Parents and guardians of children under the age of 5 live in a real dilemma at this time of the pandemic. On the one hand, they witness the end of practically all the restrictions that have marked the last two years, such as the use of masks and the prevention of crowds in closed places. On the other hand, Brazil still does not have a Covid vaccine approved for use at such young ages – Pfizer can only be applied from the fifth year of life, and Coronavac from the sixth.
In practice, this represents a double risk: these children are naturally more exposed to contagion and do not have access to immunizations, the only products capable of making the immune system more prepared to fight the coronavirus and its consequences in the body.
The solution, guarantee the experts heard by BBC News Brasil, is to combine a series of care and strategies, such as keeping the rest of the family’s vaccination up to date, encouraging the use of masks suitable for children in closed places, discussing some changes in entry times. and recess in schools, ensure air circulation in classrooms and not take the child with symptoms of a respiratory infection (such as flu, Covid or cold) to places where they interact with other people. We will detail each of these recommendations throughout the report.
And, as much as Covid is usually less severe in the first years of life, that doesn’t mean it doesn’t cause hospitalizations and childhood deaths. By the end of 2021, Brazil had recorded 1,449 deaths of boys and girls up to 11 years old related to the coronavirus. The data are from a report published by the National Council of Health Secretaries, Conass.
“These Covid numbers far exceed the records of any other infectious disease that also causes deaths in this age group”, compares doctor Marcelo Otsuka, coordinator of the Pediatric Infectious Diseases Committee of the Brazilian Society of Infectious Diseases.
Here are five steps to increase protection for those who do not yet have access to vaccines.
1. Vaccinate the rest of the family
Covid-19 immunizations are available for children over five years of age, adolescents, adults and the elderly.
From 5 to 17 years old, two doses are recommended. Between 18 and 79, it is necessary to take a booster (also called a third dose). For those over 80, the Ministry recently released the application of a fourth dose of the vaccine.
And having the vaccination schedule up to date brings indirect protection to the little ones: the fact that the surroundings of this child are more protected already reduces the risk of them having contact with the coronavirus.
“This is what we call the cocoon strategy: when there are no doses available for children, we vaccinate all family members and close contacts so that these individuals do not transmit the virus to them”, explains pediatrician Heloisa Giamberardino, head of the Epidemiology Service, Immunizations and Infection Control at Pequeno PrÃncipe Hospital, in Paraná.
This practice was already common well before the pandemic, as a way to rid newborns of whooping cough, a respiratory disease caused by the bacteria. Bordetella pertussis.
Doctors recommend that fathers, mothers, siblings, grandparents and everyone who will have frequent contact with the baby receive the vaccine that prevents contagion with this microorganism, since the doses only start to be applied from the second month onwards. of life.
Against the coronavirus, this strategy is not 100% foolproof, but it can help.
2. Wear suitable masks
Anyone who thinks that younger children don’t get used to or completely reject this protective equipment is wrong.
“They are able to understand the importance of wearing masks. It is up to adults to guide them on how to do it in the best way”, says Otsuka.
The pediatric infectious disease specialist highlights that there are suitable models for younger people. “We have specific masks available for children from two years old, which filter well, fit better on the face and seal the air inlets and outlets”, he points out.
Ideally, they should be used all the time in closed places where there is interaction with other individuals who are not part of daily life, such as schoolmates in the classroom.
3. Organizing recess, arrival and departure from schools
As far as possible and the reality of each family, the ideal is to avoid public transport on the way to or from school activities.
“Public transport represents an additional risk, since the child will be in contact with many different people in a closed place”, explains Otsuka.
“If possible, preference should be given to individual transport or with more distance and a smaller number of people [como as vans escolares]”, adds the expert.
Parents and tutors can also try to talk to the school’s management to adopt a staggering in the start and end times of classes – thus avoiding agglomerations and meetings between different classes at the entrance or exit.
“The same time-sharing scheme can be adopted at recess, and children can be instructed not to share their lunch with their peers”, adds Giamberardino.
4. Air the classroom well
Advances in science over the past two years have shown that tiny particles of saliva that contain the coronavirus are suspended in the air for some time, during which time they can be aspirated through the nose and mouth and start a new cycle of infection.
This time that the pathogen is “floating” in an environment depends mainly on air circulation.
In open places, this air exchange happens constantly, which greatly reduces the risk of having contact with the virus.
In closed places, this replacement of air takes longer, which allows the microscopic agent to remain suspended in the environment for a longer time. This, in turn, increases the likelihood of infection.
But there are some ways to reduce this risk well in the classroom. “First, it is necessary to leave doors and windows always open, to increase air circulation”, guides Otsuka.
If the room has fans, keep them on at all times. This helps to disperse those tiny suspended saliva droplets.
“If the school has an air conditioning system, it is important to remember to change the equipment filter within the deadlines set by the manufacturer”, adds the pediatric infectious disease specialist.
Ventilation not only decreases the risk of having Covid, but of all other infectious diseases that affect the respiratory system, such as flu and cold.
5. Do not go out if you have symptoms
If the child begins to feel any discomfort typical of Covid, flu or cold (runny nose, cough, fever, pain…), the recommendation is not to take them to school or any other outside activity.
This prevents the viruses from being transmitted to other people and creating new chains of contagion in the community.
“This is a very important recommendation that, I hope, will be permanently adopted by all parents and guardians even when the pandemic is over”, points out Otsuka.
Of course, keeping a child at home requires a change in routine and requires an understanding of the entire school system and the parent’s workplace.
Specialists indicate discussing with school representatives some scenarios in which the child needs to be away. Thus, you can think, for example, of some activities that the child with symptoms does at home on the days when he cannot go to school.
Vaccine coming around?
There is a possibility that Coronavac, an immunizing agent developed by pharmaceutical company Sinovac and Instituto Butantan, in São Paulo, will become available for Brazilian children aged 3 to 5 years in the coming weeks.
Butantan made a request for the release of the vaccine at Anvisa (National Health Surveillance Agency) and the analysis process is in progress.
On March 22, Anvisa held a meeting with representatives of several institutions, such as the Brazilian Society of Pediatrics and the Brazilian Association of Collective Health, to discuss the data presented.
There is no prospect of when a response to the request should come out, but the agency says that “Anvisa technicians continue working on the process”.
Coronavac is already widely used to immunize young children in countries such as Chile and China.
Abroad, there are discussions and studies that also evaluate the Pfizer and Moderna vaccines in children, but without any definition on the use of these products on a large scale in this age group.
Doctor Isabella Ballalai, vice president of SBIm (Brazilian Society of Immunizations), highlights that Anvisa’s careful analysis is essential to “give security to families that there are criteria and serious work for the approval of vaccines against Covid-19 “.
“This even overturns the fallacious argument that immunizers would be experimental and have no proven safety”, he says.
Ballalai also draws attention to the impact that Covid-19 has had on children. “We’re not talking about a mild disease or a negligible risk in children,” she warns.
“And vaccination is essential to reduce serious conditions, hospitalizations and deaths from Covid in any age group”, concludes the specialist.
Read more on the BBC
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