With New York expecting its first shipment of the COVID-19 pediatric vaccines in the coming days, CNHI's New York bureau invited Dr. Joseph R. Sellers, a veteran pediatrician and internal medicine specialist at Bassett Medical Center in Cooperstown and Cobleskill Hospital, to discuss the looming availability of those doses. State officials have decided against mandating the shots for children, opting instead to let parents and caregivers make those decisions.
Dr. Sellers, who began his practice in Cobleskill 32 years ago, was elected president of the Medical Society of the State of New York in May. He was interviewed Friday by CNHI reporter Joe Mahoney.
QUESTION: How significant is the federal approval of the pediatric vaccines for COVID-19?
SELLERS: The vaccine is the No. 1 tool we have for this pandemic. After all the stress and strain patients' families and care providers have experienced for the last year and half, we see the light at the end of the tunnel. Getting the vaccinations into young children will be a great step. The FDA was very positive (about its effectiveness). Hopefully, by the end of next week, we'll be putting shots into the arms of children (ages) five to 11.
Q: Why do a significant number of people remain hesitant to the vaccines after the federal government has approved them following lengthy trials?
SELLERS: It seems that there are three groups. There are those who are like knocking at the door, saying, 'When can I get it? When can I get it?' And you had people rushing to try and get vaccinated. We have people calling us every day asking about when can my younger child get vaccinated. I have a daughter in Buffalo who has my three grandchildren. She calls me every day:: "Grandpa, when are you going to vaccinate the kids?" So there's that group.
There's another group of people that are resistant to the science, that are difficult to convince of the safety and efficacy. But there's a middle group of people who just are questioning, or looking for information, who are hesitant, but willing to have an open mind, and I think that's where , as a medical profession, we need to help. We need to be there and answer those people's questions. I tell patients: "You know, you trust your doctor with other aspects of your health care. Listen to them, ask them the questions let your doctor provides you the reassurance and help you get confidence in vaccination." And I think that's where our efforts need to be centered.
My hope is that the group that wants it quickly and the group that has some questions that we can answer, that those two groups will be the vast majority of parents. And those who are resistant will be small. That's what we can hope and pray.
Q: Do you think there needs to be more education of the group that is hesitant towards the vaccines? Because there are some in that group that don't like the masks, either, and so if you want to get rid of masks, it seems that getting more people vaccinated gets us to where we need to be to lift the mask mandate?
SELLERS: "Yes I think that is true. Although I wear a mask all day, every day to do my work. You know, I don't quite get why some are so adverse to masks. But yes, if we want to get kids back into all their participation in sports, social activities, if we want kids to be able to play together and socialize — which is so much of the developmental task of children, so much of what they need to learn. You know, the expression: 'all you need needed to know in life you learned in kindergarten," learn to get along in the sandbox with others and share toys and all those things. Kids having to be isolated from each other, I think, has been the largest burden on our children, and having the vaccine, that is how we get back to normal. It's the most important path back to normal.
Q: How would you assess how children have been impacted by the restrictions on their group activities? High school proms and annual school outings, for instance, were canceled in some cases, as were athletic events.
SELLERS: A whole lot of the normal activities of childhood and adolescence have been curtailed, appropriately so. I mean, the precautions were important. But how we get out of that is with vaccination, and it's going to remain to be seen how we can help kids recover from that because what they missed is a part of their social development. The other (impact) is academics. And I think, proportionately, the kids who have a harder time in school have fallen even further behind. Kids are going to need a lot of help to catch up so they can get the education that they need for the current world. So those issues will be there.
Q: Why is there a great effort now to get the vaccine to children?
SELLERS: People say to me: Well, what's the risk of COVID in children? Because they don't get as sick, or not as many get super sick, and that is true. The risk of hospitalization or death with COVID in children may be less than in adults. But there are still 600 families in America that have an empty chair at the dinner table because of COVID, after they lost a child. And it is estimated that about 140,000 children have lost an adult caregiver because of COVID.
