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Infants and Toddlers Unfold Coronavirus in Properties Extra Simply Than Teenagers, Examine Finds

In most cases, the chain of transmission ended with the infected child, but in 27.3 percent of households, children passed the virus on to at least one other resident.

Updated

Aug 16, 2021, 11:26 p.m. ET

Young people were most likely to bring the virus into the home: children aged 14 to 17 made up 38 percent of all index cases. Children who were 3 or younger were the first to get the disease in only 12 percent of households – but they were most likely to spread the virus to others in their homes. The likelihood of household transmission was about 40 percent higher if the infected child was 3 years or younger than if they were between 14 and 17 years old.

The results could be due to behavioral differences between toddlers and teenagers, medical experts said.

“When we think about what the social behavior of teenagers outside the home is, they spend a lot of time together, are often confined, often touching or sharing a drink,” said Dr. Susan E. Coffin, an infectious disease specialist at Philadelphia Children’s Hospital who was not involved in the study.

These behaviors could lead teenagers to contract the virus and bring it home, she said.

On the other hand, while very young children are likely to have less social interactions outside of the home, they tend to be in close physical contact with others in their household and, in addition, frequently put their hands and other objects in their mouths, which contributes to the spread could be the virus. “Once they get it into the household, it can be easily spread,” said Dr. Coffin.

It’s also possible that the youngest children have higher levels of virus in them or have higher levels of virus shedding than teenagers, the researchers found. Some studies have shown that although young children rarely become seriously ill, they can carry similar or even higher levels of the virus than adults. Although viral load is not a perfect predictor of infectivity, the data suggest that children may be as contagious as adults.

But the dynamics of disease transmission are complex, and the exact role children play in spreading the virus remains uncertain.

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Tennessee transfer to halt vaccine outreach to teenagers ‘extremely disturbing’

Director of the Centers for Disease Control and Prevention (CDC) Dr. Rochelle Walensky testifies during a Senate Appropriations Subcommittee hearing to examine the FY 2022 budget request for the Centers for Disease Control and Prevention on May 19, 2021 in Washington,DC.

Jim Lo Scalzo | AFP | Getty Images

Tennessee’s decision to cease vaccine outreach to teenagers while in the midst of a pandemic is “incredibly disturbing,” the head of the Centers for Disease Control and Prevention said Thursday.

“I find this incredibly disturbing. Not only is it disturbing for Covid, but it is disturbing for all vaccine-preventable illnesses,” CDC Director Dr. Rochelle Walensky said in an interview Thursday with CBS This Morning.

The state’s department of health reportedly decided to cease adolescent vaccine outreach for all vaccines, not just for Covid, effectively ending all government communication or education initiatives to teens in the state about vaccines.

The decision made headlines when the state’s medical director for vaccine-preventable diseases and immunization programs at the Tennessee Department of Health, Dr. Michelle Fiscus, was fired after she sent a memo to physicians outlining state policy that allows minors to seek medical care without parental approval.

Department spokesman Bill Christian said in a statement to CNBC that the state hasn’t halted its immunization program for children and continues to support “those outreach efforts. Providing information and access are routine public health functions, and that has not changed.”

He didn’t specifically say whether the state’s outreach program itself was halted.

The Tennessean, a newspaper in Nashville reported on Tuesday that it had gained access to internal reports and emails that instructs Tennessee Department of Health staff to subsequently strip the agency’s logo off of any disseminated vaccine education materials.

In another email that the Tennessean claims was sent from the agency’s Chief Medical Officer, Dr. Tim Jones, he told staff they should do “no proactive outreach regarding routine vaccines.” Staff was also reportedly told not to do any pre-planning for flu shots events at schools. In the emails, Jones reportedly said that any school-related vaccine information should come from the state’s Department of Education.

The newspaper also claims that internal documents reportedly indicate that the agency was directed by Health Commissioner Dr. Lisa Piercey to halt all Covid vaccine events on school property and to no longer send postcards or other notices reminding adolescents to return for their second doses of Covid shots.

