The prevalence of respiratory viruses tends to rise as we enter the fall and winter seasons. This year, the reduced circulation of respiratory viruses during the COVID-19 pandemic has left a larger portion of the population vulnerable.
Colder weather prompts more individuals to gather indoors, creating environments where viruses can spread more easily. Yet, many of the community-based strategies that were put in place to control the spread of COVID-19 have been relaxed. And people, overall, are less diligent in practicing personal hygiene and preventive behaviours compared to the peak of the COVID-19 pandemic.
Navigating unprecedented challenges
This year’s back-to-school season comes with its own challenges, including the ongoing battle against wildfires, COVID-19, the emergence of new variants and the looming threat of influenza and Respiratory Syncytial Virus (RSV). It is critically important that we vaccinate our children before the fall, ensuring a safe and uninterrupted learning environment.
The rising concern: EG.5 variant and beyond
As we edge closer to the school year, a COVID-19 variant known as EG.5 has caught the attention of health authorities. The World Health Organization has labelled it a variant of interest, emphasizing its potential impact on public health. Canada’s Health Minister has underscored the significance of keeping vaccinations up to date to curb the spread of this variant and other threats. Proactive measures to maintain immunizations and adhere to health precautions can help mitigate the impact as cases rise.
A comprehensive defence: Vaccinating against multiple threats
As the influenza season coincides with the start of the school year, the risk of disruptions due to illness becomes all too real. Last year, RSV posed a significant threat to our children. Coupled with the potential resurgence of influenza, the consequences could be severe. Vaccination is a comprehensive defence strategy against multiple contagious illnesses that can strain health-care systems and disrupt schooling.
Navigating the new normal: Preventing school closures
One of the lessons learned from the pandemic is the importance of maintaining safe and consistent education for our children. School closures can have profound negative effects on learning, development and mental well-being. By vaccinating our children and taking proactive measures, schools can be a safer environment, minimizing the risk of closures from outbreaks. The combination of proper vaccination, effective hygiene practices and continuous monitoring can pave the way for a smoother school year.
A call to action: Prioritizing vaccination
Vaccinating our children not only shields them from illness but also contributes to community immunity. As young students interact with family members, teachers and other students, their vaccination status plays a crucial role in preventing the spread of contagious diseases. By ensuring a high vaccination rate among children, we create a protective barrier that extends to those who are more vulnerable, such as the elderly and immunocompromised individuals.
The new school year is a call to action for parents, educators and policymakers to work together to ensure a safe and healthy learning environment. By prioritizing vaccination, we can equip our children with the best possible defence against myriad threats, allowing them to thrive academically, socially and emotionally.
Together, we can shape a brighter and more resilient future for our young learners.
AAP’s tips for healthy learning environments in the new school year
The American Academy of Pediatrics (AAP) valuable tips for a successful school year reopening in 2023 underscores the importance of vaccination to ensure children’s safety as they return to classrooms. Children are encouraged to play their part by maintaining healthy habits such as sufficient sleep, a balanced diet and regular physical activity, fundamentals that contribute to overall well-being. Staying home if one has symptoms is also necessary to limit the potential spread of viruses. It is also important to continue practicing hand hygiene at home and in the community.
The AAP acknowledges that some level of apprehension is normal for students returning to school, especially if they are entering new classrooms with different teachers and classmates. AAP suggests families ease these worries by acknowledging shared feelings and practicing scenarios of entering new situations. Open communication is essential: Parents should inquire about their children’s concerns and work together to find solutions.
A significant recommendation in AAP’s comprehensive list of 12 tips is for parents to schedule a back-to-school physical if their child hasn’t had one within the past year. This physical should also include any necessary vaccinations.
Empowering education: Upholding COVID-19 prevention in schools amid shifting pandemic phases
The World Health Organization’s recent declaration that COVID-19 is no longer a “global health emergency” while still recognizing its status as an ongoing health threat holds profound implications for the implementation of public health measures. This shift in perspective has brought the focus onto community-level strategies, including those in schools, to uphold the principles of precaution and protection against the virus.
The transition from the pandemic emergency phase to the post-pandemic phase has sparked essential discussions regarding the practicality and imperative of sustaining population-based COVID-19 preventive efforts. It is worth noting that despite this transition, Canadian public health experts have stressed that COVID-19’s challenges will persist for years and have enduring impacts on health-care systems.
