A federal panel of health experts next week will assess possible changes in the vaccine effort of young people against COVID-19 amid rare but worrying reports of heart inflammation in some adolescents, adolescents and young adults after receiving vaccines.
The U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices will debate whether young people – who are largely at minimal risk from the disease itself – are still better off. lotis to get vaccinated, and if so, whether to reduce the doses or space them further apart could make them safer.
“It has to be fixed one way or another,” said Dr Monica Gandhi, an infectious disease specialist at the University of California at San Francisco, who is awaiting the end of the roundtable to decide whether her son 13-year-old is expected to receive his second hit. “People are worried about it. You don’t want to dismiss something like that.
The expert group’s online meeting was scheduled for Friday, but was postponed from Thursday 23 to 25 June due to the new National Independence Day on 17 June.
The CDC has recognized “rare” but increased cases of myocarditis and pericarditis, primarily in adolescents and young men aged 16 or older after receiving mRNA vaccines made by Pfizer and Moderna. Inflammation of the muscle or lining of the heart usually occurs within a week, more often after the second of the two injections, with chest pain, shortness of breath, and a rapid, throbbing, or pounding heartbeat.
For now, the CDC continues to recommend vaccination against COVID-19 for anyone aged 12 years and older, “given the risk of COVID-19 illness and related complications, possibly serious, such as long-term health, hospitalization and even death. “
Other local health experts agree, although they are watching the debate closely.
“It’s definitely pretty scary, and the good news is it’s pretty rare,” said Dr. Sara Cody, Santa Clara County health official. “It’s always weighing one advantage over another. I still think that far, far away, the benefits of being vaccinated far outweigh the risks, even with these cases of myocarditis that arise. “
The debate comes at a delicate moment in the vaccination campaign. Demand for vaccines has leveled off to such an extent that states such as California are offering prices to entice more people to get vaccinated, but health regulators are also assessing vaccine use in children under 12. years. Currently, 59% of all Californians and 70% of people 12 and older have received at least one dose of the vaccine.
Although case rates have fallen since January, many health experts remain concerned that more dangerous variants of the virus gain a foothold as California and other states drop pandemic restrictions and mask rules and that schools where children under 12 are not yet approved for the vaccine get ready to open fully in the fall.
Any hint from federal health officials that they are worried about the safety of vaccines, which have only been granted emergency use clearance as part of an expedited safety review, would surely make those who are already reluctant to receive more suspicious vaccines.
After the CDC called for a 10-day “pause” in use of Johnson and Johnson’s single-injection vaccine following reports of rare blood clots primarily in women under the age of 50, a May 6 investigation from the Kaiser Family Foundation found that only 46% of Americans expressed confidence in its safety, compared to 69% for Pfizer and Moderna.
The CDC has a number of options, Gandhi said. The agency could recommend a “pause” in the administration of vaccines to adolescents and young adults or allow continued use with a warning of additional risks for certain groups, as it did for the Johnson and Johnson vaccine.
The CDC may also advise reducing the dose of the vaccine in children, increasing the time between injections, limiting young people to one of the two injections, or advising vaccination only for young people with health problems that cause them. would make them more vulnerable to COVID-19.
Although there have been no vaccine-related heart inflammation deaths and most cases have recovered quickly, Gandhi said the incidence appears to be higher than that of blood clots.
There have been 28 reported cases of blood clots in people receiving the Johnson and Johnson vaccines, including 22 in women, and three deaths, the CDC reported last month. Per million doses administered, the risk was 12.4 cases in women aged 30 to 39; 9.4 cases in women aged 40 to 49; and 3 cases in older women and men of all ages.
The CDC had received 789 reports of heart inflammation up to May. Of these, 475 occurred in people 30 years of age or younger, and 226 of them were considered confirmed cases. Of the total 475 cases, 15 remained hospitalized, including three in intensive care, and 270 discharged, 180 of them with full recovery.
Broken down by age group, preliminary reports of inflammation after the second dose indicated a rate per million doses ranging from 5 cases for those aged 25-39 to as low as 0.9 cases for those aged 65 and over, all within the range expected by health officials. .
But the rate per million doses was much higher in younger people – 20.6 for 18-24 year olds, 35 for 16-17 year olds and 22.4 for 12-15 year olds. The number of cases for those age groups was also twice or more what one would expect, according to the CDC.
At a meeting last week of the U.S. Food and Drug Administration’s Vaccine Advisory Committee, Dr. Tom Shimabukuro, deputy director of the CDC’s Office of Immunization Safety, noted that more than half reports of inflammation were in people aged 12 to 24 who had received only 9%. of the doses administered.
Panel members expressed mixed opinions as they weighed whether to call for longer and broader trials of vaccines in young children and whether the small risks in adolescents and adolescents were justified.
Dr Paul Offit, a pediatrician at the Children’s Hospital of Philadelphia, noted that despite the low risk of polio for children today, “we still vaccinate the children of this country against polio every year, even though we don’t. we have not had a case of polio in this country since the 1970s.
But others, like Dr. Cody Meissner, professor of pediatrics at Tufts University School of Medicine in Boston, have urged caution.
“The problem for me is at what point do we say we know enough to justify the widespread use of the vaccine in adolescents and children,” Meissner said. “The first mandate is to do no harm. We do not know if we are not doing any harm.