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COVID-19 Update May 21, 2021: COVID Vaccination Availability Expands at Advanced Pediatrics; How the Pandemic Ends: Mask Clarifications

By Dr. Arthur Lavin

Glossary

  • Virus– a type of germ that consists solely of a bit of genetic material (DNA or RNA) wrapped in a protein coat.  The coat gets the genes into the target cell where the genes force the cell to make zillions of new viruses, and on it goes.
  • Coronavirus– a species name of a number of different viruses.  Called corona because its protein coat is studded with spike shapes that form a crown, halo, or corona of spikes
  • SARS-CoV-2– the specific name of the new coronavirus
  • COVID-19-the name of the illness that the new coronavirus is causing
  • Endemic– an illness always present in a region.  One could say strep throat is endemic in the US
  • Epidemic– a sudden burst of an illness that comes and goes over a limited time
  • Pandemic– an epidemic that bursts across the world not just one region
  • Spreadability– how contagious is the disease, how many people will end up infected
  • Symptoms- the experience of being ill, for example- fever, cough, headaches, loss of smell etc.
    • Asymptomatic– literally means “without symptoms”.  For COVID-19 it refers a person infected with the virus but has no and will have not symptoms
    • Presymptomatic– This is a person who was infected with SARS-CoV-2, and will feel sick, but hasn’t yet
  • Severity– what harm does the disease cause, in terms of  how sick you get and how many it will kill
  • Mask- a mask is a loose-fitting cloth or textile that covers the mouth and nose loosely.  A surgical mask is a mask used in surgery
  • Respirator-  for the purposes of the COVID-19 pandemic and other respiratory illnesses, a respirator is a mask that fits very snugly or tightly to the user’s face.  An N95 mask is a respirator.
  • Personal Protective Equipment (PPE)- PPE are any item that covers any part of the body with the design and intent of keeping viruses in the environment from infecting the wearer of the PPE. PPE’s include all masks (which includes respirators), face shields, eye shields, gloves, gowns.
  • Ventilator- a ventilator is a machine that can force a person unable to breathe to inhale and exhale and control both effectively.  They are sometimes called respirators, but during this pandemic the word respirator is now reserved for reference to a tightly fit mask.
  • Live Virus Swab– this is the swab which attempts to swipe live virus from one’s nose or throat to see if you are currently infected.
  • Antibody Test- (aka serology test) this is the blood test which looks for antibody to the SARS-CoV-2 virus to see if you have been infected in the past.
  • Vaccine Terms
    • Vaccine or Immunization– a dose of a substance that activates your immune system, as if you have the actual infection you are hoping to prevent, leaving you in fact protected from having that infection.
    • Efficacy– the percentage of people immunized with a particular vaccine who will not get infected if exposed to the target infection.  For example, a COVID-19 vaccine will be said to be 95% effective if 95% of people immunized with that particular COVID-19 vaccine will not get COVID-19 if exposed to COVID-19
    • mRNA– DNA works by dictating exactly which proteins your cell will make.  The message on how to construct each protein is delivered to the cell machinery that makes proteins by a piece of genetic material called messenger RNA, or mRNA
    • mRNA vaccine– an mRNA vaccine places a small bit of mRNA code that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected
    • Viral vector vaccine– a viral vector vaccine takes a harmless virus that is known to infect people reliably and places that weakened virus in a person where that virus will in fact infect the person.  The virus is not only weakened, but also attached to a set of genes  that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected.

COVID Vaccination Availability Expands at Advanced Pediatrics

The only vaccine company whose product is authorized for use in children ages 12-18, Pfizer, recently announced that its vaccine is stable, effective, and safe being stored in refrigerators for a whole month.  Prior to yesterday, that period was limited to only 5 days.

And the Ohio Department of Health announced, around the same time, that offices can order Pfizer COVID vaccine on an as needed basis with orders that now can be as few as 30, rather than 120 doses.

These two changes open the door to our practice making COVID vaccination available more widely to children ages 12 and up in our practice.

Here’s what’s new:

  1. We can now schedule COVID vaccinations for your 12 and up children any day of the week that a group of 6 are scheduled.
  2. We can now schedule second dose COVID vaccinations for children 12 and up who got their 1st dose elsewhere.
  3. Since each vial contains 6 doses and once readied for use is only good for 5 hours, we will need to group all our COVID vaccination appointments in multiples of 6.  If your group cannot reach a multiple of 6, we will call to offer to reschedule into a group that hits that 6 in a group target.

