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Kids hold the key to herd immunity

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As soon as the COVID-19 vaccine for children under 16 is approved, it will be crucial for families to make sure their children roll up their sleeves and get their "Fauci ouchie" — not just for their own well-being, but for the entire community. In fact, we won’t be able to reach herd immunity until they do.

Herd immunity reflects how many individuals in a community have either had the illness (and can’t get it again; something not true with COVID-19) or have been vaccinated and are protected from getting that illness.

While we are thankful that fewer children than adults have been hospitalized or died from COVID, kids have no intrinsic protection from COVID, and thus if exposed can get infected. And if infected, they can pass it to close contacts.

Across the U.S. almost 3.5 million children have had documented COVID, with 18% of all new cases being reported occurring in children. Many of these children were sick, with some having not just typical COVID symptoms, but rather a new illness never seen before called multisystem inflammatory syndrome in children or MIS-C. This post-COVID illness is severe and often results in ICU admission and occasionally death. Adding to our concerns are some of the post-COVID symptoms such as brain fog and chronic lung conditions that we are now seeing in kids.

How can we prevent children from ever catching this virus? We could keep everyone in masks for the foreseeable future. However, that’s just not a good option. Rather, we need to think about the bigger picture, which means vaccines for all. Adults are getting vaccinated to prevent their own illnesses and perhaps cut down on passing COVID-19 to others, and we need children vaccinated for pretty much the same reasons.

Scientists estimate that we need a level of herd immunity ranging from 70% to as high as 90% of the entire population. These numbers take into account different levels of protection from vaccination — from never getting infected, to having some people get infected in their nose, to some people also being able to pass infection to a limited few close contacts.

Twenty-three percent of the U.S. population is under the age of 18. Not including them will mean that we never get to herd immunity.

Doctors today rarely see infections from the bacteria that causes meningitis and sepsis, while measles is resurging. The reason for that is we have gone below the level of herd immunity for measles.

Ignoring the need for herd immunity led directly to the measles outbreak in 2019. During that outbreak, our level of herd immunity dipped below where we needed it to be, resulting in thousands of cases of measles in our schools and communities.

Viruses don’t go away. They don’t recognize highways or bridges or towns, and return to our communities when vaccination rates dip below that critical herd immunity number.

Kids invariably tolerate vaccines better than adults do, with fewer side effects and with a better immune response. Vaccine studies in children over age 12 have been completed, and the data is being assembled to submit to the FDA. Studies evaluating children under age 12 have started.

When available, these vaccines can and should be offered to families for their kids. Then, at last, we will have a fighting chance of accomplishing our goal: protecting ourselves, our families and our communities.

Dr. Sharon Nachman is chief of Pediatric Infectious Diseases at Stony Brook Children’s Hospital.

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