Dr. Mark Sawyer is a pediatrician at the University of San Diego School of Medicine, Rady Children’s Hospital, past chapter president of the American Academy of Pediatrics, CA Chapter 3, co-director of San Diego Immunization Program, and part of the FDA Advisory Committee making recommendations to the FDA about approving the COVID-19 vaccines.
August is World Immunization Month, and with in-person learning at schools back in session, local pediatricians are concerned in the overall drop of well-child visits, the decline in routine immunizations during the pandemic, and the misinformation surrounding the COVID-19 vaccine for adolescents 12-years and older.
Sawyer said the news of the FDA’s approval of the Pfizer vaccine is welcomed news.
“For those of us who work in immunizations, it is a little anticlimactic, in that we already knew about the safety of the Pfizer COVID vaccine more than we have ever known about any vaccine ever, before we started using widely and having it FDA approved,” he said. “And the reason for that is that we have been using it under the Emergency Use Authorization since late December 2020. Literally 200 million doses have been given in the U.S.”
Sawyer said that they have a “great safety network” in monitoring doses, looking for rare side effects. He said they found that it can cause clotting disorders, myocarditis (inflammation of the heart muscle), especially in young adolescent men, and that the category of COVID vaccines can cause Guillain-Barré syndrome.
“That is all out on the table, and I do not expect that we are going to learn about other side effects because we have so much experience,” he said. “One way to try and convey the risks of those side effects is that you are somewhere between 100 and 1,000 times more likely to end up in the hospital from COVID infection than you are from a side effect from the vaccine. And I am including children in that equation. Children that do not get terribly sick with COVID. Although we know about these side effects, they are extremely rare. And we keep monitoring to ensure we do not miss any, but the better decision is strongly in favor of getting vaccinated. Otherwise, you run the risk of being hospitalized from COVID or suffering the long-term effects of COVID, which we are still trying to understand.”
Sawyer said there is still a lot of reluctance and misinformation circulating in the community about COVID and COVID vaccines. He said he believes that they are overcoming the challenges and tackling this aggressively, but that they need to get people over the misconceptions and get them immunized.
“I hope today’s news about the FDA approval will help us with that,” he said. “It has been really surprising to me with how much hesitancy there is because the data is clear about safety and effectiveness. Every day we see kids and young adults put into the hospital with COVID. It is not like that is invisible. People need to sit back and think, ‘What is my lower risk? Going around unimmunized or immunized?’ I think if they think carefully about that, to protect themselves and their family members, they are going to decide to get immunized.”
Sawyer said the most important thing that can happen to get the pandemic under control is to get a larger population immunized with a first or second dose of the vaccine.
“That is going to do more to stop this pandemic than anything, even though there has been a lot of discussion in the last month about third doses for people that have abnormal immune systems, or just in general starting to give boosters, or third doses,” he said. “This virus has turned out to be a smart tricky virus. It is changing to evade our defense mechanism, and that is why we need to get everybody immunized.”
Sawyer said all eyes are looking at what is going to happen as schools open. He said that he believes that it is important for the health and socialization of children that they get back to school.
“The schools have taken lots of measures to reduce transmission, and we can now immunize kids down to age 12,” he said. “I think within a few months we will have authorization to immunize younger children. That will help at the elementary school level. I think that it is important that we continue all those measures, including wearing masks in schools, just to decrease the spread of this virus which has become very contagious.”
Sawyer said due to the pandemic with children and parents locking down since March 2020 in response to the first surge of COVID-19, children not going to their regular physicians for their normal checkups is “the untold story.”
“We have a huge gap in the young child and adolescent populations with a huge number of children in those age groups who have never gotten their regular vaccines,” he said. “We have recovered to business as normal and most pediatricians and family medicine offices, but we have not made up that gap. I am particularly nervous with school starting in-person this fall, that we may begin to see outbreaks of other vaccine preventable diseases like measles, whooping cough, and chickenpox because of this gap.”
Parents need to be aware and double check their children’s immunization records or check in with their pediatrician to see if they need extra vaccines, he said. He said a recent change is that children can get COVID vaccines at the same time they get their other required vaccinations.
“So, if kids are behind, they can go in and get a COVID vaccine if they are eligible, and they can get caught up on their regular vaccines at the same time,” he said.
Sawyer said the AAP is a professional organization of pediatricians, and the mission is to promote the health of children in the U.S. with education for providers, the public, and advocacy where it is important.“In this case, the AAP has endorsed vaccine use as it is currently being used, endorsed kids wearing masks to go back to school,” he said. “It also agrees that going back to school is important because we are seeing a lack of learning, a lack of socialization skills, and an increase in mental health diagnosis in our school-age kids.”
