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This is a weekly Q and A column written by Dr. Lydia S. Segal, M.D. in conjunction with Chaffee County Public Health. This column is focused on questions readers have about COVID-19 news and sciences.  As Segal points out, ‘Everything I write today is valid for today. COVID-19 news and science are rapidly evolving, assume updates will be made”

QUESTION:  Lately a number of questions concerning children and immunizations have been raised. As an example; a mom who asks about her two healthy, fully immunized children between five and ten years of age who attend Longfellow Elementary School. She asks for a summary of the benefits and risks for childhood COVID vaccines.

ANSWER: On October 26, the advisory committee to the FDA recommended a low dose mRNA vaccine, specifically the Pfizer vaccine, for children 5 to 11 years of age. It is expected in the next several weeks, this recommendation will go to the CDC for final review for emergency use authorization, EUA. The initial clinical trial was done on over 2,200 children using one-third the dose authorized for teenagers and given 21 days apart.  Efficacy is 91 percent against symptomatic COVID.

Lydia S, Segal, MD, MPHNow let’s review the risks and benefits of vaccinating children. Keep in mind the side effects from the vaccinations are less than the symptoms of COVID. Based on data collected by the American Academy of Pediatrics approximately 6.3 million children have gotten COVID since the beginning of the pandemic, of those 1 million cases occurred since the beginning of this school year. Hospitalization and deaths are extremely rare though children can still get COVID obviously, based on the collected data. Vaccinations reduce disease and hospitalizations and death.

Vaccinations also increase the likelihood of your children being able to attend in-person school, participating more safely in after-school activities, and being able to participate in indoor winter holiday festivities.

There were no safety signals, meaning no major risks were found in the study group. As more children are vaccinated, it might be expected to see a rare case (say one in 100,000 to one in a million cases) of pericarditis or myocarditis. These are both temporary cardiac conditions that have been seen in young males who were vaccinated that have all resolved.

QUESTION: There has been much in the press about home testing kits. Based on a number of questions, what follows is a review of the kits.

ANSWER: There are basically three types of tests: molecular, antigen and antibody. The molecular test looks for a minute amount of viral particles. It is known as the PCR test and is done in medical facilities. Results generally take several days. The PCR test lets you know if you have the SarsCoV2 virus regardless if you are sick or asymptomatic. It does not tell you if you have enough virus to be contagious.

The next is the antigen test that looks for the part of the virus called spike antigen. It is available both at medical facilities and in at-home tests. Results are ready in 20 minutes or less. The test lets you know if you are infectious. Because one can have the virus in small amounts but not yet be infectious to others, it is a two-series test done two to five days apart depending on which company’s test kit you have.

Take the following example: you either were in contact with someone who turned out to have COVID, or you are developing COVID symptoms and are not sure if you have a garden variety cold or COVID. You want to know two things; one is — do you have COVID? The other is are you infectious to others? This category of home testing can do just that, tell you if you have enough virus to be transmissible to others so that you stay home while contagious.

There are several antigen test kits currently on the market and more are coming. The federal government is putting in place programs to increase the availability of testing kits and reduce pricing.  The companies you are likely to see in the stores or online include Abbot’s Binax Now, Quident’s QuickVue, Australia’s Ellumune, and the recently approved Acon’s Flowflex. Results are ready within 20 minutes. A negative result means you do not have the virus at all, or do not have enough virus to be shedding. In either case, you would not be contagious.

The state of Colorado has a program to mail each of us free home testing kits. See the following web link to enroll and place your order: https://covid19.colorado.gov/covid-19-testing-at-home.

The third test is the antibody test. This test lets you know if you mounted an antibody response to either the disease itself or to a vaccine. In general, there are two types of antibody tests. The qualitative test gives you a positive or negative and is available at medical testing facilities.  The other, called a quantitative test, gives you a number.

Currently, the problem with the quantitative test is that no one really knows what number you need to be at to be considered to have had an immune response either to having had COVID or to a vaccine. So this test is not being encouraged as no one really knows what valuable information it provides. The exception to getting a quantitative antibody test might be the immunocompromised individual, to see if they did in fact mount an appreciable immune response.

For more information about COVID and the vaccines, eligibility, and appointments, see the links below. Pharmacies are getting small shipments of vaccines. Information will be posted on this news platform and on the county public health and hospital web pages.

http://chaffeecounty.org/Public-Health-Coronavirus

https://www.hrrmc.com/covid-19-updates/covid-19-vaccine/

Pharmacies with vaccine clinics:

Salida:  Safeway, Walmart, and Salida Pharmacy

Buena Vista: Mt. Shavano (LaGree’s), City Market, BV Drug and Valley-Wide Health

If you have questions you would like Dr. Segal to address in a future COVID Q and A column, please write to arkvalleyvoice@gmail.com

By Lydia S. Segal, M.D., MPH