Last night I dropped into a restaurant to pick up dinner. The place was packed, with every table filled, people crowding the bar, and a dozen waiting to be seated. The only mask in sight was mine. Am I being over-cautious?
As we enjoy a bit of a break in the covid pandemic, it’s easy to become complacent. It’s hard to make accurate calculations about risk, especially since we’re all very, very tired of living limited lives.
And when numbers are low, it’s a good time to loosen up, especially if you’ve been fully vaccinated. “Fully vaccinated” in adults means having had three shots. Since omicron hit in late 2021, two shots has not been sufficient.
And there’s also the issue of “hybrid immunity”.
If you had 2-3 covid shots, and then got sick during the winter surge, data suggest that the infection acts as a booster. This effect is not strong enough to risk being infected intentionally. To be perfectly clear, the risks of infection far outweigh the “boosting” benefit, especially since vaccines are so available. However, authorities in some countries (e.g. Canada) recommend waiting 3 months after infection to get another shot. (We do not make that recommendation in the U.S. If you’re due for a shot, you can get it as soon as you are out of your isolation period.)
It’s been clear for a long time that we adults need to be fully vaccinated to avoid getting severely ill. Given the current environment what should we do about our kids?
I personally believe that loosening up masking rules in schools was a bad idea, but we can easily turn that around. If we can increase the number of kids who are vaccinated, mask-off environments become much, much safer. But the low numbers of kids who have had covid shots show that we’re hesitating.
Two new studies add weight to the argument in favor of vaccinating our kids. By way of background, remember that vaccination as a requirement to be in schools is not a new idea.
For many decades we’ve used vaccination to protect our kids in congregate settings. This has been only minimally controversial, and that only in the last few years with the rise of the anti-vaccine movement.
The first study, from the New England Journal of Medicine, looked at vaccine effectiveness in children and adolescents. In summary, it showed good, continued protection against severe disease.
This confirms what we’ve been seeing in other studies—that while vaccination doesn’t always give enduring protection against infection, it does give good protection against the worst outcomes. But there have been some concernes about side-effects, which is the topic of the next study.
The CDC looked at heart complications of both covid infection and covid vaccination. This is important because of reports of heart inflammation after covid vaccination, especially in adolescent boys. What they found was very encouraging. Myocarditis and pericarditis were very rare in both covid infection and with covid vaccination. But the risk of heart inflammation was higher in people who had covid than it was as a side effect of vaccination.
Since the numbers have been down, I’ve been in restaurants twice, and even made it to the barber shop. I’m very careful, but I felt that given the numbers and my vaccination status, it’s worth it to take the small risk. I still wear my mask in the supermarket and other crowded indoor environments, and I likely will for a long time to come.
We can’t count on kids to choose to mask up when necessary. If given the choice, peer pressure and fatigue will lead them to drop it. We can make this less of an issue by requiring covid vaccination for kids in schools, summer camps, and other congregate settings. While severe disease is relatively rare in kids, the last wave especially saw a frightening number of pediatric hospitalizations and deaths, and outbreaks are very disruptive to our kids lives. No one likes remote schooling.
So let’s get those kids vaccinated. It’s safe and effective. Right now it’s a choice—it’s not being required for school. Let’s protect our kids by making a good choice.
-pal