On Thursday, the agency released a statement labeling the circulating reports as misinformation. “There has been no disruption to the childhood immunization program or access to the Covid-19 vaccine while the department has evaluated annual marketing efforts intended for parents,” Piercey said in the statement.

The statement does not address reports that the agency halted vaccine outreach for adolescents.

Fiscus said she began to feel the pressure after she highlighted a public document from a state Supreme Court case ruling that allows residents above the age of 14 to seek medical treatment without the consent of a parent “unless the physician believes that the minor is not sufficiently mature to make his or her own health care decisions,” according to the ruling.

“I am not a political operative, I am a physician,” Fiscus told MSNBC. She said she was told she was “poking the bear” and that she needed to work on her political awareness after publicizing the public document. Republican lawmakers likened the state’s adolescent vaccine outreach to peer pressure, she said.

Tennessee has one of the worst Covid vaccination rates in the country, fully immunizing just 38% of its total population, according to CDC data. The state is also seeing increasing Covid cases, with the average number of daily new cases spiking from 177 to 418 in just the past two weeks.

“We now have our most hesitant population being rural male conservative whites, who really do hang their hat on this political ideology that Covid-19 isn’t real, isn’t a threat, or that getting the vaccine somehow props up the left-wing part of our political system,” she told MSNBC.

The state and others with low vaccination rates are starting to see cases climb as the delta variant takes hold in the U.S.

“This is something that we anticipated … that we would see in areas of high vaccination, low case rates, and now we see in areas of low vaccination, high case rates,” Walensky said.

Walensky said a spike in infections could come in the next few months but that if more people get vaccinated now, the nation can “prevent what could happen in the fall.”

Correction: A previous version of the headline misquoted Dr. Rochelle Walensky.

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Teenagers Are Not often Hospitalized With Covid, however Circumstances Can Be Extreme

The researchers also counted Covid-19 hospital stays in children ages 12 to 17 from March 1, 2020 to April 24, 2021. The data comes from Covid-Net, a population-based surveillance system in 14 states that covers about 10 percent of Americans.

Updated

June 5, 2021 at 4:28 p.m. ET

The number of adolescents hospitalized with Covid-19 decreased in January and February of this year, but rose again in March and April. From January 1, 2021 to March 31, 204 young people are expected to have been hospitalized mainly for Covid-19. Most children had at least one underlying medical condition, such as obesity, asthma, or a neurological disorder.

The rate could have increased this spring due to the more contagious variants of the coronavirus floating around, as well as the reopening of schools that brought children together indoors and looser adherence to precautions like wearing masks and social distancing, the researchers said .

None of the children died, but about a third were admitted to intensive care and 5 percent required invasive mechanical ventilation. About two-thirds of adolescents admitted to the hospital were Black or Hispanic American, reflecting the greater risk the virus poses to these populations.

The researchers compared the numbers for Covid-19 to hospital admissions for flu in the same age group during the 2017-18, 2018-19, and 2019-20 flu seasons. From October 1, 2020 to April 24, 2021, adolescent hospital admission rates for Covid-19 were 2.5 to three times the rate of seasonal flu in previous years.

The data adds urgency to the drive to get more teenagers vaccinated, said Dr. Walensky, who added that she was “deeply concerned” with the numbers.

The Food and Drug Administration approved the Pfizer BioNTech coronavirus vaccine for children ages 12 to 15 on May 12. The vaccine was approved for all elderly people in December.

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CDC eases summer time camp Covid steerage, says absolutely vaccinated teenagers do not want masks

kali9 | E + | Getty Images

The Centers for Disease Control and Prevention on Friday relaxed their public health guidelines for summer camps, stating that fully vaccinated teens do not need to wear face masks or stay three feet away from others.

Fully vaccinated teens should continue to wear masks when necessary, including at local businesses and in the workplace, according to the CDC. Camps can support staff or campers who continue to wear a mask even if they are vaccinated, the agency added.

While unvaccinated adolescents should continue to wear masks, the CDC said they generally do not need to wear masks outdoors unless they are in a “significant to high transmission” area, in a crowded environment, or during activities that involve continued close contact with others.

