Is there much point getting DD vaccinated

[BasementIdeas]

We’ve had an invite through for DD (10) to get the vaccine. I’m just not sure if there’s any point. She’s had Covid twice in the last 4 months with barely a symptom either time. Also, case numbers seem to have started declining now and, if the last 2 years are anything to go by, I expect the summer to be pretty quiet. So is there any point in getting her vaccinated when the vaccine will just wear off in a few months?

I’m thinking about holding off and just reevaluating in October to potentially get her vaccinated before next winter’s surge. Anything I’ve missed?

We've just had our two DCs (6 and 9 vaccinated). We decided to do that to protect their grandparents, particularly DMIL, as the medication she is on makes her CEV so if she caught it she's at greater risk of serious illness. We know that the vaccine doesn't completely stop transmission, but it does reduces transmission. As my DCs spend a lot of time with their DGM, we decided to get them vaccinated.

We know that the vaccine doesn't completely stop transmission, but it does reduces transmission

Really? I'd love to see some evidence that shows that vaccines reduce transmission!

@Robinni no what I am saying is why are you suggesting that an out of date vaccine offers more protection against long covid from future infections than two infections of omicron which were very symptomatic. All studies showing covid vaccine reduces long covid risk is versus unvaccinated immune naive people. Whilst I’m not advocating natural immunity as a strategy of protection for adults as there is always a risk of your first infection causing severe illness, if you have had natural infections it still creates immunity. I say that as an immunologist so I have some idea what I’m talking about. I just don’t think the vaccine against the original spike protein is that relevant for children who have since had natural infection with more recent variants.

@Purpleroseas those who are vaccinated are significantly less likely to contract covid. If they don’t get it, they can’t pass it on. Although peak viral load can be comparable (this is disputed - some papers say in vacc it’s more comparable to delta and thus not the main reason for increased transmissibility, more on that below), this drops faster in vaccinated people (certainly for delta and other variants) so they are a risk to others for a comparably shorter period of time. Omicron results are more variable, however it is on the way out now.

From lancet jan 2022
Peak viral load not comparably different vacc/unvacc which has policy implications I.e. why vacc for care workers was dropped.
www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00768-4/fulltext

BMJ Feb 2022
Discusses the issue of transmission in relation to omicron, 25% of those vacc will have a breakthrough infection
“The first weekly covid-19 vaccine surveillance report for 20221 from the UK Health Security Agency (UKHSA) was more positive than Bauld’s assessment—but didn’t say outright that covid-19 vaccines prevent transmission. “Several studies have provided evidence that vaccines are effective at preventing infection,” it states, “Uninfected people cannot transmit; therefore, the vaccines are also effective at preventing transmission.”
www.bmj.com/content/376/bmj.o298

Infectious viral load in unvaccinated and vaccinated patients infected with SARS-CoV-2 WT, Delta and Omicron

• this is a preprint article so has yet to be peer reviewed
• shows viral load of delta significantly lower in vacc vs unvacc and that omicron not significantly different to delta in terms of viral load so this cannot account for increases in transmissibility.

** having a lower viral load is important as exposure to lower = less risk of infection and tend induce milder infection www.medrxiv.org/content/10.1101/2022.01.10.22269010v1 ** here’s another article from Nature referencing 2 studies that back up the assertion above and mentioning that there is more variability in viral load of omicron infections; ie vaccine may well protect against transmission in some but not others probably dependent on factors related to the host. www.nature.com/articles/d41586-022-00129-z

This from Forbes explains more and highlights that omicron doesn’t have a higher viral load than delta and it’s clearance time is quicker. Which points to the fact that omicron may be more transmissible due to an ability to suppress the immune system which is not great news.
Here’s the article, link to the paper in there.

www.forbes.com/sites/williamhaseltine/2022/01/19/new-data-suggests-that-50-of-omicron-infections-in-healthy-young-men-remain-transmissible-after-five-days/amp/

[quote JS87]@Robinni no what I am saying is why are you suggesting that an out of date vaccine offers more protection against long covid from future infections than two infections of omicron which were very symptomatic. All studies showing covid vaccine reduces long covid risk is versus unvaccinated immune naive people. Whilst I’m not advocating natural immunity as a strategy of protection for adults as there is always a risk of your first infection causing severe illness, if you have had natural infections it still creates immunity. I say that as an immunologist so I have some idea what I’m talking about. I just don’t think the vaccine against the original spike protein is that relevant for children who have since had natural infection with more recent variants.[/quote]
If we are talking about omicron specifically it largely evades immunity from past infection and two vaccine doses. Hence the increased transmissibility. You get breakthrough infection.

www.imperial.ac.uk/news/232698/omicron-largely-evades-immunity-from-past/amp/

Despite this, vaccination provides a longer duration of protection than a prior natural infection. AND the vaccine is holding up very well against morbidity and mortality preventing people from developing severe infections which would put them more at risk for long covid.

It is on this basis that I would say vaccination is preferable to natural infection for all age groups. Though I do think for kids the offer should remain non urgent for the time being and be down to individual families.

