Israel Set to Vaccinate Kids. These COVID Figures Could Help Parents Decide

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Children are tested for the coronavirus at a testing center in Jerusalem, August.
Children are tested for the coronavirus at a testing center in Jerusalem, August.Credit: Ohad Zwigenberg

Some 224,000 children in Israel ages 5 to 11 have tested positive for the coronavirus between March 2020, when the pandemic began in the country, and October 2021, according to the Health Ministry says.

There are about 1.2 million children in this age group living in Israel.

Nearly half of these infections were detected since June, as the delta variant spread in Israel. Only about 71,000 of the 224,000 children known to have contracted the virus had symptoms of COVID-19, compared to 152,000 without symptoms.

During this period, 515 children – 0.25 percent of the total – who tested positive for the coronavirus were hospitalized, though some of them for unrelated medical reasons. Of the 515 children aged 5-11 who were hospitalized, 42 were severely or critically ill with COVID-19 and four died. All the children in this group who died had other health problems.

The data was released shortly before a vaccination drive for children 5 to 11 was set to begin on Tuesday after the relevant Israeli authorities approved the move. Many parents are still undecided as to whether to vaccinate their children, and if so, whether to do so immediately or wait until more information than that provided by a Pfizer study on possible side effects is available.

Nearly all medical experts believe the benefits of the vaccine outweigh any risks, and argue that any side effects are usually minor and temporary, weighed against the rare but real risk of severe COVID-19 illness.

Experts say that while preventing infection in children is the main reason to vaccinate them, there is also the public-health benefit: Raising the overall vaccination rate in Israel can help stop the spread of the virus, especially to older adults, who are more vulnerable to illness and death from COVID-19.

That, in turn, lessens the burden on the health care system. Health Minister Nitzan Horowitz and ministry officials have clearly stated that the decision whether to vaccinate children belongs to parents alone, and the ministry will not pressure parents who decide against it.

Haaretz has gathered relevant information for this age group, so that parents are better informed as they make their decisions.

From March to December 2020, the rate of confirmed coronavirus infections in the 5-11 age group was 0.01-0.97 percent. In September 2020, at the height of the second wave of infections in Israel, some 12,000 children in this age group were infected, as opposed to 5,000 in the previous months.

However, beginning in January 2021, with the spread of the delta variant at the same time as the vaccination drive went into high gear, the percentage of children testing positive increased. In January, the number of infected children ages 5-11 jumped to 29,692, with a positivity rate in this age group of 2.44 percent of all tests that month.

Among the confirmed cases in this age group that month, only about one third were symptomatic, and 39 required hospitalization, while in the entire 10 months prior to January (March–December) the number of confirmed cases in the 5-11 age group was about 40,000 (about 4,000 a month).

From February to June 2021, the effect of the vaccinations kicked in and infections declined in Israel, which directly impacted the rate of infection among children. Thus, in February, 18,000 children aged 5-11 tested positive, versus 11,000 for March. The effect persisted for a few more months, until in June only 409 children in this age group tested positive for the virus.

Half of new infections were in fourth wave

July marked the beginning of a fourth wave of COVID-19 in Israel. This was soon attributed to a significant decline in the efficacy of the vaccine a few months after the second dose. In response, Israel launched a booster shot campaign in August. It emerged that the vaccine works well against the delta variant, but that the delta variant is highly contagious among the unvaccinated.

And so, since July, unvaccinated people – including children ages 5-11, who were ineligible for the vaccine at the time – have accounted for a significant share of new infections. In July, 6,774 children ages 5-11 tested positive for the virus. Nearly half of them, 2,984, had no symptoms of COVID-19, and 12 were hospitalized with the disease. In June fewer than 10 children in this age group tested positive.

In August, 40,473 children in this age group tested positive for the virus. Of them, 32,000 had no COVID-19 symptoms. The positivity rate – that is, the number of tested persons who were found to be infected with the virus – was 3.32 percent, up from only 0.56 percent in July. In August, 78 children in this age group were hospitalized with COVID-19.

Coronavirus infections among this age group peaked in September, when the new school year began and many Israeli Jews were in close quarters at home or in synagogue for the High Holy Days. In September, about 100,000 children ages 0-15 tested positive for the coronavirus, including 59,000 aged 5-11.

Children in that age group accounted for the highest percentage of positive coronavirus tests since the beginning of the pandemic – 4.85 percent – and 117 children were hospitalized with COVID-19.

In October, with the general decline in infections, a decline was also seen among children up to 15 – to about 23,000, among them 15,319 children ages 5-11. The number of hospitalized children in this age group was 32.

Many parents, including many who are vaccinated themselves, say they are struggling to decide whether to vaccinate their young children right away. “The risk to children in this age group is so low, and the information on side effects from the vaccine is meager. I can’t decide,” one parent told Haaretz. “To vaccinate the children to protect older adults, or people who can’t be or choose not to be vaccinated – that’s not a good enough reason,” another said.

Risk of severe illness or death

While the statistical risk of severe illness or death from COVID-19 to children in this age group is much lower than from other known risks, that’s not necessarily the right way to decide on vaccination. Any needless death should be avoided.

From 2010-19, a total of 965 children ages 5-11 died in Israel. The leading causes of death were cancer (226, or 23 percent), accidents (188, or 19 percent), nervous system diseases (116, or 12 percent) and birth defects (86, or 9 percent). No cause of death was given for 74 of the children (8 percent).

The risk of long-term illness for children who have had COVID-19 is low and may not be persuasive to reluctant parents. According to a Health Ministry survey of parents of about 13,000 children who have recovered from the coronavirus, 1.8 percent of children ages 3-6 and 2.2 percent of children ages 6-12 had “long COVID” in some form.

Some of these children had relatively mild symptoms that eventually resolved, while others had severe, persistent symptoms such as respiratory difficulties, significant weakness, loss of sense of taste and smell and neurological symptoms such as inability to concentrate and to sleep. However, pediatricians and infectious disease experts believe that these symptoms are under-diagnosed.

A rare and sometimes fatal inflammatory condition in children linked with the coronavirus is rare. It has been diagnosed in only 172 children, have of them in the 5–11 age group. That reflects a frequency of one in 3,000 children in this age group with COVID-19. In Israel, a 16-year-old with no known health problems died of this syndrome.

Fear of the future

Experts say the data supports vaccinating young children. Of course there is no certainty about the future, whether in regard to the potential long-term effects of a relatively new vaccine or in regard to anything else. Most medical professionals say, however, that based on the millions of people who have already been vaccinated and on everything that we know about the human immune system, significant side effects tend to appear days after the shot, not weeks afterward.

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