These new changes will dramatically increase our availability to offer this critically urgent health service, getting your children ages 12 and up immunized.   We do apologize in advance for any scheduling changes that will come along with our grouping our immunizations into groups of 6, and are grateful for all your flexibility.

And stay tuned to this September, Pfizer plans to achieve authorization for use of their vaccine in all children ages 2 and up!   We will be ready to help you protect all your children 2 and up as soon as they do. 

How the Pandemic Ends:  Mask Clarifications 

All indicators across the United States point to the pandemic truly ending for the immunized.

The data are clear, once you are fully immunized you are safe from getting hurt by COVID and safe from hurting others by passing COVID.

Fully immunized means you are 2 weeks past a 2nd dose for Pfizer and Moderna, or 2 weeks past your only dose of Johnson & Johnson.

So if you or your child is fully immunized, you do not need to wear a mask except in places that require it, or in certain unusual settings where very close contact is sustained over long periods of time.   This does not include outdoor events with some spacing, such as baseball games.

Now, this end of the pandemic is wonderful, but does not yet include all our children 11 years old and younger, who are all unimmunized, and therefore still able to be infected with COVID-19.

For all children 0-11 years old, and everyone 12 and up who are not immunized, steps must continue to be taken to avoid getting infected with COVID, until the spread of the terrible virus truly ceases to the point the chance of getting sick becomes negligible.  Keep in mind, a 4 year old with COVID may suffer health problems later in life or easily spread it to an adult who could be grievously harmed by such an infection.

The good news is that children in a family where everyone 12 and up is fully immunized cannot catch COVID from their family, and so no precautions are necessary within such a family group, or any group of fully immunized.   To be clear, in one home where all 12 and up are immunized, younger children need no mask or distancing.  This is because the immunized cannot spread the disease to the unimmunized, and the unimmunized cannot spread the disease to the immunized.

However, if two families get together, and there are unimmunized children in both households, children from one of those homes can spread COVID to the children in the other home.  In this situation, the immunized in the two homes need no mask or distancing, but the unimmunized children do.

What about out in the world?  Since any unimmunized people can catch and can spread the deadly COVID, all children 11 and under need to remain vigilant about not catching and not spreading it.  That means if they are able, they need to wear a mask out of the home, and at all ages maintain social distancing.

This will change once the virus ceases to spread at epidemic levels in our nation.  We are reaching this amazing moment.  Right now the nation is at 38% of our total population fully immunized.  Israel continues to demonstrate that once a nation hits 55% immunized, COVID cases nearly cease.  Israel has a COVID transmission rate of 0.3 cases per 100,000, nearly zero.  The US is seeing its rates drop dramatically still.  Our transmission rate is 9.4 way, way down from our peak of 74, and dropping.  It seems clear if we hit 55% our rate will drop nearly to the zero of 0.3.  If we achieve that rate, we will see the total number of Americans infected with COVID drop to nearly 1500, down from our current number of 50,000 or so.

Once transmission is so severely curtailed, then even the unimmunized will no longer be at serious risk, but that is for when we achieve this goal, not yet.

Bottom Lines

  1. New information on the Pfizer COVID vaccine opens the door once more at Advanced Pediatrics to us offering COVID-19 vaccination here in the office.
  2. The COVID-19 vaccine will remain available only to children ages 12 and older who are part of the practice.
  3. Our only restriction is that appointments must be clustered in groups of multiples of 6, since we need to use all 6 doses in a single vial once we use one dose from that vial.
  4. Our able front desk professionals, Tina and Nedra, will work closely with families to help achieve groups of multiples of 6 in appointments for vaccine with the minimum of inconvenience to you.  We do anticipate having to move some of your appointments from time to time, with your guidance, to achieve groupings of 6, 12, 18 or so.
  5. The data remain confirmed that if you are fully immunized, you are safe.  You are very, very unlikely to get COVID or to spread it.  This means all fully immunized can move about the world, indoors and out, without fear of the pandemic.  No masks, no distancing, except where places still require it.
  6. For all our children 11 years old and younger, and all people 12 and older not yet fully immunized, COVID is still spreading in the US, at a lower rate, but still deadly and dangerous.  All precautions should be taken for staying apart, masking, distancing for all the unimmunized.
  7. An unimmunized child or older person is safe if they are around only other immunized people, but if they are with other unimmunized people, they can catch COVID and/or spread it, so all precautions remain in place.   The CDC guidances are clear on this point.

My Takeaway – In One Sentence:

GET IMMUNIZED, we are so close to the real end of this pandemic in our daily lives, if enough of us get immunized we will get there.

To your health,
Dr. Arthur Lavin

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