Frequently Asked Questions about COVID-19 — June 8, 2022

“Shared expectations lead to predictability.”

556.  Vaccinations for children under age 5 should be FDA approved in just weeks.

         QWhy is it taking so long to approve vaccinations for children under age 5?

         A:  Children are not like small adults.  Their immune systems work differently than older people, and infections can take different pathways to manifest disease.  Clinical trials have to be thorough not only in determining the smaller dosages required, but the multiple variables in how vaccines work differently in young children.  The two mRNA vaccines, first Moderna and now Pfizer have completed their trials meeting the requirements for approval.   The FDA advisory panel is now scheduled to meet on June 21 to conduct a public hearing evaluating these findings.  But enough data has already been made available to allow speculation that both drugs will be approved.  The CDC is not expected to delay their final approval, and the vaccines should be available in just a few weeks.  In some places, appointments are being made for pre-schoolers to get their shots.  Pediatricians are expected to be the primary locations for vaccinations, but other places are also being planned.  There are about 19 million children in the US under the age of 5.

557.  The birthrate in the U.S. is differentially increasing during Covid-19.

         Q:  Has the birthrate fallen during the pandemic?

         A:  No.  The birthrate in the United States increased slightly last year, ending what had been a consistent decline since 2014, the federal government reported on Tuesday.  There were 3,659,289 births in 2021, an increase of about 46,000, or 1 percent, from 2020, when there was a sharp drop, according to provisional data released by the National Vital Statistics System, part of the Centers for Disease Control and Prevention.

The increase can likely be attributed to parents making peace with the conditions of life during a pandemic, according to Phillip Levine, an economist at Wellesley College who has studied recent fertility trends.  During the initial Covid-19 lockdowns in the spring of 2020, there was a sharp decline in conceptions that led to births, according to his analysis. (Despite frequent speculation, there typically aren’t baby booms nine months after blizzards, blackouts, and other one-off events that leave couples home alone and bored.)  As the pandemic wore on, local infection rates did not seem to factor much into people’s decisions about childbearing.  “Our acceptance of the Covid environment grew,” Professor Levine said.

Still, not all women were equally confident in having a baby during the pandemic. While the birthrate rose 2% for white and Hispanic women, it declined by 2% to 3% for Black, Asian, and Native American women.  The birthrate dropped to record lows for teenagers and declined 2% for women 20 to 24. Women in their 30s, who are more likely than younger women to be married and financially stable, experienced the greatest uptick in fertility.

558.  Mask mandates have been reimposed by schools outside of New England.

         Q:  Is everyone in the country finding Covid cases diminishing? 

         A:  While most of New England has been enjoying a rapid decrease in the number of Covid-19 cases, the rest of the country has not been so fortunate.  As coronavirus cases have increased across the rest of the United States, some universities and public school systems have reimposed indoor mask mandates on their campuses, a sign that while the academic year may be coming to a close, the pandemic is still not.  The University of Hawaii’s mandate was expanded a week ago last Wednesday on its 10 campuses, requiring masks in all indoor spaces. The university said it took the action because nearly the whole state was now in the high-risk category for community transmission under new CDC guidelines.

The University of Delaware cited rising new-case reports and hospitalizations both in its state and across the nation when it announced its mask mandate would once again include all indoor spaces.  Some public school systems also have taken similar steps two weeks ago.  The schools in Philadelphia also recently restored their mask mandate.

Another Omicron subvariant, known as BA.2.12.1, which spreads more rapidly than previous versions, has become the dominant form of the virus among new U.S. cases according to federal estimates. For the first time since February, the country is now averaging more than 100,000 new confirmed cases a day, and the widening use of at-home testing means the true number of infections is probably higher.

Still, conditions appear to be stabilizing in some Northeastern states that were among the first to see a spring surge in cases. Though still high, case rates have started to level off or decline in several New England states and in New Jersey.

559. China is continuing its “Zero Covid” policy to eliminate the infectious disease.

         Q:  Is China still demanding everyone be tested many times to get rid of Covid?

         A:  Chinese cities and provinces have turned to regular mass coronavirus testing, even in the absence of a local Covid-19 outbreak, raising concerns about the economic toll.

The 99 million residents of central Henan Province will be required to take P.C.R. tests every other day in June.  In the eastern province of Zhejiang, drivers are tested at highway exits before they can enter.  Beijing, which has a small outbreak, is among the cities now requiring a test to get on the subway or enter any public place.

In early May, Sun Chunlan, a Chinese vice premier, said residents of large cities should be able to get PCR tests within a 15-minute walk of their homes. By mid-May, nearly 10,000 booths had been set up across Shanghai. But not all local governments can afford to do what China’s wealthiest city does.

Strict containment and prevention measures have already taken a toll. Local governments in Sichuan and Anhui have called in recent weeks for public donations to alleviate strains on supplies of medical equipment.  On social media, there has been no shortage of mockery of the new efforts. On Weibo, China’s Twitter-like platform, many users suggested that coronavirus testing could stall economic growth, which has dropped under lockdowns and travel bans.  In response, Hu Xijin, a former editor of the Communist Party tabloid Global Times, praised Henan’s testing plan.  He also repeated the official line that living with the virus would never work in China and that regular PCR testing was the country’s best option.

560.  Childhood diseases in school could spread if anti-vaxxers limit those protected.

         Q:  If people refuse to let their kids get vaccinations for other diseases, will my kid be safe?

         A:  Physicians are increasingly seeing parents when they do not want their children to be vaccinated against Covid-19.  Some have expressed their unwillingness to have their children immunized against other childhood diseases that are required for admission to schools each year.  The Times Magazine took a lengthy review of people’s opposition to vaccinations in a recent article.  There is increasingly rampant misinformation related to the Covid-19 vaccines.  Pundits, like Tucker Carlson on Fox News have devoted a lot of time offering – among other untruths, that the vaccines make people more likely to contract Covid-19.

There is a long history of arguments against mandatory vaccination over the past century.  The root of this history is due, in part, to social confusion about how much autonomy any individual should surrender for the greater good.  In the early 20th century, as improvements in sanitation blunted the spread of many diseases, people saw less of their bad outcomes.  Vaccine science accelerated, too.  When the polio vaccine became widely available in 1955, it helped children avoid the frightening paralytic conditions caused by the virus, including the loss of the ability to breathe.  Such public-health successes are why some scientists regard vaccines as the single greatest medical advance in human history.  But that very triumph has, paradoxically, hindered the effort to counter vaccine skepticism. In a sense, vaccines have become victims of their own success.

Then, in February 1998, an article was published in The Lancet, a prestigious medical journal.  With only 12 patients studied, they speculatively proposed a link between the measles, mumps, and rubella vaccine and regressive autism.  Andrew Wakefield, the British gastroenterologist who had led the research, for years has continued to advocate against vaccinations, even though the scientific community overwhelmingly found the study was not accurate in its findings.  Citizens worldwide remain skeptical, and decades later, now continue to support ever-more outlandish misinformation against vaccinations.

Jason Terk, a pediatrician in Keller, Texas, called the expansion of refusing all vaccinations “the other contagion” — a new hesitation or refusal by patients to take vaccines they previously accepted.  If this dynamic continues, it could threaten decades of progress in controlling infectious diseases. The anti-vaccine movement is “so strong, so well organized, so well funded, I doubt it will stop at just Covid-19 vaccines,” says Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine. “I think it’s going to extend to childhood vaccinations.”