Let me be perfectly clear: children DO NOT NEED a sars-cov-2 vaccine before they are permitted to return to normal activities, such as school and visiting loved ones.

Any claims to the contrary are demoralizing and counter to common sense and medicine

Here is why [thread]

First, lets be honest, there is no sars-cov-2 vaccine for kids.

It may take a long time for one to show sufficiently favorable benefit/harm profile to receive FDA approval

The use of EUA (emergency use authorization) for such a vaccine as opposed to traditional approval will be debated, as the potential harms of the virus in kids are low, and the vaccine risks will not be some non 0 number-- it likely will require the traditional regulatory path

EUA might only be reasonable if the epidemic does not abate despite widespread adult vaccination*

*here I mean that adults all agree and get it, and not that many choose not to get it (that don't count)

Second, kids are paying heavily for this virus, which does not harm them commensurately

They are giving up a year of school, a year of social interactions-- this has a huge effect on their lives https://www.medpagetoday.com/blogs/vinay-prasad/90658

The virus meanwhile is *thank god* not that bad for most healthy kids, on par with seasonal influenza

Even the rate of multi-inflammatory syndrome is vanishingly low.-- although you wouldn't know that from the breathless news coverage and tweets

Third, who even says the vaccine will offer a favorable risk benefit profile in kids?

If the vaccine offers AEs similar to pfizer and moderna dose 2 in adults, I think it will be a huge debate if childhood vaccination is indicated

If the epidemic is abating, how can you justify giving 100 kids those AEs, so that perhaps 1 or 2 or even 3 will be spared a case of covid that might be as mild as the AEs themselves?

That will be a vicious debate, frankly

One has to think of the cumulative days a kid is resting in bed, vaccination might outweigh the benefits in low age.

Moreover, as death is fleetingly rare in kids, as is MIS-C, are we going to power the trials for this outcome. I doubt we will say anything conclusive

This is in contrast to adult vaccination, which is a no-brainer, and full disclosure, I have already been pumped full of mRNA, and I was grateful for that.

I don't make reverse transcriptase enzymes, so I don't sweat it

Putting it all together, it is unlikely kids will have a vaccine with a proven benefit/harm profile in the near future, if at all

They are already paying the price disproportionately

On no planet does it make sense to keep them out of schools till said *mythical* vaccine, nor does it make sense to further deprive them of social interaction

I disagree. I disagree strongly.

I disagree with fear-mongering, and the utter lack of common sense on this issue.

Once adults, particularly older adults are vaccinated, and if *god willing* there is not vaccine escape, covid19 is over

We are going back to normal

If you don't want to return to normal, don't worry, I will do twice as much normal for you. I got you covered

Cheers!

wow, i'm surprised. if you like the thread, pls read this 1800 word op-ed on why schools should be open that I wrote with @vkoganpolisci

We try to articulate the full considerations https://www.medpagetoday.com/blogs/vinay-prasad/90658