The data emphasizes the continued impact of COVID-19 and serves as a reminder that the pandemic is not over.
Between Aug. 16, 2023, and Aug. 22, 2023:
- the total number of hospital beds occupied by COVID-19 patients increased from 1,723 to 1,836 .
- the number of non-ICU beds occupied by COVID-19 patients increased from 1,671 to 1,776.
- the number of ICU beds occupied by COVID-19 patients increased from 52 to 60.
- the number of COVID-19 patients who were mechanically vented increased from 55 to 63.
Within this context, several critical factors emphasize the intricacies of maintaining these measures:
Variable public perception: The potential misinterpretation of the pandemic’s end as a complete eradication of risk could lead to a decline in adherence to preventive measures. This misalignment with the ongoing presence of SARS-CoV-2 and other respiratory viruses necessitates vigilance.
Behavioural adaptation: The pandemic has catalyzed significant shifts in societal behaviours, including mask-wearing, physical distancing and hygiene practices. Forgetting these adaptations and reinstating preventive measures would pose a formidable challenge.
Complexity of variants: The emergence of new variants, each with unique transmission and immune evasion characteristics, adds complexity. The potential for localized outbreaks underscores the ongoing need for preventive measures.
Health equity and vulnerable populations: COVID-19’s highlighted health disparities and vulnerabilities, reinforcing the importance of safeguarding high-risk groups like the elderly, immunocompromised and those with underlying conditions. Premature cessation of prevention could amplify these inequities.
COVID-19 may no longer be considered a global emergency, but it is not as benign as the flu.
COVID-19 may no longer be considered a global emergency, but it is important to recognize that it is not as benign as the typical strain of flu we encounter annually. To protect our communities and help our health-care system recover, our everyday efforts become all the more important.
The endeavour to uphold preventive measures is crucial to mitigate the risk of potential outbreaks in high-risk community settings. This responsibility transcends mere compliance, seeking to cultivate a collective understanding of the ongoing threat and shared commitment to safeguarding public health.
This collective effort, informed by the lessons learned from the pandemic, reflects a holistic approach to ensuring the health and well-being of vulnerable communities worldwide.
Appendix -1 Harnessing lessons for safer schools: Building evidence-based strategies from lessons learned
As we embark on the new school year, the lessons we have learned from the ongoing COVID-19 pandemic serve as our compass, guiding us toward effective strategies while helping us discern the ones that fall short. These lessons have illuminated the path toward creating a safer environment for our students, teachers, as well as parents, siblings, and immunocompromised grandparents at home. Let’s dig deep into these insights to inform our resource allocation and fortify our commitment to evidence-based interventions in the event of COVID-19 emergency.
| AAP: 8 Lessons Learned from the Ongoing COVID-19 Pandemic | |
| Lesson #1 | School closures were necessary at the pandemic’s start but should have been brief. Prioritize swift school reopening. |
| Lesson #2 | Universal masking is highly effective in preventing within-school transmission. Use masking as a bridge until vaccination and keep schools open safely. |
| Lesson #3 | Children can and will mask appropriately. Report data systematically, use multilayer cloth masks, and introduce more effective options as they become available. |
| Lesson #4 | Hybrid education is not supported by data when other mitigation strategies are in place. Prioritize full, in-person education with universal masking. |
| Lesson #5 | Exclusion from school after COVID-19 exposure is not effective. Allow exposed individuals to stay in school with strict masking and, if needed, use serial rapid antigen testing. |
| Lesson #6 | Focus improved ventilation where masking adherence is not feasible, such as special needs classrooms. |
| Lesson #7 | School-based asymptomatic screening testing is not effective. Prioritize testing for symptomatic attendees and utilize testing to facilitate attendance and activities. |
| Lesson #8 | Vaccine development in children was unnecessarily delayed. Enroll adolescents in adult vaccine trials and conduct pediatric trials in parallel to accelerate vaccine availability for all ages. |
In the new school year, let’s weave these lessons into our strategies. By investing resources wisely, guided by evidence and insights, we cultivate an environment that nurtures education, health and well-being for all.
