Preparing for a return to school in a COVID world

25 January, 2022

Schools are reopening and vaccines are part of the preparation. Here are some of your common questions about schools and COVID vaccination

Adapted from ABC News

 

As many parents rush to get their children vaccinated in time for school, many questions surround its importance.

Millions of Australian children are gearing up to return to school for term 1, as states and territories begin to outline their back-to-school COVID plans.

NSW is on track to reopen as planned at the end of January (or in February), with a focus on rapid testing, mask mandates, and better classroom ventilation.

As the return of classroom learning approaches, the risks of COVID-19 for kids and the rollout of vaccines have been hot topics among parents.

Here's what you wanted to know ahead of schools commencing. 

What is the risk of Omicron for kids?

Throughout the pandemic, children have been less likely to fall sick with COVID-19 compared to adults, and experts say this pattern doesn't appear to have changed with Omicron. "On the whole, most children are either asymptomatic or have a very mild illness, which may include a runny nose, some fevers, or feeling unwell for a couple of days," paediatric infectious disease specialist Asha Bowen told the ABC.

Children will experience mild illness from a COVID-19 infection, which can be easily treated.

Some preliminary data suggests the chances of children with Omicron infections needing hospital care are reduced when compared to Delta.

But because Omicron spreads so much faster, more people, including children, are becoming infected overall.

"Because of the sheer high numbers, there are more children in hospital," Dr Bowen said.

"But they are still a very small proportion [of overall cases]."

Overseas, hospitalisation rates of children and teens have risen in recent weeks, most notably in children aged under five. These children are the only age group not yet eligible for a COVID-19 vaccine.

Paediatrician Margie Danchin told the ABC that doctors were more likely to admit very young children with viral infections to hospital out of caution, to ensure they were getting enough food and properly hydrated.

Several experts have also noted that of the small proportion of young children hospitalised with Omicron, more are presenting with croup-like illness (which causes a distinctive cough) than with previous COVID-19 variants.

"That reflects the fact Omicron seems to be better at invading upper airway mucosa, but this is generally easily treated," Professor Nigel Curtis told Nine newspapers.

When it comes to the risk of long COVID, research so far suggests children are at a lower risk than adults.

While estimates vary, one large UK study last year found 1.8 per cent of children had ongoing symptoms two months after their infection. Symptoms included headaches, fatigue and a loss of smell.

Why is it recommended that children are vaccinated?

Primary school children will head back into the classroom only partially vaccinated, if at all. So, what are the risks of the now-dominant Omicron variant for kids?

Firstly, vaccines reduce the risk of severe disease (which, while low, isn't zero).

Secondly, they help to prevent kids passing the virus onto others, such as their younger siblings and grandparents.

Experts say COVID-19 vaccination is especially important for children with underlying medical conditions — such as heart or lung disease, diabetes, obesity and severe asthma — who have an increased risk of severe COVID-19.

Vaccination also has the added benefit of protecting kids against a serious but rare post-COVID-19 condition called multisystem inflammatory syndrome, or MIS-C.

Recent research shows vaccination reduces the risk of MIS-C by more than 90 per cent.

What do we know about vaccine safety and side effects for kids?

In Australia, the Therapeutic Goods Administration approved Pfizer's COVID-19 vaccine for all children aged five to 11 after it found the vaccine was safe and effective in this age group, based on international clinical trial data.

The vaccine is exactly the same one that has been rolled out to millions of Australian adults, but is a much smaller dose — just one third the size.

Children's doses come in a different vial to adult doses, to ensure mistakes are not made.

And while adults receive their vaccine three weeks apart, children are recommended to wait eight weeks between their first and second dose, to ensure maximum protection.

A sore arm is the most reported side-effect in children, although headache and fatigue can also be expected after a jab.

If my child has COVID, how long do I have to wait to get them vaccinated?

According to ATAGI's advice, children can get the jab once they have recovered from acute infection. 

However, in line with the UK's vaccination guidelines, Dr Danchin recommends waiting a minimum of four weeks before the first vaccine dose.

This extended period is useful to ensure a full recovery from the disease and an absence of multisystem inflammatory syndrome (which usually appears three to four weeks post-infection).

While infection from COVID-19 will mean they develop some immunity to the virus, experts still recommend children are vaccinated to ensure they have maximal protection.

If symptoms persist during the month following their infection, Dr Danchin recommends waiting another month before getting them vaccinated.

What will happen if my child is not vaccinated in time for school?

The federal government says there are enough supplies for all eligible children to receive their first COVID-19 vaccine before the term starts.

But the recommended eight-week interval between Pfizer's two-dose paediatric vaccine means most children won't receive their full two doses until at least March.

Worried about sending kids to school? This is what education might look like in 2022

The vaccination rollout for children is doing little to calm rising concerns about how to keep schools safe as Omicron spreads. These are the strategies experts say will help. 

As Pfizer's clinical trial only reports efficacy data for two doses, it is unclear how much protection children will get from one.

"If we were going to guess it would be 60-70 per cent protection [against symptomatic disease]," Dr Danchin recently told the ABC.

She says even though there's a "decent risk" of children becoming infected, she believes one dose will likely offer protection against severe disease.

With widespread reports of parents struggling to find vaccine appointments for their children, the government has urged parents to try state clinics and pharmacies.

In addition to vaccines, experts stress that other mitigation strategies, such as rapid testing and proper ventilation, are crucial to reducing the risks of COVID-19 transmission in schools.

How do I talk to kids about getting the vaccine?

Child psychologist John Callanan says the answer lies in keeping conversations simple and being honest. 

Laying out clear expectations avoids leaving kids feeling betrayed and helps them understand the importance of getting vaccinated.

However, going into too much detail may also amplify their fears.

Dr Callanan says it's best to stay "economical with comments" as children are highly reliant on parents for assurance and comfort. 

For needle phobia and other unique cases, GPs or healthcare providers may be able to offer specialised services or provide referrals to other clinics that accommodate.

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