children (MIS-C).

“The other thing to factor in is the Delta variant which is having a very harmful effect on children in the USA. Just las week the headlines were out saying, “Paediatric hospitals in the US in peril as Delta hits children”.

Noting that fortunately Trinidad and Tobago is not in that situation as yet, Nunez said: “We’re hoping not to be in that situation. We’re hoping that is the message we want to get across, for children to get their vaccine, for adults, parents to get their vaccine so that we do not reach that situation, because believe me, when you hear the Children’s Hospitals in Dallas, in Mississippi being full with children, having to open up more space, that is obviously a very serious problem and we’re hoping that we never reach to that stage.”

Preventing transmission

Nunez stated that children are very, very good at sharing things, especially their germs.

“It is very common for children to be transmitters, for them to be passing on these infections. We also want the children to be, if they’re vaccinated you have reduction in spreading it to all the adults, their grandparents and the teachers as well.”

He said with regards to the often used term herd immunity, part of that herd immunity has to include children as they are part of the herd.

“If we want to achieve this herd immunity we have to vaccinate the children as well. We cannot forget them, they will be a big factor after we’re moving along with the adults and their parents and their teachers. Vaccinating the children will be a part of the herd immunity approach.”

He said the statement ‘kids need to go back to school’ has been bandied about but it plays a big mental health effect on the wellbeing of the children and the parents, and it’s affecting their education and their social development in terms of the interactions they have at school.

“Children need to go back to school but more importantly, they need to stay in school because we hear reports in other countries where they open the schools and as soon as there’s an outbreak, one child getting Covid-19 in the class, panic breaks out and then the school gets shut down.”

He said the way to avoid such a scenario is having the children vaccinated.

“As an analogy, most of the times when I see children in my office coming for chicken pox vaccine is because they have an outbreak in the school and that situation creates panic. They come for their vaccines but remember that vaccination is prevention and you need weeks before you get your full immune response, so it doesn’t make sense to be giving them a vaccine when there’s already an outbreak. So, we should be looking at that. People will be much more at ease if the teachers as well as the students have had their vaccines so when there’s a case of Covid in the class, obviously you look out for symptoms but the whole school doesn’t shut down and the kids don’t get sent back.”

Nunez noted that having children vaccinated also delivers cross protection to other children who for some medical reason cannot get the vaccine, so their colleagues and their friends getting the vaccine will help protect them as well.

MIS-C and Myocarditis risks

“The risk of myocarditis is very, very low. It’s a self-limiting condition which means that it would actually get better on its own, and children make full recovery.

He said if all the children between the ages of 12 to 18 were to be vaccinated, only about 10 of them would develop mild cases of myocarditis.

“What we advise for these children is to avoid strenuous exercise for at least one week after their vaccine, especially the second dose. This is more important for children who are very athletic and they’re really straining their hearts after their vaccine. Symptoms to look out for would be chest pain, shortness of breath or palpitations.”

On the issue of MIS-C, Nunez said it is a condition that develops in some children, maybe four to six weeks after they have been vaccinated.

“Some of them can be completely asymptomatic but we know that they had it because we’re actually checking for antibodies in their blood, and it comes back positive. So this is something that some children get after getting Covid and the key presentations are having fever, rashes, red eye and red mouth, but the key one to highlight to the parent is the fever. If your child after having had Covid, starts to have fever again then please see a doctor.

He said children who develop MIS-C usually require hospital treatment but if it’s picked up early, it is something that is treatable.

“We are concerned about the possible long term effect on the heart and the swelling of the arteries around the heart.

“If all the children in Trinidad and Tobago from basically birth zero to 16 were to have Covid, we’re talking of hundreds of children with MIS-C as oppose to reminding you about the small amount, possibly 10 cases of myocarditis we’ll be looking at if all the children get their vaccine.

He noted that Covid itself can cause more serious complications as opposed to the very low incidence with the vaccines.

Risks versus benefits

“When it comes to vaccine acceptance it’s always about making an assessment on the risks and benefits, and remembering that vaccines are meant for prevention.

“If we do get a huge Delta outbreak and the hospitals are full, that’s not the time to be rushing for vaccines.

“Vaccines are safe, we’ve said that over and over again, and they are effective even against the Delta variant,” Nunez said.

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