Opinion of an immunologist about COVID-19 in children.

He believes that children must be vaccinated before attending school in person.

While that is his opinion as an immunologist, there are several pitfalls here.

I had done a detailed thread earlier. Will link it below.👇
Whether Children should be vaccinated before attending school is a topic where not everyone agrees upon.

In other words this is not a binary topic; which means that a “yes or no” answer is not relevant.

That is why the opinion of doctors who take care of patients matter.

2/
Experience in my part of India on the ground has overwhelmingly stated the following facts.

1. Regardless of what immunology says, the chance that a child will fall sick from COVID-19 is so rare - it is much rarer than chance of death from many routine things in life.

3/
In Kerala the chance of surviving Covid 19 in children = 99.992%, which basically is as close to certainty as it could possibly get.

The few children who not do well, are those with comorbidities who can easily be identified and special strategies planned for.

4/
Immunology notwithstanding, long Covid is ~absent in Kerala. When I say absent, 22 out of 25 paediatricians who each see thousands of patients have all said they’ve not seen a case. The opinion of a paediatrician is the most important in this matter.

5/
Out of the 25 pediatricians, only one doctor saw a slight uptick in long Covid like symptoms in his practice.

Another doctor saw just one case of pre-existing IBS possibly aggravated by Covid 19.

6/
This is the reason why it is important to observe and also LISTEN to people rather than just look at publications.

The reason is, publications contain filtered information. This is not to discount the value of publications; but they only form a fraction of knowledge.

7/
For instance the immunologist says that “Reinfection could be more severe”.

Nothing could be further from the truth.

The severity of reinfections are either asymptomatic or mildly symptomatic at worst. This again is the problem of relying on single case reports.

8/
The case report quoted here was that of a 66-year-old woman with multiple comorbidities in whom the first infection was suspect to start with -basically an asymptomatic case with an extremely low viral load.

9/
Vaccination among children is not without risks. No matter how much denial is done by the so-called experts, vaccines are not 100% benign products.

The equation of giving such a product to a person who is older is not the same as giving to someone with very very low risk.

10/
Instead, it is important to add as many layers of protection as possible for children, which also includes vaccination for those with selected comorbidities.

Schools need to open in a phased manner.

Because the risk of keeping them closed is higher than opening them.

11/
I will link a detailed thread below, but will add that vaccinating children is unlikely to stop spread of infection. In a classroom, there will be breakthrough infections - as was evidenced by the Texas prison outbreak secondary attack rate of 70% among fully the vaccinated.

12/

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More from @RajeevJayadevan

10 Oct
Vaccinated people have higher infection rates than unvaccinated - among all age groups over 30.

This is data from Public Health England. Rate is per 100,000.

Original graphs from PHE attached, reference link on thread.

Thanks @tlowdon

1/5
At the same time, vaccinated individuals are less likely to be admitted to hospital, or die from COVID-19.

The reported death protection is likely to be an underestimation, because vaccination preferentially occurs among people who have more background illnesses.

2/
The question is why the rate of infection is higher among vaccinated people.

It is obvious by now that vaccines aren’t very good at stopping the virus from entering the nose or throat, particularly past the initial few weeks of high antibody titres.

3/
Read 7 tweets
10 Oct
Comparison of immune response of vaccination with natural infection

1. Memory cells remains stable in number over the first 5 to 6 months in both groups

2. Memory cells continue to evolve with increased somatic mutation & emergence of unique clones

1/

nature.com/articles/s4158…
3. After natural infection, neutralising breath of memory antibodies increases with time, not much increase noted in the vaccine group.

4. We do not know yet if a third dose (or breakthrough infection) after 2-dose vaccination will generate more memory B cells

2/
5. In both groups (natural infection & vaccine), affinity maturation increased 3-7.5 fold at 5-6 months.

6. In the vaccine group, affinity increased 4.5 fold, while in natural infection it increased 11.2 fold at 5-6 months

3/
Read 9 tweets
8 Oct
Vaccination of healthy children not necessary before opening schools, writes @DrLahariya

1. Severe disease risk close to zero (exceptions don’t define policy)
2. Current vaccines not very effective in blocking virus infection in nose

1/

theindiaforum.in/article/reopen… @TheIndiaForum
When we view the outside world while standing in the ICU, it is easy to be tricked into believing that the whole world is falling severely ill.

It is true that a tiny % of children fall ill, but that % is less than 0.008 (Kerala) and is ~made up of children with comorbidity.
2/
Which is why if we only look at the severely ill children, we will not be able to see the massive denominator of healthy children who were not affected significantly by the virus.

3/
Read 14 tweets
7 Oct
T cell response in Astrazeneca vaccine recipients.

Study of 296 people aged 18 to 85 years.

Thread 👇

There has been plenty of discussion about antibodies following vaccination but studies of T cell response are uncommon. This paper gives details.

1/

science.org/doi/10.1126/sc…
Optimal T cell response was detected - that is CD4 Th1 and CD8 with a high degree of polyfunctionality, covering a broad range of spike protein epitopes.

2/
This increased T cell breadth will help fight variants. In other words, a few viral mutations here or there will not make a difference to these T cells.

This means the virus will continue to be hunted down even if it modified its appearance to gain entry into the body.

3/
Read 7 tweets
2 Oct
Should we be shutting down borders and closing economies any more?

Genomic sequencing from Rwanda tracks arrival of variants from surrounding regions (the process is bidirectional)

But did such restrictions:

1. make any long-term difference?
2. stop VOC from taking over?

1/4
Such measures, taken by several nations in 2020, were justifiable due to a fear of the unknown. Now that we have 21 months of data, it is time to sit down & see if they made any difference.

We must also not forget that it is the SAME virus, regardless of fancy Greek names.

2/4
The problem with variants of concern is two-fold.

1. They take a long time to show their true colours. Thus, by the time they are declared as VOC, modern travel would have taken them all around the world.

2. Even a single introduction is enough to infect a whole country.

3/4
Read 4 tweets
1 Oct
This thread shows instances of fully vaccinated people picking up (and spreading) infections. Apart from very low baseline risk, this is one more good reason why universal COVID vaccination for healthy children isn’t advisable. See UK study linked below. @GKangInd @doctorsoumya
Vaccinating healthy children will not stop them from picking up or spreading the virus. Such protection won’t last >3 months.

see thread above👆 for context

@ProfSomashekhar @PIB_India @DrLahariya @RemaNagarajan @IMAIndiaOrg @jayalal10 @dr_Sulphi_Noohu @drbabukv @VeenaGeorge03
Link to UK study.
(see thread above👆 for context)
Read 5 tweets

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