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Frustration for Parents of Under 5’s in the Age of COVID

For parents of children younger than five years of age, frustration and disappointment are mounting. Recently, the FDA delayed approving COVID immunizations for the under-5 age group until more data is available, regarding a third dose. This has many people upset and two timely articles were released in the NY Times and Washington Post discussing this matter (references below). What was notable was the volume and emotion of comments in response to these articles. Many parents were tired, even angry, of being told to be ‘patient’–after two years of patience. Some parents felt that enough was enough and want to resume a normal life. The vehemence and polarization in the responses is perhaps not surprising. Being told to isolate, parents wanted the same protection conferred by immunization to them offered to their children. But this isn’t the whole story. We’re still not unified in our response to COVID. According to a survey listed in the Washington Post article only a third of parents said they would get their children immunized promptly when the third dose becomes available but a quarter of parents said they would not immunize their children at all. That leaves a large group in the middle who appear uncertain about the benefits of immunizing their young children.

What’s at stake here? While it appears that serious harm is low in children (the death rate for the under-5s is 0.00034111 (307/900,000), according to the CDC approximately 1.9 million children younger than 5 have contracted COVID. This means more parental time off-work, medical and emergency room visits, day care center closures (with additional quarantines), higher risk of home spread and mental fatigue. Some children do indeed become sick enough to be hospitalized. These are not small considerations. The psychological strain of COVID precautions has parents worn down and frustrated. This mental fatigue has only been worsened by the recent FDA decision. The prolonged need to keep children isolated at home impacts their ability to care for their youngsters and it surely has an impact on their ability to work effectively.

The reason for the third dose in children is that a Pfizer study showed that there was disappointing protection offered by two doses in the two to four-year old children studied. The FDA postponed the decision in order to hedge on the side of safety for the children. It is hard to argue with the issue of safety, especially in children. But if you read the reviews from the articles, you notice that parents are angry with the FDA. They’re tired of waiting.

The FDA Press Release (reference below) stated the following: “Our approach has always been to conduct a regulatory review that’s responsive to the urgent public health needs created by the pandemic, while adhering to our rigorous standards for safety and effectiveness. Being able to begin evaluating initial data has been useful in our review of these vaccines, but at this time, we believe additional information regarding the ongoing evaluation of a third dose should be considered.” They added that the best way to protect children is to practice social distancing (a terrible term, children need social contact. Physical Distancing is a better term), wear masks, and have close contacts immunized.

Further, the lack of social contact in these children being kept at home is a growing concern. The impact on their social, emotional and speech development may take years to determine. But it likely will harm society when these children become adults and missed out on critical developmental milestones in their childhood.

It has been a rollercoaster for parents. And society. Unfortunately, with the FDA decision for immunizing youngsters still on hold, we will all have to be a little more patient.

Alan Spira, March 5, 2022