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
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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:
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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