Arguably, if we were to develop a vaccine specific to omicron, by the time it would be in industrial production, and scaled out new variants would have emerged. Leaving us back at square dot with an “out of date” vaccine. At the moment the vaccine is doing what it’s meant to, yes everyone wants sterilising immunity but that isn’t realistic. When significant cracks in the armour occur or a Voc inducing more severe pathology emerges - that is the time to upgrade the vaccine.

Also if you think about the morphology of the spike, pathology induced by prior variants was more severe and much more likely to induce long covid. If we go altering the vaccine and make it more like omicron would that then make us more susceptible if a variant emerged with similar characteristics to say alpha?

When it comes to childhood vaccination it’s a fine line as so few of them develop severe disease and die. And with omicron being milder it provides less of a case to vacc the whole cohort.

What’s your take on transmissibility of omicron being linked to immune evasion? Any examples of other viruses heading in this direction that could give an idea where this is going now? How likely is it that this will hold and become part of the biology of the covid? Do you think future vaccines will have to incorporate proteins that interact with the innate immune system in order to prevent immune suppression, as well as the spike protein facilitating cell entry, and do you know any examples where this was successful?

Asking as more your area than mine - Don’t feel you have to answer all that if you haven’t an opinion, but those are the sorts of questions I’d be thinking about now.

@JS87 all in all I take your point re. Natural immunity being equal to vaccination (though wanes faster) www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00676-9/fulltext

And in your particular circumstances it probably makes sense on the balance of risk to not bother with vacc for a few months.

But I think it’s important for those whose kids haven’t had it, that immunity acquired through vacc is safer; so don’t go out purposely exposing kids, it’s uncontrolled!

I’m less worried about the majority of kids being vacc now, than I am about evasion of the innate immune system becoming embedded in future variants. As that will cause bigger problems.

@Purpleroseas because if you’re vaccinated you’re less likely to contract Covid, so less likely to pass it on. In our case, it is the reduced likelihood of our DCs contracting Covid, and therefore being less likely to transmit to to their DGM, that was behind our decision to get them vaccinated. I’ve no idea whether they’re less likely to transmit it if they actually do get Covid, but that’s not what I meant.

@lilac57 kids

@Robinni doesn’t the vaccine reduce the overall risk that they’ll catch Covid and pass it on? I get that they’re at lower risk anyway, but there’s still some risk that they’ll pass it onto family members, isn’t there? I know a number of people who have caught Covid from their young children, so there must be some risk, even if small. That’s even more important if they’re likely to be asymptotic IMO, as they could pass it on to DMIL at any time, without us having any clue that they have Covid, so we wouldn’t know to avoid contact.

@Lilac57 there are plenty of articles on this but this one pretty much encapsulates the opinion at present
www.medrxiv.org/content/10.1101/2022.02.25.22271454v1

Conclusions and Relevance: In the Omicron era, the effectiveness against cases of BNT162b2 declined rapidly for children, particularly those 5-11 years. However, vaccination of children 5-11 years was protective against severe disease and is recommended. These results highlight the potential need to study alternative vaccine dosing for children and the continued importance layered protections, including mask wearing, to prevent infection and transmission.

So good that you got them vaccinated, but I would continue with added protections if you’re very concerned such as mask wearing indoors, ventilation, sanitiser, lateral flows, sitting in garden if warm enough. Obviously if DGM is vaccinated herself this is key for her protection. Other than that it’s being sensible if there are concerns.

Thanks @Robinni, that makes sense.

No my kids won't be having it. I don't feel they're at risk of complications, and whilst the adults in the family are vaccinated, I don't see the need for healthy children to have it

My issue is, how do you know the most effective time to have your children vaccinated? I may get it done now as it is available, but all those holding off until a new variant may get theirs done at that time, and then my children's protection will have waned. It's tricky.

From the point of first dose to maximum response it’s 12-14wks. So if you were to get jabbed tomorrow that would be hmmm end of July by the time of max response.

Some getting jabbed now for hols (vaccine requirement 2 jabs, or because of exposure to different variants than those circulating locally), others banking on seasonality and aiming to get jabbed Sept to be ready for winter onset.

I would suspect if there was a horrendous wave or new variant radically different they’d have a booster roll out anyway or lock us down.

From the point of first dose to maximum response it’s 12-14wks. So if you were to get jabbed tomorrow that would be hmmm end of July by the time of max response.

What is being used as a measure of maximum response here? @Robinni

Antibodies to the virus…

The way it falls, all the medically vulnerable children my child’s age aren’t eligible until 6 months after their booster which will be May. So useless for exam season as they’ll be already doing them.
According to a press article based on JCQ advice, exam pupils are to go in untested, even if they have symptoms (except a high temperature). They are only supposed to test if a doctor advises them to (?). If they are positive, they are allowed to resume exams only 3 days after the positive test, even if they still have symptoms.

@biokult
Takes a few wks after first jab for body to build an immune response. Then there is an 8-12 week break before the second jab where the body is challenged again and produces a stronger response, again taking a few weeks.