The CDC’s new guide is approaching Memorial Day holiday weekend, the start of the summer vacation and camping season for many Americans.

On Wednesday, CDC Director Dr. Rochelle Walensky advised House lawmakers that the agency is revising its public health guidelines for summer camps to include vaccinated adolescents. Walensky approved expanded use of the Pfizer-BioNTech Covid-19 vaccine in 12 to 15 year olds two weeks ago.

As of Thursday, more than 165 million Americans 12 and older had received at least one dose of a Covid vaccine, according to the CDC. According to the CDC, more than 132 million Americans 12 and older are fully vaccinated.

Previous CDC guidelines recommended that all children wear masks, regardless of vaccination, with some exceptions for certain activities such as eating, drinking, or swimming. It has been criticized by some public health experts and parents who say the risk of spreading Covid outdoors is low and children are less likely to develop serious illnesses.

“My whole goal is to make sure the camps stay open and there are no outbreaks,” Walensky said during the hearing. She added that her own children didn’t go to camp last summer. “I want the camps to be open this summer.”

The guidance also comes two weeks after the CDC said fully vaccinated people no longer need to wear a face mask or stay 6 feet away in most environments, whether outdoors or indoors. People who were not vaccinated should continue to wear masks, the agency said, as they continue to be at risk of mild or serious illness, death, and the risk of the disease spreading to others.

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World News

Moderna says shot is 100% efficient in teenagers, plans to hunt FDA OK in June

A young man receives his Covid-19 vaccination in a vaccination clinic. People are receiving the Moderna vaccine in Milford, Pennsylvania.

Preston Ehrler | LightRocket | Getty Images

Moderna said Tuesday that its Covid-19 vaccine was 100% effective in a study in adolescents ages 12 to 17. This makes it the second attempt after Pfizer that has demonstrated a high level of effectiveness in younger age groups.

The company plans to ask the Food and Drug Administration to expand emergency use of its Covid-19 vaccine to teenagers early next month. If approved, it would likely dramatically increase the number of recordings available to middle and high school students before the next school year. Pfizer and German partner BioNTech were approved to use their vaccine for 12 to 15 year olds earlier this month.

“We are encouraged that mRNA-1273 is highly effective in preventing COVID-19 in adolescents,” said Stephane Bancel, CEO of Moderna, in a press release. “We continue to strive to do our part to end the COVID-19 pandemic.”

The two-dose vaccine, given four weeks apart, is already approved for adults.

The phase 2/3 study the company cited on Tuesday included more than 3,700 teenagers. No cases of Covid-19 were observed in participants who received two doses of the vaccine, while four cases were observed in the placebo group, according to the company.

No significant safety concerns have been identified to date, with side effects generally in line with a previous study in adults, the company said. The most common side effects after the second dose were headache, fatigue, muscle pain, and chills, Moderna said.

The new data comes less than three weeks after the company announced in an earnings report that early data showed the shot was 96% effective against Covid in teens ages 12-17. These data were based on those who had received at least one dose of the vaccine.

The company said Tuesday that the shot in the study was 93% effective after one dose. For this it used the definition of Covid-19 from the Centers for Disease Control and Prevention, which only requires one symptom and a positive Covid test.

US regulators are expected to approve Moderna’s application for teenage use. The approval process could take about a month, in time for some summer activities and fall Classes if Moderna submits the data by the beginning of June. Pfizer and BioNTech, for example, filed for expanded use of their shot in teenagers on April 9th ​​and were approved by the FDA on May 10th.

Vaccinating children is seen as critical to ending the pandemic. The nation is unlikely to achieve herd immunity – if enough people in a given community have antibodies to a given disease – until children can be vaccinated, health officials and experts say.

According to the government, children make up around 20% of the total US population. According to medical experts, between 70% and 85% of the US population must be vaccinated against Covid to achieve herd immunity, and some adults may refuse to get the shots. Although now more experts say herd immunity becomes less likely as variants spread.

According to health experts, vaccinating children can also accelerate the return of personal learning and enable after-school activities such as sports, arts, and other personal activities after school.

