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Interview

Top doctor says receding COVID means parents won’t rush to vaccinate their kids

As the FDA prepares to approve shots for children, pediatric diseases expert Galia Grisaru-Soen warns new variants could prove ‘more serious’ for them

Nathan Jeffay

Nathan Jeffay is The Times of Israel's health and science correspondent

A health worker prepares a COVID-19 vaccine in Jerusalem, on October 3, 2021. (Yonatan Sindel/Flash90)
A health worker prepares a COVID-19 vaccine in Jerusalem, on October 3, 2021. (Yonatan Sindel/Flash90)

With America quickly moving to vaccinate elementary school-aged children against COVID-19, Israel is expected to quickly follow suit and have kids rolling up their sleeves within weeks.

The White House announced detailed plans for the vaccination of minors on Wednesday. They are expected to kick in soon after the Food and Drug Administration signs off on Pfizer vaccines for the 5 to 11 age group, and as a Centers for Disease Control and Prevention advisory panel meets on November 2-3. The 12-plus age group is already approved for Pfizer vaccines.

Israel doesn’t always wait on the FDA. It started administering booster shots to adults before America’s far more narrow deployment began. But on the issue of vaccines for kids, officials in Jerusalem decided to only convene their own discussion after the FDA has reached its final decision.

Prof. Galia Grisaru-Soen, a top expert on pediatric infectious diseases, briefed The Times of Israel on how vaccine deployment for kids is likely to pan out in Israel, why she thinks vaccination matters even though the vast majority of children experience the coronavirus lightly, and what the main hurdle to mass vaccination is likely to be in a country that is breathing a sigh of relief as its fourth wave subsides.

“At this point, with coronavirus levels low once again, it’s going to be hard to convince parents to vaccinate their kids,” she said, adding that many parents will end up shunning shots until infection levels spike again — potentially with a more harmful variant.

Grisaru-Soen, head of pediatric infectious diseases at Tel Aviv Sourasky Medical Center, said, “Nobody knows what will happen with the next variant, and it may be more serious for children.”

An Israeli woman receives a COVID-19 vaccine at a Clalit health care maintenance organization vaccination center in Jerusalem, September 9, 2021. (Olivier Fitoussi/Flash90)

How is the move toward vaccination of kids likely to unfold in Israel?

Very soon after the Food and Drug Administration approves the vaccine for children, a specialist team in Israel’s Health Ministry will have a discussion about it. All indications are that the discussions will be very transparent, so that the public understands what has been decided and how it was decided. After this, I expect that Israel will start offering vaccines to children.

Prof. Galia Grisaru-Soen, director of the pediatric infectious diseases department at Tel Aviv Sourasky Medical Center (courtesy of Tel Aviv Sourasky Medical Center)

What data will the FDA, and subsequently Israeli authorities, be considering?

The FDA will be deliberating based on data from Pfizer’s study on kids, which was of a similar size to the study on teens, and found that the safety and efficacy of the vaccine is similar to that for older age groups. If the FDA approves the vaccine based on this study, I see no reason why Israel won’t do the same.

If kids are to be vaccinated, will they receive the same dose as adults? And how many shots will they receive initially, excluding possibly boosters down the line?

The dose for children won’t be the same as the dose for adults — it will be approximately a third of the regular dose. Children are expected to receive two shots, like adults, and it’s likely that recovered patients won’t be vaccinated until several months have passed after recovery.

What is the main obstacle to child vaccination in Israel?

The problem won’t be the Health Ministry approving the vaccine, but rather convincing parents to vaccinate young children. When we started vaccinating 12- to 15-year-olds, it was easy to convince parents because soon after this age group became eligible we were deep in the fourth COVID wave. Now that’s not the case at all. At this point, with coronavirus levels low once again, it’s going to be hard to convince parents to vaccinate their kids.

People walk past a sign instructing them to wear face masks in closed places, outside the Cinema City in Jerusalem on August 12, 2021 (Yonatan Sindel/Flash90)

What, if anything, may cause a change of heart?

We know that there can be a fifth wave, but many people will say that it’s not necessary to protect kids against it now, but rather they will vaccinate if it comes. So many are likely to await until infections rise once again.

Some parents note that it’s unlikely for kids to get seriously sick with COVID, and conclude this means the push to vaccinate kids will be purely for the good of older people, to protect them from infection that minors may spread. Are they right?

No, it’s actually both. People won’t be asked to vaccinate the child just to protect the grandma. You do it for the child themselves too. It’s true that morbidity among kids is much less than among others but still, kids do have complications. As I speak I have a child on the ward with multi-system inflammatory syndrome, MIS-C, as a result of COVID-19.

There are people who retort that vaccines can also have side effects.

The coronavirus isn’t such an innocent disease as it may seem. It’s worth mentioning that complications from the virus are much greater than complications that people are afraid of from the vaccine.

Where does the possibility of a new variant fit into this discussion? Should this encourage us to vaccinate children?

Yes. We don’t know what the next variant may look like. Delta was very contagious and many more children were infected by this variant. Nobody knows what will happen with the next variant, and it may be more serious for children.

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