Discover more from Advice I Give My Friends by Dr. Kelly Fradin
Returning to normal sleep & the case for vaccinating kids
Practical and essential
Last week, Catherine Pearson from HuffPost called me to talk about how the pandemic has impacted kids sleep. I was so happy to talk to her about this issue because it’s also the most common question I’ve gotten from the parents of my first grade son’s classmates.
Whether kids were bored, anxious, or less tired with fewer activities, more children than ever started sleeping with their parents this pandemic. I think for some kids and some parents, it’s been a nice thing.
But for some children and for some parents, they may want their space back. Maybe the sleep quality isn’t as good, the schedules don’t align or parents want a little privacy. How do you reclaim your bed? Read the article to hear my advice. No guilt, clear boundaries, empathy, and perhaps some tricks from Dr. Canapri’s book “It’s never too late to sleep train” like camping out.
In the same chat, I explained that because children’s sleep is so important, I feel pretty strongly that schools and communities can advocate for the mental health of our adolescents by pushing back school start times. It’s a complex decisions because there are costs to consider (bussing affects the elementary age students and high school sports schedules), but moving school later has a big impact on teen sleep and teen sleep has a big impact on teen mental health. Now is the perfect time to let science drive the schedule and support community-wide wellness. Read the whole story here.
Whenever I update my instagram to include information about the path to having approved options to vaccinate children a handful of people message me to say, “Why vaccinate kids. They are so low risk!” While I am glad to see mainstream media like the NY Times walking back the fear-mongering, I also don’t want to be reckless about our children’s health.
In this situation, it’s all about the nuance and our cognitive flexibility and ability to process the complex reality of coronavirus. I can not worry about my kids risk if they catch COVID and also strongly recommend we take population measures to protect children. Let me explain why I support pediatric vaccines.
1) To protect the population. In the US, kids make up 22%. Estimates at herd immunity vary, but it’s likely near 80%. Reinfection after natural covid infection seems more common than we anticipated at first - up to 10% in a study of military recruits. With vaccine hesitancy it’s likely to achieve any kind of population level protection against COVID, we’ll need to vaccinate children. And yes, I think it’s unfair that hesitant adults rather directly place this responsibility on children, but the vaccine is also needed…
2) To protect the kids. I know we think of children as all healthy and low risk, but this is incorrect. Though the specific risks facing children with underlying conditions are poorly defined (how much higher risk really?), half of children admitted with COVID-19 have underlying medical problems. Nearly 33% of all children have a chronic health condition. To make schools inclusive to all (including people with low risk tolerance or underlying conditions) and relatively normal (without precautions) vaccines will be essential. There have been 354 deaths in children from COVID-19 this year, almost double the average number of deaths from the flu.Regardless, even if I view my children’s risk of COVID as low (which I do!), I want to keep community transmission low enough so that all children feel safe attending school.
When there is a safe and effective vaccine approved for children, I’ll definitely line up my kids. Pfizer is approved for 16 and up and reportedly is filing the EUA application for 12 and up, which means for those children by June it could be an option. The studies for 11 and under will take a bit longer (EUA estimated to be approved early 2022) because they are testing more doses.
So, the rub comes from questions about how we treat children while adults are vaccinated and children aren’t. As I’ve talked about in prior posts, this depends a lot on whether your kids are part of a community like school or daycare. In my opinion when they are, we have to continue to take precautions to protect that community. However, when they aren’t, like this summer, we can make decisions based on our risk tolerance.
For my family that means when I don’t have to consider the school rules, over the summer I’ll ease my kids COVID precautions and let them have playdates indoors and eat at restaurants indoors. I anticipate by summer most adults in our network will have been vaccinated and over the summer the case rates will be low. For my kids, I am not that worried about if they get COVID-19. Yes there is a risk of unusually severe COVID-19, MIS-C or longer term symptoms but for children the risk is low.
When a pediatric vaccine is approved, it will mean that it’s safe. The benefits of the vaccine at preventing the complications of COVID for kids and promoting community health are substantial and well-justified.
Thanks to everyone who entered the giveaway for my book Parenting in a Pandemic! I was so touched by all the kind words and familiar names I decided to give ALL 134 of the entrants a copy! Surprise & congrats! If you didn’t enter and you’re still interested you can find it here.
Many media outlets are getting this incorrect, the New York Times quoted data on deaths from the flu based on mathematical modeling. In 2019 188 children died of the flu, but computer estimates that the flu virus might have been involved with up to 600 deaths. This has to do with coding data, children who pass away of acute respiratory failure for example may have underlying influenza. Using this number is potentially more accurate, but if you are going to compare you should compare apples to apples and extrapolate all the deaths from COVID rather than just the actual count. The same thing applies to people comparing influenza rates and covid rates, we have never done population level digging for flu the way we have for coronavirus so these comparisons are so flawed as to be misleading (in my opinion!).