The state reported another child died of COVID-19 in Louisiana on Wednesday, the second death of a child in under a week.
In all, seven of the 16 deaths of children have come in the last three months, since the fourth wave of the pandemic began in early July.
Few have been more vocal or outraged by these deaths than Dr. Mark Kline, the physician-in-chief at Children’s Hospital New Orleans.
“Children are being put at risk for serious illness and death by unvaccinated adults,” he tweeted on Sunday.
“Is there an acceptable pediatric body count? I think not. If you’re an adult who cares about the health and well-being of children too young to be vaccinated, get the vaccine,” he continued. “It’s that simple.”
Children are being put at risk for serious illness and death by unvaccinated adults. Is there an acceptable pediatric body count? I think not. If you’re an adult who cares about the health and well-being of children too young to be vaccinated, get the vaccine. It’s that simple.
— Mark W. Kline, M.D. (@MarkWKlineMD1) September 19, 2021
The deaths came as Pfizer and BioNTech announced promising results from their vaccine trial for children ages 5 to 11. The companies said the trial showed the vaccine is safe and effective, prompting a strong antibody response against the virus.
The U.S. Food and Drug Administration will review the data, and Louisiana state health officer Dr. Joseph Kanter said approval could come as early as October or November.
If approved, the vaccine is “going to be a tremendous step forward,” especially for families younger children, Kanter said.
“We all kind of wanted to jump up and down cheering” after the Pfizer announcement, said Dr. William Lennarz, the system chair of pediatrics for Ochsner Health.
Here’s what you need to know about COVID, children and vaccinations.
What we know about the children who’ve died
The health department releases few details on these deaths, but it did say the child whose death was reported Wednesday was between the ages of 12 and 17.
The child whose death was reported last Friday was between the ages of 5 and 11, meaning that child had no opportunity to be vaccinated. In August the state reported the death of an infant under the age of 1.
More is known about one case, that of a 14-year-old high school football player from Baker, Louisiana named Patrick Sanders. His death was first reported by local media in late August. Local officials said Sanders died not long after a beloved police officer in the town also died of COVID-19.
“The loss of such a young life is always a tragedy and the preventable loss of that young life is heartbreaking,” Darnell Waites, the mayor of Baker, said in a statement. “Young Mr. Sanders had his entire life ahead of him; one full of ambition and promise.”
State health officer Dr. Joseph Kanter has used increasingly emotional language to describe these deaths. He’s also called the deaths “heartbreaking” and talked about “grieving as another promising young life ends too soon."
“We do see people who are young or very healthy, or both, get sick and even die, and we don't know why,” Kanter said. “And that's the scary thing about COVID.”
How and why kids are getting sick and dying of COVID-19
The deaths of children remain rare. The death toll this week has averaged 70 deaths a day in Louisiana. Kanter said the state has reported 50 to 150 deaths every day for the last month.
But child cases, hospitalizations and deaths have spiked dramatically in the fourth wave of the pandemic. That’s true across the country. Children make up one quarter of new COVID-19 cases, according to data compiled by the American Academy of Pediatrics.
Public health leaders and doctors say this is happening for two reasons.
The first is that people who are unvaccinated are spreading the virus. More than 80% of all cases, hospitalizations and deaths of COVID-19 in Louisiana are among people who have not been fully vaccinated.
The other driving factor is the delta variant. Health officials and doctors have repeatedly said we’re essentially in a new pandemic, because the delta variant is far, far more contagious.
Only about 53% of those eligible for a vaccine in Louisiana, people 12 years and up, are vaccinated. Vaccinations are lower among children: Only 36% of those 12 to 17 are vaccinated in Louisiana.
Those low vaccination rates are driving childhood disease from COVID-19.
“Kids are at the mercy of everyone else around them,” Kanter said.
Dr. William Lennarz, the system head of pediatrics for Ochsner Health, said that because children under aged 12 are 100% unvaccinated, they’re placed at a greater risk of contracting the virus.
He said the majority of kids being treated at Ochsner hospitals have at least one unvaccinated adult in their family.
“It's disappointing when a pediatric illness and certainly when a pediatric death may have been prevented by more adherence to public health advice, and particularly to the availability of vaccines,” he said.
Kline said infections mostly happen in the child’s home.
“It's a very traumatic experience for the families,” he said. “One can only imagine how it would feel to know that, that you transmitted the virus to your child, and then your child was severely ill and had to be hospitalized in an intensive care unit, or perhaps even died.”
There have been weeks during this fourth wave of the pandemic where the majority of patients being treated at Children’s Hospital New Orleans were under the age of 2, Kline added.
Physicians need to remain “as open as we can” to understand why parents might not be getting vaccinated, Lennarz said. Once a child is diagnosed or hospitalized with COVID-19, their parents often ask about getting vaccinated, he added.
How treatment for COVID-19 differs from treatment for adults
The best treatment for COVID-19 isn’t available for some children.
Monoclonal antibody treatments have been shown to decrease the chance of someone getting seriously ill from COVID-19, but children under the age of 12 aren’t eligible to receive these treatments because they haven’t been approved for that age group by the FDA (the treatment is under emergency use authorization for older children and adults).
That leaves doctors and nurses with trying to find ways of essentially trying to help the child’s body fight the disease on its own, Kline said.
That could mean oxygen, fluids, antibiotics, or certain steroids to help with inflammation. Or ECMO, which is a treatment where the blood is circulated outside of the child’s body.
What we know about vaccines for children under 12 years old
Only the Pfizer-BioNTech vaccine is approved for emergency use for ages 12 to 15. It has full approval for use in those 16 years of age and older.
Pfizer is also the only vaccine manufacturer to announce it will apply for emergency use authorization for use in children aged 5 to 11. It said the vaccine proved effective at a smaller dose than used in adults: 10 micrograms, compared to the 30 micrograms given to people 12 years and older.
The company said it will submit its data to the FDA. The next step would be an emergency use designation that would allow parents to vaccinate their young children for the first time since this pandemic began and seven months after anyone 16 or older was eligible for the vaccine in Louisiana.
“That will be a big, big moment for all,” Lennarz said.
“We have the chance for families to get their kids vaccinated ahead of the spring semester,” Kanter said. “And that would give a lot of confidence to people.”
Lennarz said parents have been waiting “anxiously” to vaccinate their kids. But it’s not clear whether all or even most parents will choose the vaccine. Only one in three children currently eligible for vaccines in Louisiana have had their shots.
Kanter said vaccination rates have slowed as the fourth surge of the pandemic has begun to decline, with hospitalizations falling to 1,221 from a high of over 3,000.
Misinformation around the vaccines also remains potent on social media.
Lennarz said he tells parents hesitant about the vaccines that “millions and millions of people have now received the vaccine without significant side effects” and that COVID-19 is far more likely to cause illness in children than the serious, but rare, complications from the vaccine.
“Not everyone has received, you know, the best information,” he said.
That’s been compounded by controversies over mask mandates in schools, which have highlighted opposition public health efforts to curb the spread of COVID-19.
Republicans in particular have criticized mask mandates in Louisiana schools. During the previous legislative session, some lawmakers and groups supporting anti-vaccine legislation repeated misinformation proven to be false. Republican Attorney General Jeff Landry has been fighting against vaccine mandates at colleges and sports arenas. Another prominent Republican, Congressman Steve Scalise, said he supported the vaccines, and then dismissed mask mandates as “government control.”
Kline has a plea for people in power, especially politicians, to spread the need for masks and vaccines, for people to make what he called these “modest” sacrifices.
“And as for everyone who's spreading misinformation, about vaccines, and about masks. Shame on you. People will die as a result,” Kline said.