EDUCATIONAL related Covid-19 clusters have increased since the reopening of schools, especially given the Omicron surge.
Hospital Banting head of paediatrics, Dr Noor Hafiza Noordin, says most children who are infected stay asymptomatic, but they may easily transmit the virus to others, including those who are at higher risk of severe disease.
Following the vaccination drives for adults and adolescents, Malaysia has started to roll out Covid-19 vaccination for children. Many countries like the United States, Canada, Germany, Austria, Belgium, Hungary, Greece, Singapore and Indonesia started vaccination for children aged 5 to 11 in late 2021.
Dr Noor Hafiza says many parents in Malaysia are concerned about the safety profile of the Pfizer-BioNTech vaccine for younger children but clinical trials have indicated that most adverse events were mild to moderate, and no serious adverse events related to vaccination were reported.
There has also been concern over cases of myocarditis and pericarditis following the administration of mRNA vaccines. Myocarditis is a rare but serious adverse event that has been associated with mRNA-based Covid-19 vaccines.
Reporting rates for vaccine-associated myocarditis appear highest among males aged 12–29 years. To date, myocarditis among children aged 5–11 years is very rare with approximately 11 cases in 8.7 million.
Taylor's University School of Medicine senior lecturer, Dr Lim Yin Sear, says myocarditis was well-described long before the Covid-19 pandemic. It can occur when a virus, such as the common cold, influenza (flu) or indeed the SARS-CoV-2 (the virus that causes Covid-19) infects the body.
Fortunately, current studies show that post-vaccine-related myocarditis is typically much milder than classic myocarditis due to a viral infection, with symptoms lasting for a shorter amount of time and usually resolving with minimal, if any, medical treatment.
In two recently published randomised controlled trials on the Pfizer-BioNTech vaccine for children and adolescents, the investigators reported that the vaccine achieved over 90 per cent reduction in the risk of contracting Covid-19 in children aged 5 to 11 as well as adolescents, with no serious adverse events such as myocarditis observed in the period of study.
"However, as with adults, mild reactions such as injection site pain, fatigue and headache were reported. Parents and guardians of children aged 5–11 vaccinated with Pfizer-BioNTech should be informed of the possibility of such reactions after vaccination, probably more likely after the second dose," says Dr Lim.
Parents should also advise their child to avoid strenuous exercise two days before and up to two weeks after vaccination.
Some parents are considering opting out of vaccinating their children in the hope of depending on herd immunity.
Dr Lim explains that traditionally, herd immunity is achieved when 80 per cent of the population has been fully immunised against an infection. But this is not so with Covid-19, especially with the new Omicron variant.
"We will likely need more than 95 per cent of the population to be fully immunised to achieve a degree of protection similar to that conferred by herd immunity."
Herd immunity, she adds, is also a dynamic phenomenon that depends on the movement of the "herd".
For example, if a family has five adults and one child, and all adults are immunised, then one can say that the family has herd immunity—provided the family lives in the same house all the time and the child never spends any time outside.
If the child goes to school, the majority of the population are children. If all children who are not immunised congregate there, there is no herd immunity in that setting.
The current phenomena of an apparently milder course of illness when one contracts the Omicron variant is the result of having our immunity propped up by vaccination, explains Dr Lim.
The illness will certainly be more serious across the population if we are not vaccinated.
"Some believe we should now be treating Omicron like the flu, but we should not let down our guard just yet."
Vaccination is still the most effective way to prevent Covid-19 infection and the development of serious complications, including reducing the likelihood of transmission in the home and school settings to safeguard vulnerable persons and create a safer in-person learning environment.
Without effective Covid-19 vaccines for this age group, children could potentially become ongoing reservoirs of infection and sources of newly emerging variants.
Dr Lim says widespread vaccination across age groups is therefore essential in ongoing efforts to curtail the pandemic.
Children aged 5 to 11 years old are encouraged to be vaccinated against Covid-19.
Nevertheless, if the child has any pre-existing medical conditions or his parents are in doubt, they should seek advice from their medical practitioner or paediatrician.
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