• Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

    COVID Update September 21, 2021: The Door Opens Soon to Protect All School Children

    By Dr. Arthur Lavin


    • 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 (genes and protein coat), and on it goes.
    • Variant- also known as a mutation, a variant strain of a virus is the same species of virus but with a change in the genetic code.  The change is minor if it has no impact on contagious the new variant is, or how deadly it is, or if it allows the virus to neutralize our vaccines. Variants that substantially increase harm are now listed by Greek letters, the most troublesome one now is Delta.
    • 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.
    • 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.

    The Door Opens to Protect all School Children

    This week Pfizer made the announcement they promised would be coming in September, that they have completed their studies on how their COVID vaccine works in children ages 5-11 years old.   And their conclusion was that the vaccine works very well, and is very safe in children ages 5-11 years old.

    This announcement is the first of four steps to opening the door to protecting all school children from the suffering and danger of COVID-19.

    Here are those 4 steps:

    1. The vaccine manufacturer completes studies on their vaccine’s effectiveness and safety.  They present the data on how well it works and if it causes any harm.  Done
    2. The vaccine manufacturer presents their data to the FDA in a request for authorization to use the vaccine.  Soon to happen.
    3. The FDA decides on whether to issue an EUA, an emergency use authorization.
    4. Only then, does the CDC’s Advisory Committee on Immunization Practice, the ACIP, meet to decide whether to recommend use of the vaccine, at what ages, at what timing.

    The moment all 4 of these steps are concluded, then the Pfizer COVID-19 vaccine can be given to any child ages 5 years old and older.   The first step is done.  The second, the application for the EUA is underway and is expected to occur in September.

    The 3rd step is very important, it is the job of the FDA to act on our behalf, to be our voice, to challenge the manufacturer to make sure the evidence is conclusive.  I am extremely confident the evidence will be conclusive.  There are no biologic reasons to believe a vaccine that is as safe and effective as this one in children 12-18 years old won’t be for 5-11 years old.  Further, the vaccine has been given over 4 billion times, we know this vaccine, we know it works, we know it is safe.

    So all anticipate the last two steps will be concluded in October.

    This means all children ages 5 and up will be able to be protected against COVID-19 likely by this October, how will it be given?

    We know that people are of three minds on the COVID vaccine.   We know that most people realize that it saves lives, the need is extremely urgent, and when the vaccine is available they do anything in their power to protect those they love.  The day this vaccine is recommended for children 5-11 years old, there will be great pressure to make this vaccine available immediately to these children.  Real danger combined with real love demands real action.  We all agree!

    The second group are fully in the grips of the anti-vax movement.  They will not immunize their children, even in the face of the obvious fact that pediatric ICUs are full of young children suffering from COVID, nearly all because they are not immunized against COVID.

    And then the third group are the hesitant, the ambivalent.  They know that the vaccine could save the life of someone they love, but worry haunts them, pushing them to wait until doubts clear, and the decision to protect the children they love is certain.  Most in this group will end up immunizing their children, but they will not be pushing the day the approval comes.

    Putting all this together, we anticipate a massive surge of demand from parents to save the lives of their 5-11 year old children the day the COVID vaccine is approved and recommended for these children.

    I have consulted top public health authorities and they concur that the challenge will be real to respond that day, that week, to the door opening, and their conclusion makes compelling sense.  It will take a combination of efforts to make sure every Mom and Dad of a 5-11 year old gets the protection their child deserves ASAP.

    That combination will include:

    • Hospitals
    • Pharmacies
    • Community health centers
    • Cuyahoga County mass immunizations sites, east and west
    • and, your pediatrician’s office

    All these sites will be up and running when the approval for the 5-11 year olds comes to be, again we hope, in October.

    And, we are very proud to do our part.

    Advanced Pediatrics will be a COVID immunization site for all children 5 years old and older once the approval and recommendation are granted.

    We will do all we can.  Meaning, we will order vaccine as soon as we can.  We will give as many doses as our office can manage to give.

    We ask only one thing from parents whose urge to protect their child we applaud:  Be willing to work with us through two frustrations that will be unavoidable:

    1. It will take some time for us to have our vaccine delivered.  We cannot order it until it is approved as there is currently no demand in our office for children 12-18, all whom were going to be immunized, have been already.
    2. We will only offer a set number of doses to be offered, a number set by our ability to prepare and administer this complex vaccine.

    So, when the approval comes, we urge, we really urge, all parents to get all their children ages 5 and up protected from a fatal threat, ASAP.  If we cannot get your child in to our office fast enough, go to the pharmacy, go to the hospital, go to the health center, or the Cuyahoga County immunization site.

    We will only succeed in ending the threat to our children if we all work together.  And we are eager to do just that, we hope you are too.

    What the Availability of COVID Vaccine for all Children ages 5 and Up Means

    In a word, it means life.

    Even back in June of this year, a calculation was made looking at nations who have immunized, asking, how many lives had the COVID vaccine saved by June of 2021, and the answer was staggering.  In the US, over 200,000 lives saved and around the world over a million!

    There is no doubt, we have the power in our hands to end the pandemic, to save so many lives, including the lives of our children.

    If all three groups, those ready to protect their children, those hesitant to do so, and those opposed to doing so, join forces, and if all children ages 5 and up are fully immunized here is what will happen:

    • School will be safe from COVID.  No more holding our breath to see if your child is the next person to get COVID or any of its highly unpredictable complications.  Children from Kindergarten through College will be able to go to class and learn, without interruption, without dread danger.
    • Team sports can return to full normalcy, and full audiences
    • Theater, Dance, Music, Clubs. All the essential, fun, parts of life can return to our children’s lives, in full safety.
    • Play. Our children, at least those 5 and older, will be able to get together with friends, have birthday parties on rainy days, have sleep overs, with worries nearly eliminated.

    Once we reach the goal of all people 5 and up fully immunized, the other rather extraordinary benefit will be that the pandemic will come to an end, the carnage will cease, new variants will appear far less frequently, avoiding the current risk of a new variant that could pierce all immunization protections.

    Bottom Lines:

    1. As predicted, Pfizer has concluded its studies of its COVID-19 vaccine in children ages 5-11.  And they found it works very, very well, and very, very safely.  Just like in everyone else.
    2. Now three steps remain:  Pfizer applies for emergency use authorization, FDA reviews the data and decides on granting the EUA, the CDC reviews the data and issues official recommendation on use.
    3. It is expected that the Pfizer COVID-19 vaccine for children 5-11 years of age will be available this October.
    4. There will be an instant and huge demand when this door opens.  Advanced Pediatrics is ready to do our part, along with hospitals, pharmacies, community health centers, and Cuyahoga County mass immunizations sites, to get everyone 5 and up vaccinated.
    5. When the door officially opens, we will issue guidance on when we can offer COVID-19 vaccine again.  When you call you will find out if time slots are, and if they are available.  We will give as many doses as we can.
    6. The day is approaching soon when we can protect all children from Kindergarten, through elementary school, middle school, high school, and college.  If we who care for our children succeed, then school, sports, and play can return to our children and adolescent’s and young adult’s lives without threat of a deadly disease.  The power and choice remains entirely in our hands.
    7. Lastly, we now anticipate the same move forward for all children ages 6 months through 4 years of age to occur sometime in November or December.

    My One Takeaway Sentence:

    The power to save our children’s lives is in our hands and about to expand dramatically- please, please, please use that power, save our children’s lives, get immunized, stop the Pandemic.

    To your health,
    Dr. Arthur Lavin



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