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COVID vaccines could be the key to solving the global youth mental health emergency

October 28, 2021, 9:28 PM UTC

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,




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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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