As Delta spreads, it’s time to put children’s health first

As pediatricians, we are committed to putting children’s health first. Last year, though, when hospitals filled with adults with Covid-19, we turned our attention to caring for them. Across the country, pediatric units were closed to make room for sick adults.

Our pediatric patients didn’t complain, and neither did we. Although kids appeared to be largely spared by the virus during the early phase of the pandemic, we saw with our own eyes the gravity of severe Covid-19-related illness in young people: more than 100 children in our hospitals’ ICUs required life-saving treatment due to Covid-19 and many more have persistent symptoms that affect their daily lives.

As the pandemic evolved, youths’ education was put at risk due to concerns of the virus spreading in schools. Pediatricians and other researchers worked hard to assess whether children, their caregivers, and teachers could be protected from the virus by wearing face masks, social distancing, and better ventilation in classrooms or child care settings. They largely did.

Even so, most young people were forced to learn from home mainly to protect adults and reduce the potential spread of Covid-19 in their communities. Data are now pouring in demonstrating how poor the educational outcomes for children were in the virtual arena, and we are in the midst of dealing with the mental health crisis that ensued for youths of all ages.

Highly effective and safe vaccines became available for all adults in the late winter of 2021. Yet despite all of the sacrifices children made to protect adults last year, many adults have not stepped up for children in return by taking the simple steps needed to keep kids safe: getting vaccinated and continuing to support requirements for children and adults around them to wear face masks to protect unvaccinated children.

With the highly transmissible Delta variant on the scene, more young people are becoming sick with Covid-19 than ever before, especially in under-vaccinated regions of the country. Youths with Covid-19 fill pediatric ICUs and many children’s hospitals are at or beyond capacity.

Young people are susceptible to the Delta variant, a highly transmissible virus. They accounted for 180,000 cases of Covid-19 in the U.S. for the week ending August 19, comprising about 18% of newly reported cases, with the increase in pediatric cases beginning in July, reports the American Academy of Pediatrics and the Children’s Hospital Association.

This increased vulnerability of children to infection with SARS-CoV-2, the virus that causes Covid-19, is happening just as millions of them head back to the classroom for the new school year.

As pediatricians, we and our colleagues make children’s health our priority in clinical care, medical innovation, and biomedical research. We assumed that the development of Covid-19 vaccines for children would lag well behind their development for adults, so we did everything possible to support children. Vaccines were studied in pediatric animal models, as were kid’s responses to the virus itself, predicting that the early-life immune system responds well to the existing highly effective vaccines.

Pediatricians participated in committees that aimed to make the best decisions on these vaccines for the safety of all ages. Some led vaccine trials in children; others felt compelled to enroll their children in those trials, not only in the hopes of protecting them but in hopes of bringing immunity and protection to all children. Pediatricians spent time educating parent groups and often had difficult one-on-one conversations with parents of teens to speed vaccine uptake.

We and our colleagues did this while treating children who became severely ill from Covid-19, some of whom developed a new disease caused by the virus (multisystem inflammatory syndrome in children), as well as long-haulers — children who continue to have symptoms long after they have cleared the infection.

Pediatricians are advocates for children and protectors of their health. As such, we are now asking that children be put first. Preserve their in-person education by mandating vaccines for all who are eligible and wearing masks in schools. Give them the ability to be protected by the highly safe and effective Covid-19 vaccines. We join the American Academy of Pediatrics in calling for rapid emergency use authorization of the vaccines for children ages 5 to 11, followed by younger children, with the same urgency that was given for adults.

It’s time to stand up for children, who have been pushed aside since the response to the pandemic began. Pediatricians, parents, educators, lawmakers, and others need to protect kids’ education — and their lives — by giving them immunity and protection that will prevent disease.

It is the children of this pandemic that we will rely on to bring us the next lifesaving innovations, perhaps the ones that will prevent pandemics like Covid-19 in the first place.

Sallie Permar is pediatrician-in-chief at NewYork-Presbyterian Komansky Children’s Hospital and chair of the Department of Pediatrics at Weill Cornell Medicine. She reports having consulted for Merck, Moderna, Dynavax, and Pfizer in regard to their cytomegalovirus vaccine programs. Jordan Orange is pediatrician-in-chief at NewYork-Presbyterian Morgan Stanley Children’s Hospital and chair of the Department of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons. He reports consulting for several pharmaceutical companies, including Janssen. None of his consulting work is in the area of vaccines.