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Coronavirus Files: FDA authorizes vaccines for younger children

Coronavirus Files: FDA authorizes vaccines for younger children

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Since April 2020, the Center for Health Journalism has been publishing a special newsletter geared to journalists as they report on one of the biggest and most complex stories of our times. Each Monday, while the pandemic runs its course, The Coronavirus Files will provide tips and resources and highlight exemplary work to help you with your coverage. This week, The Center for Health Journalism’s Coronavirus Files Monday newsletter is curated and reported by science writer Amber Dance, PhD. Have a suggestion or a request? Write us at editor@centerforhealthjournalism.org.

CDC study: Greatest hospitalization, death among American Indians/Alaska Natives

It’s been apparent since the pandemic’s early days that Black and Hispanic people are more likely to be hospitalized with COVID-19, but long-term data on other racial and ethnic groups has been lacking.
 
A new study by CDC researchers, drawing on data from hospitals 99 counties in 14 states during the pandemic’s first year, finds that American Indian and Alaska Natives had the highest rate of hospitalization, admission to the ICU, or dying in hospital. This population had more than seven times the risk of death of white people, according to the study in JAMA Network Open. The authors point to a variety of causes, including high rates of diabetes and structural racism. The researchers also found slightly higher rates of hospitalization, ICU admission and death among the Asian and Pacific Islander group, which were lumped together in one category; they suggest the rates might have been even higher for Pacific Islanders if they were considered alone. The authors also note that some COVID-19 patients might not have had an official COVID-19 test, so their numbers are likely underestimates.
 
State reporting of vaccination data by race and ethnicity has also been subpar, note Stanford University researchers in a letter in the same journal. The researchers were only able to assess white, Black, Hispanic and Asian groups in the state data they looked at, which confirmed lower vaccine uptake among Black and Hispanic people during the first few months of the rollout. They write that the study “demonstrated the need for equity-focused policies to ensure that underserved communities are not left behind.”
 
Vaccines for ages 5 to 11 just around the corner
 
The FDA on Friday granted emergency authorization to Pfizer’s low-dose COVID vaccine for children as young as 5. Agency scientists decided the potential benefits of vaccination “would clearly outweigh” any risk for myocarditis as a side effect.
 
Among the caveats: They noted that if case rates drop significantly, vaccination might cause more hospitalizations for myocarditis than they prevent for COVID-19, but that the myocarditis cases are generally milder than the viral infections requiring hospitalization.
 
A committee of outside advisors considered their decision carefully before endorsing the authorization, weighing whether all children need vaccination and worrying that authorization could lead to mandates. The latter is unlikely unless the vaccine achieves full approval, noted Dr. Paul Marks, FDA’s director of the Center for Biologics Evaluation and Research.
 
CDC’s Dr. Amanda Cohn reminded the committee that more than 700 children have died of COVID-19; the virus is now the ninth leading cause of death in kids aged 5 through 11. The scientists also weighed CDC data estimating that more than 40% of children in this age group had already contracted the infection by June — before delta increased infections among kids — though it was noted that number might not hold true across the entire pediatric population. “That figure was much higher than anyone expected,” notes Apoorva Mandavilli in The New York Times, and several experts told her it might be too high. Data from the American Academy of Pediatrics yields a rate closer to 9% for all the nation’s 73 million children.
 
Committee member Patrick S. Moore, a microbiologist at the University of Pittsburgh, called the vote “a hard decision but a clear one.” It’s also expected that vaccinating children will reduce transmission of the virus among all age groups. Katherine J. Wu at The Atlantic deems pediatric vaccination “one of the few big levers the government has left to pull in the fight against the coronavirus.” However, the vaccines don’t fully eliminate transmission: A recent U.K. study found that vaccinated people with breakthrough infections were still able to share the virus with others in the same household.
 
A CDC committee will consider the vaccine on Tuesday (follow along here), meaning shots could become available this week. The latest poll from the Kaiser Family Foundation indicates about one-quarter of parents will rush to get it, while others will wait or never seek it. For children younger than 5, Pfizer may have results by the end of the year.
 
Meanwhile, Moderna reported last week that its pediatric vaccine, at half the dose used in adults, provided a strong immune response in kids as young as 6, with tolerable side effects such as fatigue and fever. The company plans to submit its own data to FDA soon.
 
