Can omicron cause severe disease in unvaccinated kids? Here’s what parents should know

Judy Woodruff:

As Omicron continues its spread, as we have been discussing, children under the age of 5 are still ineligible for vaccinations, leaving many families in limbo, wondering how best to navigate everyday life.

Stephanie Sy has a conversation in a moment about some of those important questions.

But let's begin with what we heard from some parents across the country and how they are coping nearly two years into the pandemic.

Lori Sipe-Chen, Parent:

My name is Lori Sipe-Chen, and I live in Oakland, California. I have — I'm a mother of a 3.5-year-old, and we are expecting our second child in about three weeks.

Tim Sookram, Parent:

My name is Tim Sookram. I live in Chapel Hill, North Carolina, and I have two kids ages 4 and 6.

Meg Trelease, Parent:

My name is Meg Trelease. I live in Philadelphia, Pennsylvania. And I have two children. I have a 4-year-old girl named Saoirse (ph). My son, Beckett (ph), is 2, and he has Down syndrome. He is awaiting a heart procedure. He is immunocompromised.

Detriecia Taylor, Parent:

My name is Detriecia Taylor. We live in Clarksville, Tennessee.

Having a 4-year-old who's not vaccinated, when the rest of the house is vaccinated, it's been a little hard as far as traveling and even having people come into the home.

Lori Sipe-Chen:

Right now, with the surge, we're continuing to send our child to child care, because we need that help. We both work full-time. We're getting ready for a baby. And so I keep saying, like, it's tradeoffs of life decisions on a week-by-week basis.

Tim Sookram:

He's 4 years old. He's already gotten COVID at day care, even if they — and he's been wearing masks as long as he's been back at school. And it seems crazy that he might get it again.

Day to day, you kind of just have to fool yourself and say that your kid's not going to be the one that goes to the hospital. Your kid's not going to be the your kid's not going to be the one that gets complications. And I don't know that for sure.

Meg Trelease:

We have family that love us and friends that love us and want to see our kids. But it's like, well, what if we wore a mask? Well, what if we tested? Well, what if we? Well, what if we?

And I go into these conversations knowing that, ultimately, I'm going to have to say no, but I enter into them because I don't want to be that person. So we're just literally in our house, and we have been in our house for two years. And I feel so beaten down.

Detriecia Taylor:

It is scary, because she can just — a little cold, you're kind of like, oh, my goodness, is that what that is? Is it that the new variant? Or she's running a fever for no reason? It is the new — it's like you're constantly wondering, everything that's happening to her, could it be that new variant?

And, if it is, how bad is it going to get for her? Is she going to — will she have to be hospitalized?

Lori Sipe-Chen:

It's really like, what are the risks to my unvaccinated 3.5-year-old? But, also, like, are there additional risks to an infant? Like, is there a difference between an infant and, like, a child, even though they're under 5 and not vaccinated, if there's some other, additional risks that we're taking on?

Our 3.5-year-old goes to preschool right now. And they have safe practices, but it just — it's hard for me to quantify the amount of risk that we're taking on.

Tim Sookram:

My big question is, how has it taken so long for kids under 5 to get approved for a vaccine? Why aren't they more of a priority? It's bad for us parents. We're really worried about our kids' health, but they're worried too.

Meg Trelease:

The public health information has been so confusing.

I do wish I had a little bit more information on community spread, because, right now, Philadelphia is hovering at about 40 percent positivity rate. When is it safe for me to send my unvaccinated 4-year-old back to preschool, so that she doesn't bring COVID and infect my son or herself?

Detriecia Taylor:

I was able to finally get my 6-year-old vaccinated.

So it's like, we're getting there, but we're just waiting for her, so we can go see family members more often and travel more. We're hoping that something comes down. Maybe the age will lower even before that time frame. That's what we're looking forward to. We're left in the dark, kind of.

Stephanie Sy:

All right, let's try to address some of the concerns of these parents.

And, for that, I'm joined by Dr. Ibukun Kalu. She's a pediatric infectious disease doctor at Duke University Hospital.

And, Dr. Ibukun Kalu, I should say I have my own 3-year-old toddler, so I can relate to some of the anxiety we just heard from some of the parents. We know Omicron is more contagious. For most vaccinated people, it's more mild.

