Features
The conundrum of Covid vaccines for children, adolescents and youth
By Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL).
Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
There is a lot of interest as well as differences of opinion and even misinformation regarding many aspects of vaccination of children, and young people, against Covid-19. This has led to a considerable amount of anxiety in the minds of parents, and even the youth themselves, regarding the different facets of vaccinating these subjects against the coronavirus infection that is running riot, all over the world, including Sri Lanka. Against this background, it is also pertinent to point out that there is a very definite recent increase in the numbers of children who have tested positive for the coronavirus disease, especially in some of the developed countries with facilities available for large scale testing of the general population.
There is a considerable number of differing opinions expressed regarding the need to vaccinate these age groups of subjects. True enough, it is argued that children, and young people, are not as susceptible to major effects. However, there are documented cases, though quite rare, of children, and young people, getting the Multisystem Inflammatory Syndrome (MIS-C) complication of Covid-19. That particular problem could affect several body systems and organs. It is a somewhat delayed but a rather nasty complication which, if it is not properly and promptly treated, could even lead to death. Then, of course, there is the spectacle of ‘Long Covid’, where there are persistent symptoms, particularly of a respiratory nature, for quite some time, after apparent recovery from symptomatic Covid-19. There are some reports of persistent vague symptoms, even in those who were originally not sick with symptomatic disease. It is also noteworthy that there are reports of significant x-ray changes that have been detected in some completely asymptomatic positive cases. It must also be considered that the clinical picture of Covid-19, in children, seems to fluctuate considerably, over different time periods. There is no guarantee that there is no risk at all of the disease suddenly turning quite virulent and starting to produce marked and severe symptoms, even in children. This is particularly of relevance in view of the propensity for the coronavirus to undergo mutations, as it keeps on replicating.
Children rarely become severely ill from Covid-19. However, in the US, in August, 2021, the Delta variant has landed nearly 30,000 of them in hospital. According to the American Academy of Pediatrics, nearly 5.9 million Americans younger than 18, have been infected with the coronavirus. Of the roughly 500 Americans, under 18, who have died, about 125 were aged 5 to 11. “It really bothers me when people say kids don’t die of Covid”, said Dr. Grace Lee, an Associate Chief Medical Officer, at Stanford Children’s Health, who also leads a key Advisory Committee to the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. She also said “They die of Covid. It’s heart-breaking”. About one in six Americans infected, since the beginning of the pandemic, was under 18. But with the surge of the Delta variant, children accounted for as many as one in four infections in recent times, according to the American Academy of Pediatrics.
Then, of course, there is the problem of asymptomatic afflicted children carrying the virus around and spreading it, and, perhaps, much more importantly, the scenario of them taking it home and infecting susceptible adults and the elderly. With rather close gatherings during transport, to and from schools, and also in the classrooms themselves, the risks of these children contracting the virus is something quite real. There are some sporadic studies that indicate that there is some protection provided by the vaccines in actually preventing, to a certain degree, the exposed individuals from contracting the virus. This is, of course, is not 100% protection by any means, but is a rather minor but a positive reason for vaccination.
At this point in time, the only coronavirus vaccine that is universally authorised to be administered to children and, young people, over the age of 12, is the mRNA Pfizer – BioNTech Covid-19 (BNT162b2) vaccine, with the brand name “Comirnaty”. The European countries, and Australia, have been provided provisional authorisation for the use of the Moderna mRNA-1273 vaccine with the brand name “Spikevax” in those over 12 years of age. In several studies, the effectiveness of these vaccines, as well as their safety, have been established.
