When Aya Khalil’s youngest daughter recently tested positive for COVID-19, Khalil and her husband had to make a choice: bring their unvaccinated daughter to the hospital or keep her home. Her 2-year-old suffered a high fever that broke 105 degrees. But thousands of National Guard soldiers had been deployed to Toledo, where the family lives, following high rates of COVID-19 infections that crumbled Ohio’s health care system.
Khalil’s husband, a health care worker, knew that even if they wanted to take their sick child to see a doctor, she would likely not be able to get treated. They decided it was too risky and treated their toddler at home with over-the-counter medicine. Khalil’s daughter recovered, but the uncertainty of her condition had been terrifying.
“It was scary,” said Khalil, an Arab American author and working mother of three. “We thought that we were going to have to [bring her to the hospital] because she might get seizures if her fever stays high like that.”
Khalil admitted feeling more mentally exhausted than anything.
“I just feel like nobody cares about the kids anymore,” she said.
Children under 5-years-old remain unprotected from COVID-19 as the only age group in the U.S. that is unable to get vaccinated. With less access to health care, people of color are disproportionately more likely to contract and die from the virus. BIPOC are also more likely to live in high-infected areas, and are significantly more likely to hold “essential worker” job titles that make them more vulnerable to exposure. The delay in a vaccine for their young ones is especially worrisome.
The vaccine delay for young children is largely due to results from a clinical trial by Pfizer/BioNTech involving 2-to-4-year-olds, who were administered two 3-microgram doses of the vaccine but did not show a satisfactory immune response against the virus compared to older children who had received a larger vaccine dose. The company adjusted the study to give a third dose to the younger age group, but results from the amended vaccine trials are not expected until April. Moderna, the country’s other major vaccine developer, expects data for this age group by March.
The delays have pushed back government approval over a vaccine for younger children, leaving them unprotected as the more virulent Omicron variant ravages the U.S. The American Academy of Pediatrics and the Children’s Hospital Association reported nearly 1 million pediatric COVID-19 cases in the week of Jan. 13 alone, representing a 69% increase from the week before, which was 580,247 cases. According to numbers reported by state agencies, as of mid-January, children represent 21.4% of total weekly reported cases in the U.S. While children make up just a little over 22% of the total population, they represented only 17.3% of cases the week ending in Jan. 6. Beyond that, a total of 762 deaths among children from COVID-19 has been recorded between May 2020 and mid-January.
“In terms of an individual child that gets COVID, it’s a pretty low risk of them getting it,” said Adrian Zurca, the program director of the Pediatric Critical Care Fellowship at Penn State Health. “But … now with Omicron, so many kids are getting COVID. If you have a small percentage of a large number, it still ends up being a large number of children that are actually getting sick from it.”
Zurca said the surge of child infections has played out inside his own pediatric intensive care unit (PICU), with more children becoming acutely sick from the virus. Children with mild cases develop fevers and low oxygen levels that resolve within 48 hours. But severe cases have involved extreme organ inflammation and lung disease, which requires young patients to be put on ventilators.
“We’ve also seen a good amount of children that have had brain injury directly from COVID,” said Zurca, who estimated that his hospital unit had been receiving at least one child sick with COVID-19 every day since mid-December.
While the rest of the country seems to have moved on, parents of children under 5 years old are still awaiting access to vaccinations for their kids. Data from pediatric COVID-19 infections suggests this younger age group is now seeing a much higher rate of hospitalizations compared to older children, a portion of whom are vaccinated.
But a sick child at home can still be disastrous. After her toddler became sick, the rest of Khalil’s family was exposed to the virus, including her fully-vaccinated 6- and 9-year-olds. The older siblings tested positive for COVID and suffered low-grade fevers that lasted a few days.
“I tried to keep my [then-not sick] older daughter away from my toddler and my son. It worked for maybe one day,” she said. “It’s just really hard with the kids. They want to play, they want to see each other, and it was during winter break.”
Alyssa Reynoso-Morris, an Afro-Latiné mother of a 2-year-old in northeast Philadelphia, shared that limiting her daughter’s risk of exposure has been challenging since both she and her husband work. She counted herself among the lucky ones, having a supportive spouse and a mostly accommodating workplace. But her child’s needs and her work demands have inevitably collided at times.
“Like today, our day care is closed, so I had her in the morning, and I even had to bring her into work with me for a little bit,” said Reynoso-Morris, who works as chief-of-staff for a local state representative. It’s not something that can be helped for working parents, she said.
“We live in a society in which it’s seen as unprofessional for you to talk about your kids,” said Reynoso-Morris, noting a shift in workplace norms since the pandemic. “In a lot of ways, that’s really detrimental as a society because it’s hard to … work well together if we don’t see each other’s common humanity.”
Balancing work and protecting their unvaccinated child is especially challenging for parents who are health care workers. Zurca, a father of three biracial Asian/Latinx children, including an unvaccinated 3-year-old, has constantly worried about bringing the virus home, particularly as a pediatrician who understands the severe damage it can wreak on children’s health. In October, after an intense school board meeting where unmasked people protested health mandates, the family relocated to a new home in another district.
“It was hard to be living along people that felt so differently about how we feel about safety and child health,” said Zurca, who masks up and isolates at home from his wife and kids whenever he suspects COVID-19 symptoms. “It felt very selfish … people were just willing to put other people’s lives at risk for their own comfort, or their own individual perceived rights.”
Amid the challenges, parents continue to hope that a safe vaccine for their young children will be developed soon. If a safe vaccine for her toddler were accessible next week, Khalil, the mother of three, said, “I’ll be first in line.”