So the key question, I think, for a lot of us parents is, how big of a risk is there of serious illness in unvaccinated children under 5?

Dr. Ibukun Kalu, Duke University Hospital:

Thank you so much for having me, Stephanie.

I hear the frustration. And pediatricians and providers around the country have felt the same, as we're trying to tackle how best to keep kids safe, particularly those that are not yet eligible for a vaccine.

So, to your question as to how severe this is, we have seen more cases in the community, which has meant more kids ending up in the hospital. But we're also seeing milder infections even in kids.

So what that means is, we're seeing upper respiratory infections. But for our youngest kids, the infants, even a simple upper respiratory infection could affect their ability to feed, taking milk, for example, or just maintain their typical health status. And so they need a little bit of support for their breathing or for hydration.

So that has meant a few more infants in the hospital with COVID.

Stephanie Sy:

I'm glad you answered that question about infant, because a parent asked specifically about that.

I also want to ask you about immunocompromised children. We heard one parent who has a 2-year-old in that situation. How much more dangerous is COVID to that child? And should they avoid sending their children to day care?

Dr. Ibukun Kalu:

Those questions are so difficult, because it really depends on that family's situation.

You may need to send a child to day care just to be able to get to work, to be able to manage the household. So, ultimately, it depends on if you have options where you can remove a child from day care or put them in day care.

As much as you can, ensure the day care setting is safe, so all the eligible adults that are present should be vaccinated and hopefully should get a booster. And particularly for immunocompromised patients and our youngest immunocompromised patients, I think a lot of people have aimed for protective bubbles, so smaller day cares, fully vaccinated adults eligible, people that are there masking, if at all possible, and ensuring you're preventing other respiratory viruses, such as influenza, which has a safe and effective vaccine at this time.

Stephanie Sy:

I want to go back to vaccines in a second.

But you talked about protocols, safety things that schools and preschools can do for this age group. Is it appropriate to be testing kids this young regularly? Should they be all wearing kid-size N95 masks?

Dr. Ibukun Kalu:

It depends.

I think I keep coming back to that answer. I don't necessarily think a kid-size N95 mask is necessary for all our kids. What I think is a properly fitted mask that can stay on that child's face for as long as they will tolerate it should be the goal.

So, if you have a mask that has a proper filter, if you have masks that have ties, you can tie around the child's head when they go into day care, I think those are safe and effective. If you have a mask for a child that has N95 properties, and the child will keep it on, then it's fine to use it.

As to the other question about testing, if they have symptoms, it's good to get a COVID test and maybe even some other testing based on the symptoms. Talk to your provider as soon as you can if you're worried about COVID or other illnesses.

Stephanie Sy:

I just want to follow up on that, because a lot of parents I have heard from whose young children under 5 have had positive COVID tests have basically reported symptoms of a cold.

If your child starts to exhibit symptoms of a cold, should you get them tested?

Dr. Ibukun Kalu:

Yes.

Based on our current community rates, it would make sense to at the very least get a test for COVID-19. The chances are high that the common cold could be the presenting symptom for COVID. If you don't have access to a test — and I really hope we get past the point where, if you want to get tested, you have to stay in long lines to get tested — you could stay home and monitor the child and communicate the symptoms that are going on with your provider until you can get a test done.

Stephanie Sy:

Do you think it should be a priority, Dr. Kalu, of the federal government right now to make the vaccine available to children under 5?

We heard from that one dad who thought that would be a good idea. And do we have data on its safety and efficacy at this point?

Dr. Ibukun Kalu:

We're waiting for more data on the clinical trials that have occurred in children less than 5.

I think what we know has been based on some media reports, and what the companies that are working on this vaccines have provided to us publicly, we know that they're working on it. We know that they had to go back and run this trial for longer, possibly including an additional dose, to ensure that, whatever that final product is, it actually does what we need it to do, which is protect our youngest kids, and help them mount a protective level of antibodies.

I don't know the timeline. I certainly think this should be a priority for everybody. And it is a priority for everyone. But I want to also ensure that it's done safely and effectively. And that's what we're all waiting for.

Stephanie Sy:

Dr. Ibukun Kalu with the Duke University Hospital, thank you so much for joining us with your advice.

Dr. Ibukun Kalu:

Thank you for your time.