Protecting your family this summer and beyond

Answering your COVID questions

BY KRYSTEN GODFREY MADDOCKS

With COVID-19 vaccines on the horizon, parents are hopeful that their children will be able to enjoy sports, camping and fun-filled days at the beach. While inoculations will provide some protection, doctors urge families to remain vigilant in their health and safety practices throughout the summer. Because vaccines have yet to be approved for use in children and teens, for the next several months everyone will still need to follow state guidance and the CDC protocols related to mask wearing, social distancing and hand-washing. We talked to three New Hampshire pediatricians to help you better understand how the vaccine will help reduce risk, what to do while you wait for your shots and how to safely get back to the activities you enjoy.

Vaccines have not yet been authorized for children. Will my children be safe this summer in the absence of a vaccine? Is it worth getting them vaccinated when it becomes available?

Many parents are concerned that because their children will not be eligible for vaccines, their kids could be left unprotected at school or summer camp. The good news is that as more adults get vaccinated, the overall community rates of infection will decrease, according to Dr. Susanne Tanski, MD, a pediatrician and section chief of general pediatrics at Children’s Hospital at Dartmouth-Hitchcock (CHaD).

Although clinical trials for teens are now in progress, it will be a few months before scientists know how well these vaccines work in younger adolescents. And it may be even longer before we know how effective they are for kids under 12, Tanski said.

“If the vaccine shows safety and efficacy as expected, I would absolutely encourage parents to get their teens vaccinated,” she said. “While we have seen that our young people overall have had relatively mild illnesses as compared to older adults, some kids indeed have had severe disease and some have died. We also know that a small number of kids and young adults have had a delayed illness that has been linked to COVID infection that is a multisystem inflammatory syndrome. To me, it would be absolutely worth preventing the infection and risk in the first place with a successful vaccine.”

Dr. Pamela Beahm, MD, a pediatrician at St. Joseph Hospital Pediatrics in Nashua, agrees that there are risks to not vaccinating your older child or teen.

“The risk of not vaccinating is that your children will be more susceptible to catching COVID-19 when they come into contact with it,” she said. “COVID is continuing to circulate in the community. The more people who are vaccinated, the more we can get that under control. Although we know kids don’t get the disease as severely as adults, there are kids who get a severe case of the disease — and there’s no predicting who that might be.”

Dr. Kristen Johnson, MD, a pediatrician with Core Physicians in Exeter, said that although the long-term side effects of the coronavirus vaccines are not yet known, neither are the long-term effects of contracting the coronavirus.

“The risks of not vaccinating your teenager would be complications of the illness for themselves as well as for friends, family and the community,” she said.

I am a low-risk adult with lowrisk children. Should I still get vaccinated for COVID-19?

Everyone lands somewhere on the spectrum of risk when it comes to how they’ll react to the coronavirus, and that can be hard to determine. For example, someone who has significant lung disease, cardiovascular disease and diabetes is at high risk for severe infection, hospitalization and death; however, someone who works with the public and interacts with many people is potentially at a higher risk of infection overall due to repeated exposure, Tanski said.

“We know infection alone, even with mild disease, carries potential long-term effects,” she said. “You may know someone who had very minimal symptoms, but weeks and weeks later still cannot smell or taste. Or you may know people who have persistent fatigue, even after a mild illness. All of this is to say that it is worth all of the things we are doing to prevent infection — masking, physical distancing and hand-washing — and vaccination when available.”

In addition, many cases of COVID-19 are spread through close household contact, and the more immune you are, the less likely you are to transmit the disease to someone in your household, Beahm said.

“(By getting vaccinated) you can help protect elderly grandparents and older people and others who might be higher risk,” she said. “At this point, we can’t protect children, so protecting the adults in your household is important.”

Johnson recommends that lower-risk parents absolutely get vaccinated when it’s their turn. Not only will they protect the greater community, but they will also reduce time they or their families would potentially have to spend in quarantine.

“One significant challenge for many families has been quarantining after exposure to a positive patient,” she said. “This requires a 10-day quarantine even if you have no symptoms. The new guidelines will recommend that no quarantine will be needed for an exposure if you have no symptoms and more than two weeks have passed since you received two doses of vaccine. This will allow more people to stay in work or school and make things less challenging in the setting of quarantine/isolation guidelines.”