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To Vaccinate Youthful Teenagers, States and Cities Look to Colleges, Camps, Even Seashores

Not all teenagers crave the vaccine. Many hate taking pictures. Others say because young people often get milder cases of Covid, why should they risk a new vaccine?

Patsy Stinchfield, a nurse who oversees vaccination for children in Minnesota, has strong evidence that some cases can be serious in young people. Lately, not only have more children with Covid been hospitalized, but also Covid patients aged 13, 15, 16 and 17 years in the intensive care unit.

The new FDA approval means all of these patients would be eligible for admissions, she noted. “If you can keep your child from going to intensive care with a safe vaccine, why wouldn’t you?” She said.

Mr. Quesnel, the superintendent of East Hartford, Connecticut, said the strongest message of reaching older teenagers would likely appeal to younger ones too. Instead of focusing on the fact that the shot will protect them, they are taking up the idea that this will avoid having to quarantine them if exposed.

“They are not so afraid of the health threats from Covid as they are of the social losses it brings,” he said, adding that 60 percent of his district’s seniors or about 300 college students received their first dose at a mass vaccination website published on April 26th operated by the Community Health Center. “Some of our biggest levers right now are this social component – ‘You will not be quarantined. ‘“

Michael Jackson of North Port, Florida can’t wait for his 14-year-old son Devin to receive the vaccine. Last year, he said, his son’s popular Little League games were suspended and the family had to skip regular Sunday meals with their grandparents. Devin, an eighth grader, had to be quarantined three times after being exposed to Covid.

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With Covid Vaccines for Teenagers and Youngsters, Timing Issues

“In the end, this will be very good for vaccines as so much emphasis has been placed on the process, safety and verification,” said Dr. Campbell.

“I don’t think people in the past have realized how closely they look at the response to a vaccine,” said Dr. Campbell, or how much attention is paid to the timing, dose, and immune response of a new vaccine, is tested.

When it comes to the Covid vaccines, Dr. Maldonado: “We are not unduly concerned about anything about this vaccine, we are just following normal processes.”

Still, it’s possible that younger children, who usually have more robust immune systems than adults, may be more responsive to the Covid vaccines. For this reason, vaccine studies in children carefully examine dosage and immunological reactivity. Dr. Beers said, “They often start with a smaller group, give a lower vaccine dose, test the response, and work their way up to the dose necessary for an appropriate dose of immunity.”

Dr. Campbell and his colleagues in Maryland are just starting their first study of Covid vaccines in children under the age of 12. And no one should try to convince parents that the vaccines are safe and effective in this age group until the data are available: “I have no reason to believe that they are not safe and effective, but the evidence is in Pudding – I want to see the pudding. “

It makes sense to convince children of their regular vaccinations as it will protect them well if other diseases flare up after the pandemic lowered the rate of usual childhood vaccinations. Doctors are concerned about a whole list of vaccine-preventable diseases, including measles, whooping cough, meningitis, HPV, and flu.

Do Covid vaccines eventually fit into the routine vaccination schedule for children, and if so, at what age? Since the new vaccines are still in an emergency approval phase: “Nobody has answers; We have to see the passage of time, ”said Dr. Maldonado.

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For Some Teenagers, It’s Been a Yr of Nervousness and Journeys to the E.R.

In a recent report, a CDC-led research team found that fewer than half of emergency rooms in US hospitals had clear guidelines for dealing with children with behavioral problems. In order to get to the bottom of a complex behavior problem, it can take at least days before patients are observed, say psychiatrists. And many emergency rooms don’t have specialists, dedicated space, or outside resources to do the job well.

For Jean, her son’s diagnosis was complicated. He has since developed irritable bowel syndrome. “He lost weight and started smoking pot because of the boredom,” said Jean. “It’s all due to fear.”

The Columbus, Ohio National Children’s Hospital has an emergency room the size of a children’s hospital with a capacity for 62 children or adolescents. But long before the coronavirus arrived, the department was trying to treat more and more patients with behavioral problems.