From the EMA (although this is from a european agency it’s written concisely and in a manner that’s easy to understand)

www.ema.europa.eu/en/news/comirnaty-covid-19-vaccine-ema-recommends-approval-children-aged-5-11

“A main study in children aged 5 to 11 showed that the immune response to Comirnaty given at a lower dose (10 µg) in this age group was comparable to that seen with the higher dose (30 µg) in 16- to 25-year-olds (as measured by the level of antibodies against SARS-CoV-2). The efficacy of Comirnaty was calculated in almost 2,000 children from 5 to 11 years of age who had no sign of previous infection. These children received either the vaccine or a placebo (a dummy injection). Of the 1,305 children receiving the vaccine, three developed COVID-19 compared with 16 out of the 663 children who received placebo. This means that, in this study, the vaccine was 90.7% effective at preventing symptomatic COVID-19 (although the true rate could be between 67.7% and 98.3%).

The most common side effects in children aged 5 to 11 are similar to those in people aged 12 and above. They include pain at the injection site, tiredness, headache, redness and swelling at the site of injection, muscle pain and chills. These effects are usually mild or moderate and improve within a few days of vaccination.”

Actual paper the recommendation based on
www.nejm.org/doi/full/10.1056/nejmoa2116298

You can also measure a vaccines effectiveness/efficacy based on the number of people who get sick of those who get vaccinated vs a control group. More on that here.

www.who.int/news-room/feature-stories/detail/vaccine-efficacy-effectiveness-and-protection

@JS87 is an immunologist so can explain immune responses post vaccination much better than I can.

@Blogblogblogblog I think if any child is CV or CEV and concerned they can request a separate room or other accommodations.

This is common practice for children with medical conditions/disabilities anyway and would certainly be a reasonable accommodation under the circumstances.

Yes luckily my child has this. It’s just these last few weeks leading up to A Levels when there’s 1500 in the building.

At least the invigilators will be very happy they got lucky with her! They’re all older people so I can’t imagine they’ll love invigilating this year.

Is it a waste to get them vaccinated now? If they catch it at say, Christmas, will it have neen pointless vaccinating them; will it have worn off? Or, once vaccinated, do you always have some antibodies, no matter how many months pass? One child has had Omicron, and one child has had no infection. Struggling to decide.

@Mymincepie what you’ll get is the antibody response revved down, this waning of humor immunity over time, but you will have Memory B cells ready to come to action. with repeated exposures to covid via boosters/infection (as long as in line with what you would expect naturally 1-2x a yr) this would maintain response.

You can google how the immune system works or how vaccines work, I’ve attached as simplistic a diagram as I could find.
From here: www.aboutkidshealth.ca/article?contentid=3937&language=english

Hope this helps.

@Mymincepie
A a guide to vaccinology (see figure 3)
www.nature.com/articles/s41577-020-00479-7

Covid 19 vaccines modes of activation
www.nature.com/articles/s41577-021-00526-x

Immune memory (oct 2021)
www.science.org/doi/10.1126/science.abm0829

Thank you. I guess it is worth just getting them vaccinated soon then. I take it chance of myocarditis is higher following covid than following vaccination too?

@Mymincepie

This is a direct copy from a reply I made to a mum worried about her 18yo son.

Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis
Published 11/04/22

• outlines that there is an enhanced risk for males but no more than for flu vaccine and less than for smallpox. Also states that the benefits of vaccination outweigh the risks, while clearly laying out what those risks are.

www.thelancet.com/journals/lanres/article/PIIS2213-2600(22)00059-5/fulltext

Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection
Published 14/12/21

• extra cases of myocarditis 28 days after vaccine: 1-6 extra per million post first dose, 10 extra per million after second dose
• extra cases of myocarditis 28 days after covid infection 40 per million
• increased risk of pericarditis and cardiac arrhythmia observed post covid infection, but not after vaccination.

www.nature.com/articles/s41591-021-01630-0

Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study
Published 27/08/21
(Visual abstract attached to post)
“ Increased risks of haematological and vascular events that led to hospital admission or death were observed for short time intervals after first doses of the ChAdOx1 nCoV-19 and BNT162b2 mRNA vaccines. The risks of most of these events were substantially higher and more prolonged after SARS-CoV-2 infection than after vaccination in the same population.”
www.bmj.com/content/374/bmj.n1931

These are just some of the many evidence based papers showing that the risk of vaccination is lesser than the risk faced from covid infection, and indeed other vaccines your son may have already had without the bat of an eyelid.

There has been a lot of unsettling publicity over this issue, from what I’ve read, and you will too if you take some time to research it - even when there are adverse effects such as the above they are largely resolvable for the minority in which they occur.

I would still read around it yourself @mincepie there was a lot of concern a year ago, but so many have been vaccinated since there’s a pretty firm evidence base that covid itself is more risky.

Adverse reactions info and data for the U.K. here. www.gov.uk/government/publications/coronavirus-covid-19-vaccine-adverse-reactions

Take your time until you feel confident and don’t feel swayed by scare tactics either way - it’s your child.

I’m not on a campaign trail to push for children’s vacc, I just don’t like all the hysteria and misinformation around this. And I was reading covid threads to help myself as I’m ill with it myself at the moment. All the best