Younger, unvaccinated populations are enduring the effects of the rapidly spreading Delta variant of COVID-19, with children representing a higher percentage of positive cases than in the past, Atrium Health officials said in a press conference last week.
As of July 15, children represent 12.7% of cumulative positive cases in the state, up 0.1% since the start of the month, according to data from the American Association of Pediatrics. However, over the first two weeks of July, children have made up 15.3% of all new cases.
National data shows a similar trend, with pediatric cases representing 43,033 of new cases over the same period.
The Delta variant, which is more contagious and severe than other strains, according to Atrium Health officials, is the dominant version of the coronavirus.
The variant accounts for about 83% of new cases nationwide, Dr. Rochelle Walensky, director of the U.S. Centers for Disease Control and Prevention, said during a U.S. Senate committee hearing Tuesday.
Children are especially vulnerable to some complications of infection, including MIS-C, or multisystem inflammatory syndrome, a rare but potentially serious condition requiring hospitalization.
The rate of hospitalizations for the Delta variant is two times higher than that of earlier variants, with nearly 99 of admitted hospital patients unvaccinated, Dr. Katie Passaretti, the medical director of infection prevention at Atrium Health, said. Providers are also starting to see an increase — from what had been extremely low levels — in ICU-level patients and patients on ventilators.
But the rising infection rate has not resulted in rising hospitalization rates among children in the Atrium Health service area.
“We’re actually not seeing an increase in hospitalization in our children, and hopefully that will continue to stay that way,” Dr. Amina Ahmed, a pediatric infectious disease expert and epidemiologist at Levine Children’s Hospital, an Atrium Health facility, said.
Nationally, it’s a slightly different story, with hospitalizations for 12- to 17-year-olds increasing, Dr. Ahmed said.
Low vaccine rates for youth
One reason for the shift since the beginning of the year is that younger populations are less likely to be vaccinated.
In North Carolina, about one-quarter of teenagers between the ages of 12 and 17 have received both shots. By comparison, 83% of adults 65 and older are fully vaccinated, according to N.C. Department of Health and Human Services data.
“With only 24% of North Carolinians ages of 12 and 17 fully vaccinated, and because anyone under the age of 12 cannot be vaccinated yet, we still have a long way to go,” NCDHHS Secretary Dr. Mandy Cohen said at a press conference Wednesday.
The department released a “StrongSchoolsNC” toolkit, encouraging districts to adopt mask policies for unvaccinated students.
Gov. Roy Cooper declined to detail specific enforcement measures if a district opts not to enforce a mask policy. “We all know what to do,” he said. “We need to all pull together and make sure we try to get it done.”
Pediatric vaccine trials underway
The Pfizer-BioNTech is the only vaccine currently approved for children ages 12 and older. Moderna is likely on track to offer a second option for teenagers, having filed for emergency use authorization from the U.S. Food and Drug Administration in June.
For children younger than 12, vaccines may be available by midwinter, an FDA official said earlier this month.
Pfizer’s pediatric clinical trials are currently underway, involving up to 4,500 participants ages 6 months to 11 years across 90 clinical sites in the U.S., Poland, Spain and Finland.
Pfizer, which is testing lower doses for children, anticipates having results for 5-to 11-year-olds — who are receiving 10-microgram doses as opposed to the 3-microgram doses that children under 5 are receiving — by September. By contrast, those older than 12 received 30-microgram doses.
Results for 2- to 5-year-olds should be available soon after, and results for those under 2 by October or November.
The companies use trial results to submit to the FDA for emergency use authorization.
Children, especially infants and toddlers, require separate vaccine trials because they may have not yet built immune systems strong enough to respond to some vaccines, making their responses stronger than those of adults.
“One key goal of the COVID-19 vaccine clinical trials in children will be to determine the optimal dosage for each age group,” Judy Martin, professor of pediatrics at the University of Pittsburgh, wrote in The Conversation.
State health officials encourage adolescents eligible for vaccination now to get them.
NCDHHS launched an incentive program for youths, Summer Cash 4 College, whereby participants younger than 18 who receive their full vaccination are eligible to win scholarship funds through Aug. 4. Some organizations are hosting vaccine walk-in events that target young people.
Free COVID-19 vaccines are available to everyone over the age of 12 and can be scheduled through the Find My Vaccine Provider online tool.
Complications due to vaccinations are extremely rare, in the order of a few per million doses given, Dr. Passaretti of Atrium Health said. “The risk of vaccination is so far below the risk of getting COVID infection.”
Editor’s note: This article was updated to clarify that Atrium health officials said the Delta variant is more contagious and severe than other variants.