The COVID-19 vaccine was developed and approved very quickly. Should I be worried?

Vaccines are heavily studied and safe tools that protect us as individuals and communities against infectious diseases, Tanski said. Parents should not be any more concerned about one of their children or family members receiving this vaccine as they would any other. “We have been so fortunate that science was ready to respond to SARS-CoV-2, the virus that causes COVID-19, allowing us to fight this pandemic as quickly as this. Every step of the vaccine development pathway has been followed, and the safety follow-up for COVID-19 vaccines is essentially the same as it has been for all other vaccine trials,” she said. “What’s different with COVID vaccine is that we have not yet completed the usual two-year follow-up period; however, no other vaccines that have been licensed in the United States have been found to have unexpected long-term safety problems. This is very reassuring to me as a physician, mom and recipient of the vaccine myself!”

Should it be safe for kids to return to sports this spring?

This fall and winter, many youth sports across the state were canceled, restricted to specific geographic areas or were off-limits to fans. The Governor’s Reopening Task Force this winter recently updated its Safer at Home Amateur and Youth Sport guidelines, which call for ample safety precautions including masking and social distancing. Pediatricians agree this is likely to stay in place for spring and summer sports.

“Today, our rates of community infection remain higher than they were when some of our kids were playing sports in the fall,” Tanski said. “We also know that some sports activities have been drivers of infection spread, leading to a lot of kids and families being affected.”

One positive aspect: Spring and summer sports move kids outdoors, away from crowded gyms and rinks. Open fields mean better ventilation and the ability for coaches, players and fans to keep their distance.

Keeping kids active is important to supporting their overall health and development, Beahm said, and parents should encourage sports so long as their kids are able to participate in them safely. Certain sports, particularly those where players are in close contact and are apt to breathing heavily, pose a higher risk. Wearing masks and avoiding close contact can help mitigate that risk, she said.

Will masks and social distancing be required throughout the spring and summer, even after adults have been vaccinated?

socializing with friends, they should stand ready to mask up and keep their distance for the longer haul. While many may be tired of adhering to this routine, they should not back off yet, Tanski said.

“Our rates of community infection are still much higher than they were last spring at the start of the pandemic. We saw how quickly infections can increase, especially after our Thanksgiving and winter holidays,” she said. “Now that infection rates are starting to come down, we need to stay on top of our actions and encourage our kids to keep up their good work.”

Beahm agrees that even if most of your family has received a vaccine, vaccines are never 100% effective.

“If someone who is vaccinated gets exposed, it prevents them from getting severe disease and helps decrease transmissions,” she said. “But you can still shed it and carry it in small amounts and to a lesser degree. You decrease the chance of getting a severe form of the disease and reduce your risk of transmission, but it’s still not zero.”

Another reason why masking and social distancing will continue to be important is that COVID-19 has mutated into new strains, Johnson said. For example, New Hampshire saw its first case of the U.K. variant in mid-February.

“This may continue based on emerging strains and changes that are happening within the virus itself, as well as the challenges facing our public health community in terms of consistent messaging across the state or country,” she said. “While vaccines are incredibly effective, 95% protected means 5% not protected, and until we have a very high percentage of people who are protected, you will want to maintain personal safety by wearing masks and socially distancing.”

What other tips do you have for keeping safe?

• Even if you start visiting family members who’ve been vaccinated, keep wearing a mask and keeping your social distance.

• While vacation destinations may be open for business, some choices are safer than others. Renting a home with your family where you can socially distance might be a safer choice than going to an amusement park where there are lots of people. However, if you do opt for a crowded vacation destination, it’s important to wear a good mask, wash that mask often and understand that you are putting yourself in a higher-risk situation, Beahm said.

• Keep practicing good hand hygiene throughout the summer months. Maintaining the integrity of your skin and mucous membranes are important components in keeping yourself protected from infectious diseases, Johnson said. This means keeping your skin hydrated and preventing it from cracking and drying. You should also maintain good humidity in your home and keep your nasal passages moist, she said.

• COVID-19 recommendations are continually evolving. Be mindful of new guidelines that come from your child’s physician, school nurse, town health officers, the state of New Hampshire and the CDC. ✪

Krysten Godfrey Maddocks is a former journalist and marketing director who now regularly writes for higher education and technology organizations in New Hampshire and Massachusetts.