Yet for all that, there are some of the more recent reports of the occurrence of the extremely rare complications of myocarditis and pericarditis occurring, especially in adolescent and young males with all mRNA Covid-19 vaccines, particularly after the second dose of the vaccine, occurring typically within a few days after vaccination. Myocarditis is an inflammation of the heart muscle and pericarditis is an inflammation of the lining that surrounds the heart. Available data suggest that the immediate course of myocarditis and pericarditis, following vaccination, is generally mild and responds to conservative treatment. So far, major problems, with long-term heart functions, have been see in these cases and follow-up is ongoing to determine possible long-term outcomes. All young recipients of mRNA vaccines should be instructed to report for medical attention if they develop symptoms, indicative of myocarditis or pericarditis such as new onset and persisting chest pain, shortness of breath, or palpitations, following vaccination against Covid-19. It has to be reiterated that these complications are extremely rare. In the USA there have been no deaths reported in young people developing myocarditis, following mRNA Covid-19 vaccines.
In a most reassuring publication, released on 22nd October 2021, hot off the oven so to speak, both BNT162b2 (Pfizer-BioNTech) and ChAdOx1 nCoV-19 (AstraZeneca) vaccines offered substantial protection against death from coronavirus disease 2019 (COVID-19) caused by the B.1.617.2 (Delta) variant, according to a study published in The New England Journal of Medicine. Meanwhile, another study, also published recently in The New England Journal of Medicine, suggests that the BNT162b2 (Pfizer-BioNTech) vaccine was highly effective against both documented infection and symptomatic COVID-19 with the Delta variant among adolescents, between the ages of 12 and 18 years. The latest information available to us seem to confirm the benefits of Covid-19 vaccinations in adolescents and young people.
The most recent development, from the standpoint of Covid-19 vaccinations for children, is the application due to be made by Pfizer to the Food and Drugs Administration (FDA) of USA for authorisation for usage of its Covid-19 vaccine for children, 5 to 11 years of age. In a highly anticipated announcement, Pfizer has said that a Phase 2/3 trial showed its Covid-19 vaccine was safe and generated a “robust” antibody response in children, aged 5 to 11.
These are the first such results released for this age group for a USA Covid-19 vaccine.
The trial included 2,268 participants, ages 5 to 11, and used a two-dose regimen of the vaccine, administered 21 days apart. This trial used a 10-microgram dose, which is one third of the 30-microgram dose that has been used for those 12 and older. Pfizer has said that the 10-microgram dose was carefully selected as the preferred dose for safety, tolerability and immunogenicity in children 5 to 11 years of age.
Participants’ immune responses were measured by looking at neutralising antibody levels in their blood and comparing those levels to a control group of 16 to 25-year-olds who were given a two-dose regimen with the larger 30-microgram dose. Pfizer has said the levels compared well with older people who received the larger dose, demonstrating a “strong immune response in this cohort of children, one month after the second dose”. They have further stated that the vaccine was well tolerated, with side effects generally comparable to those observed in participants, 16 to 25 years of age.
However, it is a matter for some concern that this data has not yet been peer-reviewed or published in a reputed medical journal. Pfizer has said that it plans to submit the data directly to the US Food and Drug Administration for emergency use authorisation. Apparently, the FDA officials have said that once the data is submitted, the agency could authorise the vaccine for younger children, in a matter of weeks.
Albert Bourla, Chairman and Chief Executive Officer of Pfizer, said in a statement “Since July 2021, pediatric cases of COVID-19 have risen by about 240 percent in the USA, underscoring the public health need for vaccination. These trial results provide a strong foundation for seeking authorisation of our vaccine for children 5 to 11 years old, and we plan to submit them to the FDA and other regulators with urgency”. Pfizer also said that it is expecting trial data for children as young as six months as soon as the fourth quarter of this year.
In addition, Moderna Incorporated plans for double enrolment in a trial of its Covid-19 vaccine in children under age 12, following a request from U.S. regulators to collect additional safety data. Moderna’s study will enrol an estimated 13,275 participants aged 6 months up to 12 years old, according to a listing on the clinicaltrials.gov website. In a post from late July, the Cambridge, Massachusetts-based company said it would seek to enrol about 7,000.
