Children X Covid-19X Other Respiratory Infections: New Challenges!

Children initially had fewer clinical reactions to moderate / severe forms of Covid-19 than adults. Despite this behavior, they were not immune to the occurrence of more severe forms such as Covid-19-related acute respiratory syndrome (SARS) and pediatric multisystem inflammatory syndrome. It is important to note that more than 3,000 children and adolescents have died of the disease in Brazil since the epidemic began in 2020. In addition, we have highlighted the long-term Covid-19 and its consequences, particularly in relation to the cognitive aspects of attention and learning.

At the height of the epidemic, most schools only conduct online activities, which cause serious harm to children and greater mental weakness and develop behavioral changes, such as excessive fear of disease, boredom, loneliness, anxiety, feelings of loneliness, depression, and so on. . The children had to leave the “cluster” imposed by the apparent family protection and go back to school, to outdoor games, to physical activity, in short, to life! Therefore, the reopening of schools in 2022 is a topic that made significant headlines and, for the most part, parents were initially apprehensive about the risks involved in this return. Everyone wanted to know: will the environment be safe for students and teachers when the school is reopened?

In terms of social flexibility, it is well established that measures such as adequate hand washing and the use of masks, depending on the age group, are basic practices for preventing respiratory virus infections. In fact, some states maintain the adaptation of wearing masks when children return to school.

Fiocruz’s infographic system, which monitors respiratory infections, warns of a significant increase in the incidence of SARS in pediatrics in the first five months of the year. The data shows an increase of about 50% compared to 2021, especially among children aged 0 to 4 years. In this epidemic of respiratory virus outbreaks, including SARS-COV-2, there is a need to rethink the use of masks in school environments.

One explanation for this increase in cases is related to the fact that social isolation during the epidemic has reduced exposure to other respiratory viruses and increased children’s susceptibility.

Regarding the vaccine against Covid-19 in pediatrics, researchers around the world have confirmed that there are reasons to strongly recommend its use in this group. In 2021, the United States began using the Pfizer vaccine in children between the ages of 5 and 11, demonstrating safety with pediatric presentation, using one-third of the standard vaccine dose. Significantly, in the United States, 98% of adverse events observed with real-life data were considered mild. Pfizer recently applied to the Food and Drug Administration (FDA) for approval of a new pediatric presentation for use in children aged 6 months to 5 years, with high chances of approval still pending in June.

In Brazil, we used Pfizer vaccine for children 5 to 11 years old and Coronavac for those over 6 years old. We are facing a major challenge regarding the immunization of children due to the spread of fake news by the deniers. So, we think it is essential to enlighten the population with accurate and clear information. Our country needs to increase the coverage of two-dose vaccines for children over 5 years of age, which has not yet reached 70% of the target population. Preliminary studies of the coronavak vaccine in children and adolescents aged 3 to 17 years have shown a good response to this population vaccine and it has been used in several countries over the age of 3 years. Anvisa has also received a new request to publish Coronavak for ages. We will stand firm and focused on protecting our children and adolescents!

* Eduardo Jorge da Fonseca Lima Member of the Scientific Department of Immunization at the Brazilian Society of Pediatrics


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