Both Ricky and Vanessa make excellent points. I would also add that undoubtedly and with little fanfare, a strong immune system is the best line of defense. You so briefly mention sleep and diet, and no mention at all of exercise. There have been many studies, far more reputable than virtually all of the poorly executed and biased Covid studies, that definitively show a link between lifestyle and immunity. Our kids are sleep deprived, unfit, rarely get outdoors and eat too much sugar. Don’t you think we should be sounding the alarm bells on that rather than on risky, unproven, and temporary vaccination? We’re barking up the wrong tree. And yes it’s only serving to fuel yet another crisis- fear and paranoia. Seriously, you call yourselves educated??!!
We certainly agree that maintaining a strong immune system is crucial for overall health. However, we would like to address some points in their argument and provide a counterpoint.
Firstly, it’s essential to acknowledge that there’s no one-size-fits-all approach when it comes to health. While sleep, diet, and exercise play significant roles in maintaining a healthy immune system, they are not a panacea against infectious diseases like COVID-19. The COVID-19 virus has proven to be highly contagious and has led to severe illness and death in many cases, even among individuals with otherwise healthy lifestyles.
The reason vaccination has received so much attention is that it’s a proven and effective tool for reducing the spread of the virus, preventing severe illness, and saving lives. Numerous clinical trials and real-world studies have demonstrated the safety and efficacy of vaccines in reducing the risk of infection and hospitalization. Vaccines have historically been one of the most successful public health interventions, helping to eradicate or control many deadly diseases like polio, measles, and smallpox.
Furthermore, it’s not accurate to dismiss the extensive research on COVID-19 as “poorly executed and biased.” Scientists and researchers worldwide have been working diligently to understand viruses and develop effective treatments and preventive measures. The scientific community operates under rigorous standards and peer review to ensure the validity and reliability of their findings.
While it’s essential to address lifestyle factors like sleep, diet, and exercise to promote overall health and immunity, it’s equally vital to acknowledge that vaccines can provide an additional layer of protection, especially in the face of a highly contagious and potentially deadly virus like COVID-19. Combining multiple strategies, including vaccination and healthy living, is the most responsible and effective approach to safeguarding public health.
We absolutely agree that the marketing and sale of sugary products, especially those targeting children, have significant implications for the overall health and well-being of our young ones. Dental caries, commonly known as tooth decay or cavities, are an excellent example of how excessive sugar consumption can harm our children’s health.
The marketing tactics employed by the food and beverage industry often target children with colorful packaging, appealing characters, and persuasive advertising campaigns. This marketing can make sugary products more enticing to kids, leading to higher consumption.
Many public health advocates and policymakers have called for stricter regulations on the marketing of sugary products to children and efforts to reduce sugar content in foods and beverages. These measures aim to protect children’s health by limiting their exposure to unhealthy foods and drinks.
The issue of excessive sugar consumption and its impact on children’s dental health is a significant concern. It highlights the need for informed dietary choices, responsible marketing practices, and public policies aimed at safeguarding the well-being of our children. By addressing this issue comprehensively, we can help protect our children’s oral health and contribute to their overall physical well-being.
To complete your reference list, I suggest the book below. One needs to be informed of both the good and the bad aspects of vaccinations. I too, having been in public healthcare for 30y, dismissed vaccination opponents as a few fries short of a happy meal. A true review of the documentation pharma provides us (as surely there a lot of locked filing cabinets that have not been opened), shows that we have been misled regarding the complete safety profile of children’s vaccines and the real efficacy thereof – for a variety of motives.
Tom Cruise said it best “…show me the money”.
https://www.amazon.ca/Turtles-All-Way-Down-Vaccine/dp/9655981045/ref=sr_1_1?keywords=turtles+all+the+way+down&sr=8-1
Couple things – respectfully:
Can you show us the RCT of the covid booster vaccine efficacy and safety profile in children (heck, I’d take adults).
Can you show us the epidemiology of North American children and how SARS-COVID2 affected them – ie. death from (not with), hospitalization from (not with). Moreover, can you specify which strain/variant for which you are providing the statistics – as we know current strains are much, much weaker.
Injecting children with a new mRNA technology is a very serious thing so having an entire safety profile of the what is the syringe is imperative. Until then, let’s not inject them.
