Hi readers,
This week, the U.S. came closer to authorizing COVID vaccines for children. After a drawn-out debate on Tuesday, an FDA advisory panel voted to recommend a kid-sized dose of the Pfizer vaccine for children aged 5 to 11. Pending the approval of this recommendation by the FDA and the CDC, Pfizer’s vaccine could become the first COVID vaccine to be administered to the roughly 28 million elementary school children across the country. Moderna, hot on Pfizer’s heels, said on Tuesday that a smaller dose of its vaccine produces a strong antibody response in kids aged 6 to 11 and plans to submit this data to regulators.
The FDA advisory panel’s decision wasn’t easy. Over a day of tense discussions, panelists weighed the risks and benefits of a smaller dose of Pfizer’s vaccine (one-third of a full dose), which, according to data from the company’s clinical trial, is 90.7% effective at preventing symptomatic disease in children. Most of the debate focused on the real but very small risk of vaccination-induced myocarditis, an inflammation of the heart muscle that has occurred in a small number of people who got either of the available mRNA vaccines (Pfizer or Moderna), particularly young men under age 25.
The conversation also touched on the negative social and educational impacts of the pandemic on children, which have been profound—and could be mitigated by widespread vaccination for children. CDC infectious disease specialist Fiona Havers pointed out that school closures due to COVID affected over a million students—a disproportionate number of them children of color—between August and early October.
Children around the world are suffering through an unprecedented mental health crisis, largely because they haven’t been able to attend school during the pandemic. This month, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association jointly declared a national emergency in child and adolescent mental health. They noted that the stress brought on by the pandemic had accelerated an already existing mental health crisis that saw rates of mental health concerns and suicide rise between 2010 and 2020. Now, not only are kids facing “soaring rates of depression, anxiety, trauma, loneliness, and suicidality,” but more than 140,000 children, the majority of them children of color, have lost a parent or primary caregiver to COVID.
In the same way vaccination has allowed many adults to resume a somewhat normal life, it would let most children finally return to in-person learning, socialize with other children, and avoid disruptive school closures and frequent testing—which no doubt would be a welcome change for harried parents, too. But beyond that, it would also restore access to important services provided at school—free meals, counseling, mentoring, and access to the internet and recreational facilities—which can be crucial lifelines for kids, especially those from low-income families.
Many experts around the world have called attention to the impact of the pandemic on children’s mental health. In July, a group of scientists from France argued in The Lancet that the detrimental effects of school closures on children’s education and well-being were reason enough to vaccinate children. “School closure can affect learning, lead to anxiety and depressive symptoms, exacerbate tensions or even intrafamily violence, and deepen social inequalities,” they wrote. In September, the editorial board of Nature Medicine warned that the “consequences of failing to curb transmission and keep children in school could be dire” and go far beyond the impacts on education and mental health. For many children, they wrote, spending more time at home or on social media increases the risk of abuse, domestic violence, and, in some countries, even childhood marriage or genital mutilation, which has increased during the pandemic.
The physical health risks of vaccinating kids against COVID are real, but the mental health risks of not vaccinating kids must be factored into the conversation as well. While most people with vaccination-induced myocarditis have recovered quickly, as my colleague Dana Smith wrote in Fortune this week, the impact of the pandemic on children’s mental health could last throughout their lives, leading to long-term mental health or substance abuse issues.
Not all children will be affected by the pandemic in the same way, of course, but among the most vulnerable are children of color, whose well-being has been disproportionately impacted by the pandemic. They have been more likely to lose a parent, suffer educational setbacks, face food or housing insecurity, lack internet access, and, in some cases, experience race-based harassment.
The mental calculus of vaccinating one’s children differs for every parent. Results of a Kaiser Family Foundation poll released today showed that 27% of parents would seek vaccination for kids aged 5-11 “right away.” Thirty-three percent, however, say they will wait and see how the vaccine is working first, and 30% said they definitely won’t vaccinate their kids. The majority of these parents expressed concerns about the unknown long-term health effects of vaccination on their kids. While the data reviewed by the FDA show that a low dose of the Pfizer vaccine is safe for children, these concerns are fair and understandable. But concerns about the unknown long-term mental health effects of the pandemic must be given similar weight.
Thanks for reading, and please reach out if you have any questions or comments—I’d love to hear from you.
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Stay safe out there,
Yasmin
DIGITAL HEALTH
OneDrop and Bayer launch a digital platform for cardiovascular health. On Wednesday, the precision health company OneDrop—best known for its sleek, streamlined glucose monitoring tools and app—announced a new platform for preventing cardiovascular disease, developed in partnership with Bayer. The platform uses A.I. to detect trends in blood pressure and weight, measured through devices designed by Withings, and use them and data from other inputs to guide the user toward healthier habits in real time. The platform is the first joint offering between the two companies since 2019, when Bayer made a deal to use OneDrop’s predictive capabilities and mobile platform and made significant investments in the company. (FierceBioPharma)
INDICATIONS
A common antidepressant shows promise for treating COVID. Results from a large clinical trial published Wednesday in the Lancet Global Health showed that treatment with a common antidepressant, fluvoxamine, reduced the need for hospitalization in high-risk patients with early COVID. Fluvoxamine, sold in the U.S. as Luvox, is an inexpensive selective serotonin reuptake inhibitor that’s prescribed to manage mental health conditions like depression and obsessive-compulsive disorder. It’s also been shown to have anti-inflammatory effects, which is why it drew the attention of researchers studying COVID. The results are promising—in part because fluvoxamine, which costs about $4 for a 10-day course, is relatively inexpensive—but questions remain about the drug’s impact on a wider swath of patients and its utility alongside other COVID treatments. (New York Times)
What to know about the emergence of Delta Plus. AY.42—a variant of the coronavirus that’s becoming known as Delta Plus—was recently detected in the U.K., where it’s responsible for almost 10% of cases. Described by Harvard epidemiologist Bill Hanage as “delta’s grandchild,” the variant may be slightly more transmissible, but more data is needed to know for certain. Experts have pointed out that any rise in prevalence may be the result of its appearance in areas with high spread, or it might be better at evading the immune system. Right now, it doesn’t appear to be having an impact in the U.S. (at least according to U.S. sequencing data, which is not nearly as robust as that of the U.K.), and the decline in cases is expected to continue. (STAT News)
THE BIG PICTURE
Biden drops efforts to decrease drug pricing in his economic bill. The new $1.85 trillion bill that President Biden pitched to House Democrats on Thursday includes important provisions for climate change and child care, but it ditched all efforts to reduce prescription drug prices. Many Democrats in Congress ran on this platform, and it has been a major focus of the Biden administration since at least August, when the president called on Congress to allow Medicare to directly negotiate drug prices. “At the end of the day, there are not yet enough votes to get something across the line to deliver what the American people need and expect on prescription drugs,” said a senior administration official, as the Washington Post reported.
REQUIRED READING
How Tyson Foods’ CEO convinced 96% of his 120,000 employees to get vaccinated for COVID in just 3 months, by Josh Funk and the Associated Press.
Hong Kong’s COVID policies are forcing world’s biggest banks to consider shifting resources from the city, by Yvonne Lau.
We need to talk about long COVID in kids, by David Meyer
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