The CDC also updated its guidelines for immunocompromised people, suggesting they get an additional, fourth shot, six months after their third. Finally, CDC added mood disorders, such as depression and schizophrenia, to its list of factors that put people at risk for severe COVID, making those people eligible for boosters.
 
Antidepressant might dampen COVID, large study reports
 
It might be possible to stifle a case of COVID with a prescription that costs $10 or less. In a Lancet Global Health study of nearly 1,500 people in Brazil, a 10-day course of the drug fluvoxamine (Luvox) reduced the need for hospitalization. The medication has been used for decades to treat obsessive-compulsive disorder, but it also happens to minimize inflammation, which can be deadly in severe COVID-19. There are still questions about the best dosage, and whether the medication would make a difference for vaccinated individuals with breakthrough infections. Nonetheless, scientists anticipate changes to the National Institutes of Health’s COVID treatment guidelines in response to the findings, writes Benjamin Mueller at The New York Times. Physicians can already prescribe fluvoxamine off-label. Child psychologist Angela Reiersen of Washington University, who first considered fluvoxamine for COVID, told Esther Landhuis at Science News, “We believe it should be used in COVID-19 for patients at high risk.”
 
Survey shows how pandemic changed science journalism
 
“COVID-19 has thrown science and science journalism into the spotlight like never before,” writes Ruth Douglas at the independent news source SciDevNet, which focuses on science and tech for global development. Science reporters are dealing with an “intense” workload, according to the organization's new survey of 633 writers. The pandemic has led more than half of reporters to cover preprint research, posted online before review by peers. Fortunately, sources can help put these and other findings in context: “Many journalists said scientists had been more easily available during the COVID-19 pandemic and more open and talkative than previously,” writes Douglas. (See “Events & Resources” below for tips on finding sources and covering preprints.)
 
U.K. cases rising with 'delta plus': Is U.S. next?
 
The United Kingdom, where COVID patterns sometimes anticipate U.S. waves, is battling a new surge in cases. It may be due to early lifting of social restrictions in July or waning immunity from vaccines, writes Paola Rosa-Aquino for New York Magazine’s Intelligencer. But another potential culprit is the viral variant known as AY.4.2, or delta plus, which now makes up about 10% of cases in England. (Since the World Health Organization has not yet deemed it a “variant of concern” or “variant of interest,” it doesn’t have its own Greek letter.) While little is known about the variant so far, the CDC has included it as a variant of concern” alongside the parent delta strain, and it may be 10% to 15% more transmissible than its already highly contagious forebear. Delta plus currently makes up fewer than 1% of U.S. cases. “At this point, it’s too early to say what impact, if any, AY.4.2 will have in the United States,” writes Andrew Joseph at STAT.
 
While U.S. cases are declining and some experts suggest the worst is over, a fifth wave in future months is a real possibility, agree NIH’s Dr. Anthony Fauci and University of Minnesota epidemiologist Michael Osterholm. The reason: “Just remember that 65 million Americans who could be vaccinated right now are not,” Osterholm told Minnesota Public Radio Cathy Wurzer’s on Minnesota Now. “That is more than enough wood for this coronavirus forest fire to burn.”
 
From the Center for Health Journalism
 
11/3 Webinar: Reporting on extreme heat
Join us as we glean lessons and insights from a yearlong Los Angeles Times investigation into extreme heat. Sign-up here!
 
APPLY NOW: 2021 Impact Funds
The USC Center for Health Journalism's Impact Funds provide reporting support — funding and mentoring — to journalists who think big and want to make a difference. The National Impact Fund supports reporting on health equity and health systems across the country. The California Impact Fund supports reporting that brings untold stories to light in the Golden State.
 
What we're reading
  • “Americans abroad search for a first vaccine dose as millions at home get their third one,” by Dan Diamond, The Washington Post
  • “Thousands of workers are opting to get fired, rather than take the vaccine,” by Andrea Hsu, Morning Edition, NPR
  • “How public health took part in its own downfall,” by Ed Yong, The Atlantic
  • “Book excerpt: Sounding the first alarm on COVID-19,” by Gregory Zuckerman, Undark
  • “How the pandemic severed one of Southern Africa’s main economic lifelines,” by Marko Phiri, BuzzFeed News
  • “Africa tries to end vaccine inequity by replicating its own,” by Lori Hinnant, Maria Cheng and Andrew Meldrum,

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