We value your input, and we believe that it’s essential to engage in a well-informed dialogue on these important matters. Let’s address each of your points:
1. COVID-19 Booster Vaccine Efficacy and Safety in Children and Adults:
To address your concern regarding randomized controlled trials (RCTs) for COVID-19 booster vaccines, we’d like to provide information on some recent studies:
Mrak et al. conducted an RCT on heterologous vector vs. homologous mRNA COVID-19 booster vaccination in immunosuppressed patients, which was published in Nature Communications in 2022 [1].
Another RCT by Bonelli et al. investigated additional heterologous vs. homologous booster vaccinations in immunosuppressed patients without SARS-CoV-2 antibody seroconversion after primary mRNA vaccination and was published in Annals of the Rheumatic Diseases in 2022 [2].
Lv et al. conducted a systematic review comparing the immunogenicity and safety of heterologous vs. homologous prime-boost schedules with an adenoviral vectored and mRNA COVID-19 vaccine, published in Infectious Diseases of Poverty in 2022 [3].
It’s important to note that these studies are part of ongoing efforts to understand the efficacy and safety of booster vaccines in different populations.
2. Epidemiology of SARS-CoV-2 in North American Children:
Epidemiological data on COVID-19 in North American children can indeed vary by location, time, and viral strains. However, it’s essential to consider the latest data, such as:
According to CDC data, in the United States alone, there have been 1,847 reported COVID-19-related deaths in children.
A study published in JAMA assessed COVID-19 as the underlying cause of death among children and young people aged 0 to 19 years in the US, highlighting that COVID-19 has caused substantially more deaths than many other vaccine-preventable diseases historically [4].
3. Safety Profile of mRNA Vaccines:
Your concern about the safety of mRNA vaccines is valid. It’s important to note that these vaccines underwent extensive testing before approval.
VAERS (Vaccine Adverse Event Reporting System) is a national program in the U.S. that monitors vaccine safety by collecting reports of possible side effects or reactions. It serves as an early warning system to identify potential vaccine-related issues [5].
Ongoing surveillance systems like VAERS continue to monitor vaccine safety, allowing for the detection and investigation of potential adverse events. Safety profiles for specific age groups, including children, may evolve as more data becomes available.
Continuous research and vigilant monitoring through methods like RCTs and surveillance systems such as VAERS are vital for assessing the effectiveness and safety of vaccines. This is also crucial in comprehending how COVID-19 affects various populations.
When making decisions about vaccinating children, it’s imperative to carefully balance the potential benefits and risks. Ultimately, these decisions should align with guidance provided by well-founded research, the best available evidence, recommendations from public health authorities, insights from healthcare professionals, and the oversight of regulatory agencies. These entities possess the latest data and the expertise needed to make informed decisions that prioritize safety and public health.
Scientific dialogue and the sharing of information are vital in addressing concerns and making informed decisions about public health interventions. Continued research and transparency are essential to ensure that we protect the health and well-being of all individuals in our communities.
References:
(1). Mrak, D., et al. (2022). Heterologous vector versus homologous mRNA COVID-19 booster vaccination in non-seroconverted immunosuppressed patients: a randomized controlled trial. Nature Communications, 13, 5362. doi: 10.1038/s41467-022-33036-y
(2). Bonelli, M., et al. (2022). Additional heterologous versus homologous booster vaccination in immunosuppressed patients without SARS-CoV-2 antibody seroconversion after primary mRNA vaccination: a randomised controlled trial. Annals of the Rheumatic Diseases, 81(5), 687-694. doi: 10.1136/annrheumdis-2021-221558
(3). Lv, J., et al. (2022). Immunogenicity and safety of heterologous versus homologous prime-boost schedules with an adenoviral vectored and mRNA COVID-19 vaccine: a systematic review. Infectious Diseases of Poverty, 11(1), 53. doi: 10.1186/s40249-022-00977-x
(4). Flaxman, S., et al. (2023). Assessment of COVID-19 as the Underlying Cause of Death Among Children and Young People Aged 0 to 19 Years in the US. JAMA Network Open, 6(1), e2253590. doi: 10.1001/jamanetworkopen.2022.53590
(5). Vaccine Adverse Event Reporting System (VAERS). (n.d.). Retrieved from https://vaers.hhs.gov/about.html
Writing any article takes a lot of work, so I thank the authors for their time.
Yet, I’m uncomfortable with targeting children, who, at scant risk fromCovid, should not be, and should never have, been used as human shields.
