Michigan has a new leader in the surge of COVID cases: kids

Sarah Rahal
The Detroit News

COVID-19 cases in Michigan among kids ages 10 to 19 have risen 133% in the last four weeks, faster than any other age group as the state confronts another spike in virus cases.

It's also the first time during the pandemic that this age group has led in confirmed and probable cases in Michigan, according to data from the Michigan Department of Health and Human Services. But the level is well below the surge seen in November and December.

The rise in infections that began in mid-February is tied in part to youth sports resuming, according to state health officials, but also coincides with Michigan's push to get kids back in classrooms. On Thursday, Michigan added 5,224 new COVID-19 cases, the largest daily total this year and the most since Dec. 10, when the state reported 5,937 daily cases in the throes of a second deadly wave.

Getting kids vaccinated, particularly teens who are about twice as likely to become infected compared to younger children, is crucial to fully reopening schools, achieving herd immunity and ultimately bringing the pandemic to an end, health experts tell The Detroit News.

Seventh- and eighth-grade English teacher Hanna Kim, of Novi, walks to her next class for the afternoon session with her portable, stand-up desk, as she passes a group of students leaving the morning session.

It's a process that is expected to last well into 2022, medical experts predict, in part because there is just one vaccine, Pfizer's, that has been granted emergency authorization for kids ages 16-17 and none that have been deemed safe for kids 15 and younger.

"What we know is right now, we can do 16 and above, and that the next eligible group will be the older kids, 12 to 16 likely, and it will be a long time before the youngest kids will get vaccinated," said Dr. Preeti Malani, chief health officer at the University of Michigan.

Neither Moderna's nor Johnson & Johnson's vaccines are approved for anyone younger than 18.

Moderna and Pfizer have begun testing their vaccines on children. For those ages 12 to 15 years old, the results may be available by summer, possibly in time for vaccines to be rolling out by the start of the school year this fall, said Dr. Tina Tan, a professor of pediatrics at Northwestern University's Feinberg School of Medicine. The trials are ongoing and problems could arise during testing, she said.

"Experts have estimated that in order for the United States to reach herd immunity threshold, at least 70% of the population must be immune against COVID-19 in order to stop the spread of the disease and those under 18 in the country account for over 25% of the population," said Tan, although that number is slightly lower, at 22%, in Michigan.

"Even though the pace of vaccination in the adult population is increasing, a good portion of the pediatric population needs to be vaccinated for us to reach herd immunity."

School outbreaks rising

Michigan has seen a 77% increase in cases since mid-February, mainly attributable to youth sports,according to the state health department. 

New school outbreaks have increased since last week from 162 to 207 at education institutions including K-12 schools and 21 outbreaks in child care programs.

Dr. Joneigh Khaldun, Michigan's chief medical executive, said while children are less likely to get severely ill from COVID-19, they still can pass it on to others who could be severely impacted.

Tan, a pediatric physician of infectious disease, said children younger than age 10 appear to be less effective transmitters of the virus than teens, but they shouldn't be dismissedas the pandemic has had a long-lasting impact on schooling.

"The negative impacts of the pandemic are significant including a major increase in adolescent

"The negative impacts of the pandemic are significant including a major increase in adolescent mental health issues, falling standardized test scores, a decrease in academic progress for all students and an increased number of absences or have dropped out altogether," said Tan, adding as more people get vaccinated, "I think there's going to be a decrease of fear of returning to an in-person school setting.”

The state continues to monitor multisystem inflammatory syndrome in children, a syndrome associated with COVID-19 that causes multiple organs to become inflamed, potentially cause long-term damage and even death. So far, 95 cases of MIS-C have been identified in Michigan children, resulting in five deaths.

The number of unvaccinated children in Michigan has been increasing since 2018 and experts fear during the pandemic, the number of vaccinated children will continue to dwindle.

According to data from the Michigan Care Improvement Registry, as of June, only 54% of Michigan children under 2 years old were fully immunized with recommended vaccines.

