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HomeMy WebLinkAbout2022_06_17 KGould_Risks of child vaccine_response2From:Kincaid Gould To:Berry, Allison Cc:Board of Health; contactus@kptz.org Subject:Re: Question for Dr. Berry Date:Friday, June 17, 2022 11:11:59 PM ALERT:BE CAUTIOUS This email originated outside the organization. Do not open attachments or click on links if you are not expecting them. Dear Dr. Berry, Thank you for your response. I'm looking forward to hearing what you have to say on Tuesday. As far as lightning strikes go, though, I would like to invite you to reread Dr. Meissner's analogy, as he noted that there were 270 people struck by lightning each year, not killed. This NWS page may be where Meissner drew his information from. You wrote "And that includes adults and children so the actual accurate comparator if you’re wanting to compare deaths in a specific age cohort like children under 5 would be even smaller." You are, of course, correct to say that children under 5 make up a very small proportion of those who are killed or injured by lightning strikes. An analysis of US lightning strike victims between 2006 and 2019 found that : "The greatest number of fatalities occurred between the ages of 10 and 60, with a relativeminimum in the 30-39 age category. While there is no conclusive evidence why this minimum should occur, possible hypotheses include that parents in this age category with young children are either more cautious when thunderstorms are in the area, or parental duties limit the amount of time they spend participating in vulnerable activities" (page 4, italics mine). This would also likely explain why children have such a low risk of being injured by lightning. The fact that fewer children are injured by lightning strikes is largely a result of protective external factors, not anything inherent to the child, and so I don't personally believe your classification of this as not being an 'accurate comparator' is valid on those grounds. Children would very likely make up a greater share of lightning deaths and injuries if they were not so well-looked after by their guardians. The point of this email is not lightning strikes, although I did enjoy looking into it. You, Dr. Meissner and I all know that it is rare for someone to get struck by lightning. Neither he nor I posited that a child is more likely to die from a lightning strike than to die with COVID-19. Rather, he noted that 270 people being struck by lightning in the United States every year, and 220 deaths occurring in the relevant age group per year--actually, less than that, as we should note that the vaccine has not been made available to children under six months, and according to the 27th slide of the CDC slide deck prepared for the VRBPAC meeting, there were only 202 COVID- 19 deaths in children between six months and five years old, less than half of the number Meissner used--are both 'very rare event[s].' I might even hypothesize that the latter number will trend downward as treatments improve and more and more children build a natural immunity to the disease (and it is interesting to note that only children without evidence of a prior COVID infection were entered into the Moderna trial, despite such a large percentage of the relevant population already having had a COVID infection). All of this to say that the 270 vs 220 comparison is, I think, quite useful for contextualizing how large 220 is, if for nothing else. You, of course, are welcome to disagree. Thank you for your time and attention, Kincaid------- Original Message -------On Friday, June 17th, 2022 at 2:37 PM, Berry, Allison <allison.berry@clallamcountywa.gov>wrote: Hi Mr. Gould, I’m happy to address your question around vaccine safety in children on air nextTuesday. I always have and continue to support full discussions of risks and benefits ofmedical interventions with the patients and their families. I think where you and Ioften differ is in our understanding of the relative risks of the disease and theintervention. Since I probably won’t read Dr. Meissner’s remarks in full on the air, I wanted tolet you know that he was incorrect when it comes to his lightning strike analogy.The number of Americans killed last year in lightning strikes was not 270 it was17. And that includes adults and children so the actual accurate comparator ifyou’re wanting to compare deaths in a specific age cohort like children under 5would be even smaller. Now this was a long meeting and he may have misspokebut since you’re citing his statement as a source, I wanted to make sure you hadaccurate data. Thanks so much for your question and engaging in this process. Allison Berry, MD MPH (she/her/hers)Clallam & Jefferson County Health OfficerOffice: (360) 417-2437allisonberry@clallamcountywa.gov On Jun 17, 2022, at 12:01 PM, Kincaid Gould<kincaidgould@protonmail.com> wrote:  *** EXTERNAL EMAIL *** This message was sent from outside our County network. Dear KPTZ, Please submit this question to Dr. Berry for the upcoming BOCC Meeting. On Day 2 of the recent VRBPAC Meeting, there was a recurring theme among the voting members. Although they all voted to recommend approval of the vaccine for children six months to five years of age, they consistently noted that it was very important that the risk of the disease posed to children in this age group be clearly communicated to the public and to parents specifically. Dr. Meisner, at 6:12:54, presented this opinion quite concisely. I have transcribed what he said below. (I'm frantically typing this up to get it out before 12:00 and there may be a typo here or there. I apologize if that is the case.) "I think it's very important, as Dr. Cohen said yesterday, that the communication or the messaging be made as clear as possible for parents to understand the relative risk and the relative benefit. I think, we, for example, heard several times that there were approximately 442 deaths so far in the pandemic among children less than 5. So that means about 220 deaths a year, approximately. Now if you look at the number of people who are struck by lightning in the United States on a year, it's 270. So we're talking about a very rare event. If we talk about hospitalizations among children between 6 months and 5 years of age, the hospitalization rate on the CDC website is 2.3 per 100,000, or 23 per million, and there about 20 million children in this age group, so 20 times 23 is 460 hospitalizations associated with COVID in this age group that we're considering today, and probably only a fraction of those are because of COVID-19 infection rather than a coincidental association. So really, we'd be talking about vaccinating close to 20 million children in order to prevent two or three hundred deaths, and it's a matter of how an individual weighs the risks and benefits. I think the vaccine should be available for certainly high risk children and for families that are so concerned, they are troubled by that risk ratio, and they should have access to the vaccine, but I again feel very strongly that parents should understand how small these numbers are, it's a very low risk from the vaccine but it's also a very low risk from the infection itself, and I think that has to be communicated clearly to parents so they can participate in the decision about vaccinating a child in this age group." My question to Dr. Berry is, will you commit to making the risk posed to children in this age group very clearly known to peopleattempting to vaccinate their child? Thank you, Kincaid Gould