Leading into 1955, there were about 16,000 cases of polio per year in the United States.  Dr. Jonas Salk produced a vaccine against this terrifying public menace, which he tested on himself, his wife, and his three sons.  Soon after, on April 25th, 1954, a trial was instituted with 1.3 million children as subjects.  It was done with the highest clinical research standards (randomized, controlled, and double blind) and the study found the vaccine to be 80 to 90 percent effective in preventing polio.  A day after the results of the study were released, the vaccine was licensed.  Today, polio does not exist in the United States.*

I received the vaccine in 1955 when I was eight years old.  In later years, my mother spoke to me about the agonizing decision she and my father, and all parents, had to make to allow their children to get vaccinated.  There was no question about the immediate effectiveness and short term safety of the vaccine, but what about long term complications?

Recalling this conversation, I have a lot of sympathy for the difficulty parents face today regarding vaccinating their children against Covid-19.  A month after little kids became eligible for the vaccine, only 5.3 percent of Illinois children have received at least one dose.  As with the polio vaccine, there is no question about the short term safety and efficacy of the Covid vaccine.  But there can be legitimate questions about long term side effects.  Supply issues may be part of the problem for the low numbers, but I wonder how much influence vaccine naysayers may be playing a role in the small numbers. 

Dr. Marty Makary is a surgeon with a masters in public health at The Johns Hopkins University School of Medicine.  He is a prominent critic of the government’s response to the Covid epidemic and has frequently appeared on Fox News (where he faces uncritical, simpering interviewers) with messages that question many of the interventions that the government has undertaken to prevent/treat Covid.  

He published a piece in June of this year about “6 things parents need to know” regarding vaccinating children between 6 months and 5 years of age.  He feels the studies on which the CDC (Centers for Disease Control) based its recommendation to vaccinate were too small to make definitive decisions.  And that, at any rate, 75 percent of children between zero and 17 years of age already had the disease, and were therefore already immune. 

I believe many of his points are worthy of debate, but I am struck by the omission of other important considerations that should go into decision making on whether to administer a Covid vaccine to children.  One is the “Multisystem Inflammatory Syndrome” in children (MIS-C). This is a rare condition that appears to be related to Covid infection.  Its manifestations are protean and can be life threatening.  Vaccination against Covid confers a high level of protection against MIS-C.

What about the “long haul” complications of Covid infection in children?  You can find alarming studies that document symptoms like debilitating lassitude that last for over 120 days after infection, even in some children with minimal or no symptoms at the time of infection. Vaccines have only recently been approved in children, so their effect on the incidence of the long term complications is unknown.  But it is something to consider.

And even if Covid infection in children is not very dangerous, does vaccinating children help to safeguard the adult population, especially the elderly?  Probably.  Computer models have shown that vaccinating children can reduce Covid infections by 11 percent in the general population.  Even if unproven, vaccinating children to reduce the possibility of Covid infection in grandma and grandpa seems like a worthy public health measure.

Finally, vaccinating children may be worthwhile even if they have been infected with Covid.  Considerable evidence exists that “double immunity” (immunity that results from “natural” infection and  vaccine induced immunity) is superior to the immunity gained from getting the infection.

In previous posts, I have decried “misinformation by omission.”  Dr. Makary’s “six things” piece is a good example of this.  I do not believe that cherry picked opinion is helpful to parents who are faced with an understandably difficult decision about vaccinating their children.

*At the time of this writing, the first case of polio in the United States in ten years was reported.