Dr. Arsala Bakhtyar, vice chief of pediatrics at Beaumont-Dearborn, said there's been an increase in people resistant to getting their children vaccinated, even for the routine vaccines that have been around for decades, but she's encouraged as more parents inquire about vaccines to combat the virus.

"Of course, there is hesitancy, but I really believe that since the vaccination started in 16 years and older, and the doctors were the first ones to get it and there were no major side effects that they noticed, more and more parents are asking if the little ones will be vaccinated," Bakhtyar said. "Children, on the other hand, are very excited that once they have the vaccine, they will return to school with their friends."

In Michigan, parents or guardians can obtain medical, religious or philosophical waivers for school vaccine requirements. From 2007 through 2019, most immunization waivers in Michigan, about 66%, were for philosophical reasons but religious waivers have increased from 17% to 29% in the last five years. About 5% of waivers were for medical reasons, according to the Michigan Department of Health and Human Services.

Doctors can't "unscare" parentswho are against a vaccine, Bakhtyar said,adding most parents who oppose vaccination also have likely not witnessed the severity of the deadly disease.

"Vaccine trials will not be successful if you don't enroll our children. So I encourage parents to step forward and enroll their children, to save other children," she said. "Once we have these trial results back, we can vaccinate about 85% to 90% of the population and develop the herd immunity that's needed to fight this pandemic and get rid of this disease."

Data on childhood vaccines can provide hints about how well the COVID-19 vaccine will perform in specific communities.

Vaccine trials underway 

Moderna last week kicked off the second phase of its "KidCOVE" study, testing the mRNA vaccine on young children, including babies.

It gave the first doses to children ages 6 months to 11 years old and plans to enroll approximately 6,750 healthy children in the U.S. and Canada by the end of spring. Some will receive the vaccine while others will receive a placebo. The Moderna trial is taking place in eight states, although not in Michigan.

Beaumont and Henry Ford Health System officials say they have not been asked to take part in the studies, but that could change should the trials advance to a third and final phase.

Pfizer and BioNTech have completed enrollment of more than 2,200 volunteers ages 12 to 15 and are in the third phase of their trials. They hope to report findings by June and open trials to kids ages 5 to 11 later this year.

Results from the trials are not expected until the end of the fourth quarter of 2021 or the start of 2022, Tan said.

Pfizer on Thursday said dosing has begun in a pediatric study that will involve more than 4,500 children under age 12, Bloomberg reported. The two-part trial will first study three dose levels in 144 children from age 6 months to 11 years, the company said in a statement. Once dosages are established for the three age groups, 4,500 more kids in the U.S. and Europe will be enrolled in the second part of the trial that is expected to last six months.

"It is unclear, at this time, what impact the emerging COVID-19 variants will have on the effectiveness of these vaccines, and we need to continue to track these to see whether there is a need for booster vaccines," Tan said.

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Once companies enroll kids, they have to administer two doses one month apart, monitor for side effects, and then study the immunogenicity data to see if children are producing antibodies after four to six weeks.

Beaumont's Bakhtyar, an infectious disease physician, said vaccinating young children and monitoring their immune response presents different challenges than adults.

"So scientists are trying to use the lowest possible dose, in order to mount an antibody response that is robust, yet does not cause side effects. It is definitely going to be challenging," she said.

Elizabeth Griem of Sterling Heights, one of three masterminds who set up the Detroit Area Vaccine Hunters Facebook group to help connect residents with expiring doses, says as a mom, she looks forward to the day her 2-year-old daughter, Aaliyah, is able to get the vaccine.

"Once it's approved by the CDC, I trust the science behind it," said Griem, 33. "She's up-to-date with her regular vaccines even during the pandemic. Right now, we mostly hear from a lot of moms on the page looking for vaccines for their 16- or 17-year-old kids and pregnant women looking for vaccines, too."

srahal@detroitnews.com

Twitter: @SarahRahal_