By immunizing children, we also protect the adults. We protect the parents, and we protect the grandparents who would be the most vulnerable, because then kids are not sharing it, bringing it home, and giving it to Grandma and Grandpa. You know, for so many children, a very important person in their life is now gone. So to protect children, we need to immunize adults. And to protect adults, we need to immunize those children.
Q: What I hear anecdotally from people in my own circle is that the impacts from the restrictions have been particularly profound on older children, as social activities are so important in their lives, and perhaps the very young children are not so impacted. Could you please comment?
SELLERS: You know, the impact on children is not going to be the same, child to child, because some children have more resilience. They have more family support. They have parents and grandparents and siblings that help support them. Other children were already in stressful living situations pre-COVID. And unfortunately, this adds even more stress for them. So the kids who are starting life on second or third base will probably make it to home plate. But when you are starting life on first base, it's a long way. And so I think one of our obligations as a community going forward will be to find what can we do to help those kids catch up. But the very first step absolutely is to get everybody immunized, and then start concentrating on helping the kids coming out of the pandemic catch up so they can have the lives we wanted for them.
Q: In your view, as a pediatrician working closely with parents, are the schools adequately staffed with counselors and nurses who can help address the emotional impacts children have experienced during the pandemic?
SELLERS: Unfortunately, we have not had adequate funding and staffing for the mental health of everybody, particularly children, pre-COVID. So I think it's going to be even more so coming out of COVID. Yes, that really does need to be a point of emphasis, for government funding, for emphasis by our school boards and for the parents. The schools do need to have those supports in place for children.
Q: With the approval of the vaccines for children 5 through 11, the children less than 5 still won't be eligible yet. Do you project any timeline for getting these very young children vaccinated?
SELLERS: I think that the CDC and the FDA have been very carefully looking at the data, and slowly lowering the age at which we give the vaccines to not only make sure they're effective, but also to make sure that they're safe. And I can see that the vaccine eventually will be down into infancy. But it may take some time. It's easier to find adults to volunteer for studies than it is to find parents to volunteer their children. I think being prudent, careful, following the science, making sure we have good data before we lower the age, is a very appropriate thing. The No. 1 way to protect young children, those under five, is to have their siblings and their parents and grandparents all vaccinated. And that's really how we're going to protect the little ones.
Q: Several unvaccinated individuals have told me they are holding off on the shots because they feel the government rushed the development of the vaccines now being offered. Could you please comment?
SELLERS: Well, I don't think it was rushed. Our government really got behind this effort, and governments around the world got behind it. It's amazing what you can do when you devote billions of dollars, and the best minds in science to projects. And so it was a remarkable success. And I think we really have to give credit to the former administration for that one. That is something they did get right. And we have to give credit to these great scientists. They really are heroes. And the fact that we have provided the vaccines to hundreds of millions of people and we have not seen untoward effects or unexpected effects We have had other vaccines like this over the past 100 years and if there were any side effects they presented themselves in the first two months. I had my first vaccine around Christmastime last year. So I think you have to look at the other side, and the risk with COVID is real. COVID kills people and it puts people in the ICU and some people have long-term COVID, and that's a real risk. The other risk is the risk to our lives and having things closed and the effects on our school children. So I think anyone who fairly looks at the risks versus the benefits, vaccination comes down head and shoulders above non-vaccinated.
Q: Do you foresee a point when the pandemic will end?
SELLERS: I believe there is a good chance this will go away like other pandemics have, and then we won't need to be vaccinating or worrying about it. But there's also a good chance it may become an endemic issue that is there in the background and periodically rises itself just like influenza is, and so it may be that we wind up with an annual COVID booster just like getting the annual flu shot. But we will see. And the other good thing about this is all the work that's being done, looking at prevention, looking at how it is spread, looking at developing medical therapies, introducing new things that we haven't had before. And I think a lot of this — the vaccine technology, medication technology, and just a lot of the science of epidemiology — is really improving with all the effort that's being put into COVID. And hopefully they will help us with other illnesses and other infectious disease.