To suggest children suffer the considerable negative consequences of social distancing and mask wearing upon language and social development alone is unjust … let alone the risk to their mental health, as well as to hearing impaired, mentally challenged, and ESL children who rely on social interaction and facial expression for vital comprehension clues and reassurance . Especially considering that the highest grades of evidence have found no overall benefit to universal masking. Cherry picking low grades of evidence is not good science and it must be stopped.
The novel Covid booster shot may be warranted for some high-risk patients. But without human-outcomes data, pushing it upon children is alarming. Particularly considering these vaccines have a been found to cause myocarditis in young people at a rate six to 28 times the incidence after infection, according to a 2022 JAMA Cardiology study.
Furthermore, the authors are inferring that covid vaccines provide herd immunity, when it is established that their ability to control viral transmission is seriously handicapped. In addition, they are subject to short lived benefit due to considerable wane of protection over a relatively short period of time.
Our clinicians need to think very carefully about endless fear mongering with less than stellar evidence on a now untrusting public. I fear the harms of the loss of trust, and the consequences of that upon the public health are far greater than any seasonal viral illness.
Thank you for your comment, Vanessa. We appreciate your interest in our article and your feedback. A global analysis by UNICEF estimated that more than 1.2 million children have lost a primary or secondary caregiver due to Covid-19. Therefore, children are not immune to the direct and indirect impacts of Covid-19, and they deserve protection from this disease. These sources provide strong evidence that children are not immune to the direct and indirect impacts of Covid-19, and they deserve protection from this disease. Therefore, it is important to prioritize children’s needs and rights in the response and recovery efforts and to ensure their access to essential services, support, and opportunities.
References:
1. Hillis S, Unwin HJT, Chen Y et al. Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: a modelling study. Lancet 2021;398:391–402. DOI: https://doi.org/10.1016/S0140-6736(21)01253-8
2. Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report | World Health Organization (WHO). https://fctc.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.1
3. Children in monetary-poor households: COVID-19’s invisible victims | UNICEF DATA. https://data.unicef.org/covid-19-and-children/
4. Education: From disruption to recovery | UNESCO UIS. https://www.unesco.org/en/covid-19/education-response
The study titled “Myocarditis or Pericarditis Events After BNT162b2 Vaccination in Individuals Aged 12 to 17 Years in Ontario, Canada” published in JAMA Pediatrics in April 2023 aimed to investigate the incidence and clinical information associated with myocarditis or pericarditis following BNT162b2 (Pfizer-BioNTech) vaccination in adolescents aged 12 to 17 years:
Variation in Risk by Age and Gender: The study revealed that the risk of myocarditis or pericarditis following COVID-19 mRNA vaccination varies depending on age and gender. Male adolescents, particularly those aged 16 to 17 years, had a higher risk of experiencing these events.
Increased Risk After the Second Dose: A significant majority (66.2%) of cases occurred after administering the second dose of the BNT162b2 vaccine, suggesting an elevated risk associated with the second dose.
Medical Care and Hospitalization: Most adolescents who developed myocarditis or pericarditis sought medical care in the emergency department. Approximately 44.2% of these cases required hospitalization, although the hospital stays were generally short in duration.
Treatment Approach: Many affected adolescents (74.0%) received treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) alone, while a smaller percentage (14.3%) required no treatment. This indicates that many cases were relatively mild and manageable with NSAIDs.
Incidence Rates: The study reported the highest incidence of myocarditis or pericarditis among male adolescents aged 16 to 17 years after receiving the second dose, especially in those with a short interdose interval (≤30 days).
Rare Occurrence: It’s important to note that the overall risk of these events following BNT162b2 vaccination remains extremely low, despite variations in incidence among different age groups. The study underscores the importance of considering the benefits of COVID-19 vaccination when assessing the risk. Healthcare providers and parents/caregivers should remain informed and encourage vaccination for eligible adolescents, taking individual factors into account.
Source: Buchan SA, Alley S, Seo CY, Johnson C, Kwong JC, Nasreen S, Thampi N, Lu D, Harris TM, Calzavara A, Wilson SE. Myocarditis or Pericarditis Events After BNT162b2 Vaccination in Individuals Aged 12 to 17 Years in Ontario, Canada. JAMA Pediatr. 2023 Apr 1;177(4):410-418. doi: 10.1001/jamapediatrics.2022.6166. PMID: 36848096; PMCID: PMC9972235.