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Within this page, you will find Industry Perspective blogs written by the UCA Corporate Support Partners (CSP); Insights from UCA Chief Executive Officer Lou Ellen Horwitz; Practice Management blogs to help you better manage center operations; and bonus UCA education in Educational Insights.

 

EDUCATIONAL INSIGHTS: Pearls from a Practicing Pediatrician - “COVID in Children Potpourri – Latest Information on Impact, Ages and Vaccine Trials””

Posted: Oct 23, 2020
Comments: 0
Author: UCA Admin

Content provided by Thomas W. Tryon, MD, MBA, FAAP; UCA Pediatric Section Chair

 

As all of us care for children on the front lines of the battle with the novel Coronavirus SARS-COVID19, it seems like information about the virus and its impact on children changes on almost a daily basis. According to the American Academy of Pediatrics, “State-level reports are the best publicly available data on child COVID-19 cases in the United States. The American Academy of Pediatrics and the Children’s Hospital Association are collaborating to collect and share all publicly available data from states on child COVID-19 cases”. Here is their latest information that was published in late-September 2020:

 

  • Children represented almost 625,000 COVID-19 positive cases since the onset of the pandemic, which is 829 cases per 100,000 children in the population
  • Only 10.5% of all cases in states that report age demographics represent children
  • While many states don’t report mortality or hospitalizations by age, available data indicate COVID-19 death or hospitalization is uncommon in children. From states that did provide data on children, they comprised 0.5%-3.7% of total reported hospitalizations, and between 0.2%-7.9% of all child COVID-19 cases resulted in hospitalization
  • Severe illness due to COVID-19 appears to be rare among children
  • As for child mortality due to COVID-19, 17 states reported zero child deaths. In states reporting child mortality, 0%-0.16% of all child COVID-19 cases resulted in death
  • Of note, over the two week period of September 10 – 24, 2020, there was an increase of more than 74,000 cases reported in children. This represented a 14% increase.

Recently while working a shift, we had a three week old infant brought in for concerns that the infant had COVID-19. One of our first thoughts was, what is the data of the youngest patient with documented COVID-19? According to the Centers for Disease Control, the youngest case of COVID-19 was reported in China in a newborn infant that was 30 hours old. Here is what the CDC has to say about COVID-19 and newborns:

Much is still unknown about the risks of COVID-19 to newborns born to mothers with COVID-19. We do know that:

  • Infections causing COVID-19 in newborns born to mothers with COVID-19 are uncommon.
  • Some newborns have tested positive for the virus that causes COVID-19 shortly after birth. It is unknown if these newborns got the virus before, during, or after birth from close contact with an infected person.
  • Most newborns who tested positive for the virus that causes COVID-19 had mild or no symptoms and recovered. However, there are a few reports of newborns with severe COVID-19 illness.
  • Preterm (less than 37 completed weeks gestation) birth and other problems with pregnancy and birth have been reported among women who tested positive for COVID-19 during pregnancy. It is unknown whether these problems were related to the virus that causes COVID-19.”1

You may receive questions from parents about the development of a vaccine for COVID-19 and whether it will be available for children. As of now, none of the vaccines under development are being tested in children so none are on track to be licensed for use in children. Recently, the American Academy of Pediatric President Dr. Sara (Sally) Goza in a letter to the FDA and HHS had this to say on this issue: “Children must be included in vaccine trials to best understand any potential unique immune responses and/or unique safety concerns.” “It would also be less than desirable to have one or more SARS-CoV-2 vaccines licensed or available under Emergency Use Authorization at a time when no data have been collected on the safety, tolerability, dose, and regimen for children,” Goza wrote. “For these reasons, we urge the inclusion of children in vaccine trials as we move forward in the development of a SARS-CoV-2 vaccine.”2

At our virtual national AAP meeting last week, vaccine expert Dr. Paul Offit relayed that one of the two mRNA vaccines in clinical trials, produced by Pfizer, requested an amended protocol with the FDA to include adolescents as young as 16 years of age in their expanded enrollment of 44,000 patients He believes this will be the beginning of stages of testing in younger and younger children.3

As we continue to work on the front lines of this pandemic, information and knowledge will continue to change almost on a daily basis. My wish for you is to stay safe and well as we head towards what will be a very interesting and challenging winter.

 

1https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.htm

2https://www.aappublications.org/news/2020/10/01/covid19vaccinetrials100120

3https://www.healio.com/news/infectious-disease/20201004/time-to-include-children-in-covid19-vaccine-trials-experts-say

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