“This was a big problem before the pandemic,” said Dr. David Axelson, chief of psychiatry and behavioral health at the hospital. “We saw an increase in visits to the emergency room for mental health problems in children, particularly thoughts of suicide and self-harm. Our emergency room was overwhelmed by this, and children had to get into the medical department while they waited for psychiatric beds. “

In March last year, Nationwide Children’s opened a new pavilion, a nine-story facility with 54 dedicated observation and extended stay beds for people with intellectual disabilities. It has taken the strain off the hospital’s regular emergency department and significantly improved care, said Dr. Axelson.

In this pandemic year, when the number of patients with mental health problems has increased by around 15 percent compared to previous years, it is difficult to imagine what it would have been like without the additional, dedicated behavioral clinic, said Dr. Axelson.

Other hospitals out of state often call in hopes of getting a patient into crisis, but there just isn’t enough room. “We have to say no,” said Dr. Axelson.

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Some Teenagers Volunteer for Covid Vaccine Trials to Get Their Lives Again

“And I also thought it was important that people of different ages and races be represented,” added Audrey, who, like her brother, is Asian. (Her mother Rachel, a nurse researcher who volunteered to try a vaccination, asked that their last names be withheld for privacy reasons.)

Overall, the teenage studies may be less different because the adult study results showed no discernible difference in results by race. And because the adult studies have been so successful, up to two-thirds of teenagers may be offered the actual vaccine instead of a placebo.

Pfizer, whose study is fully enrolled, expects results from its studies for children ages 12-15 years old in the first quarter of this year to be submitted to the Food and Drug Administration for review. Moderna is still recruiting teenagers for its studies. The data is expected to be available this summer. Other companies expect to begin studies for teenagers soon. Shortly thereafter, researchers will open studies for children ages 5 and up, most likely at more modest doses.

As in any medical study, investigators are indifferent to discussing risks and benefits. Instead of teaching young subjects, Dr. Campbell, whose clinic will be conducting a Moderna study for younger children, puts her in conversation.

“Do you remember your tetanus shot? Tell me about it, ”he might say. And then: “So it’s similar and how is it different.” He wants to make sure that the teen is actively involved in the decision-making process. “We always say, ‘Don’t do this for your parents. ‘”

Dr. Sarah Hasan, senior recruiter for DM Clinical Research who oversees the Houston Fights Covid campaign and most of the city’s vaccine studies, said the educational sessions for teenagers and adults are quite different. She has more fun with the teenagers.

“Usually adults scan the form, ask a few questions, and they’re done,” she said. “But kids ask a lot more questions than adults and actually listen, which is pretty nice.”

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5 Methods Teenagers Can Get Extra Fruits and Greens Into Their Diets

Buying organic foods, which tend to cost more than traditional foods, is not strictly necessary, he added.

In 2012, the AAP published a clinical report that found that diets high in organic, dairy and meat products could reduce exposure to pesticides and potentially drug-resistant bacteria. However, there is no evidence that organic foods offer more nutritional benefits than conventional foods.

“What is most important is that children eat healthily, rich in fruits, vegetables, whole grains and low-fat or fat-free dairy products, whether they are conventional or organic,” one of the report’s lead authors said in a press release at the time.

You can also save money by buying fruits and vegetables in bulk. For example, a 3-pound bag of organic gala apples at Whole Foods in Brooklyn costs $ 4.99. If you were to buy the same amount of apples individually it would cost about $ 7.50.

Vanessa Rissetto, a registered nutritionist and acting director of the Diet Internship program at New York University, also suggested other money-saving tips: Sharing a community-supported farm membership with another family can be cheaper than owning one to buy. Or you can buy fruits and vegetables from companies that offer “ugly” organic products at high discounts.

Even if your child is not attending school in person, check to see if school lunches are still available that must include fruits and vegetables, said Diane Harris, a senior health scientist at the CDC and one of the study’s authors.

Keeping plenty of easily accessible fruit and vegetable options in your home can increase the chances of your teen choosing nutritious foods to nibble on, the experts say.

“Teens tend to be hungry and often search for food in the kitchen and pantry,” said Dr. Natalie D. Muth, a pediatrician and nutritionist in Carlsbad, California, snacking on them. This works especially when there aren’t many other processed snacks readily available. “