As things stand now, the scientific information regarding the feasibility of administering the Covid-19 vaccination to very young children is, at best, in a state of flux at the present time. We need to await the results of several on-going Clinical Trials. The Sri Lanka College of Paediatricians will keep a close watch on the developments and would take all necessary steps to advise the authorities on the best course of action, when more tangible evidence from Clinical Trials emerge in the future.
The gut-feeling of a lot of authorities involved in child healthcare is that it would be possible to vaccinate even young children against Covid-19 in the not-too-distant future. The benefits due to be gained seemingly appear to be that much more important and would override the very rare undesirable effects in our quest towards victory over this pandemic that has brought the entire world to its knees.
Features
How Black Civil Rights leaders strengthen democracy in the US
On being elected US President in 2008, Barack Obama famously stated: ‘Change has come to America’. Considering the questions continuing to grow out of the status of minority rights in particular in the US, this declaration by the former US President could come to be seen as somewhat premature by some. However, there could be no doubt that the election of Barack Obama to the US presidency proved that democracy in the US is to a considerable degree inclusive and accommodating.
If this were not so, Barack Obama, an Afro-American politician, would never have been elected President of the US. Obama was exceptionally capable, charismatic and eloquent but these qualities alone could not have paved the way for his victory. On careful reflection it could be said that the solid groundwork laid by indefatigable Black Civil Rights activists in the US of the likes of Martin Luther King (Jnr) and Jesse Jackson, who passed away just recently, went a great distance to enable Obama to come to power and that too for two terms. Obama is on record as owning to the profound influence these Civil Rights leaders had on his career.
The fact is that these Civil Rights activists and Obama himself spoke to the hearts and minds of most Americans and convinced them of the need for democratic inclusion in the US. They, in other words, made a convincing case for Black rights. Above all, their struggles were largely peaceful.
Their reasoning resonated well with the thinking sections of the US who saw them as subscribers to the Universal Declaration of Human Rights, for instance, which made a lucid case for mankind’s equal dignity. That is, ‘all human beings are equal in dignity.’
It may be recalled that Martin Luther King (Jnr.) famously declared: ‘I have a dream that one day this nation will rise up, live out the true meaning of its creed….We hold these truths to be self-evident, that all men are created equal.’
Jesse Jackson vied unsuccessfully to be a Democratic Party presidential candidate twice but his energetic campaigns helped to raise public awareness about the injustices and material hardships suffered by the black community in particular. Obama, we now know, worked hard at grass roots level in the run-up to his election. This experience proved invaluable in his efforts to sensitize the public to the harsh realities of the depressed sections of US society.
Cynics are bound to retort on reading the foregoing that all the good work done by the political personalities in question has come to nought in the US; currently administered by Republican hard line President Donald Trump. Needless to say, minority communities are now no longer welcome in the US and migrants are coming to be seen as virtual outcasts who need to be ‘shown the door’ . All this seems to be happening in so short a while since the Democrats were voted out of office at the last presidential election.
However, the last US presidential election was not free of controversy and the lesson is far too easily forgotten that democratic development is a process that needs to be persisted with. In a vital sense it is ‘a journey’ that encounters huge ups and downs. More so why it must be judiciously steered and in the absence of such foresighted managing the democratic process could very well run aground and this misfortune is overtaking the US to a notable extent.
The onus is on the Democratic Party and other sections supportive of democracy to halt the US’ steady slide into authoritarianism and white supremacist rule. They would need to demonstrate the foresight, dexterity and resourcefulness of the Black leaders in focus. In the absence of such dynamic political activism, the steady decline of the US as a major democracy cannot be prevented.
From the foregoing some important foreign policy issues crop-up for the global South in particular. The US’ prowess as the ‘world’s mightiest democracy’ could be called in question at present but none could doubt the flexibility of its governance system. The system’s inclusivity and accommodative nature remains and the possibility could not be ruled out of the system throwing up another leader of the stature of Barack Obama who could to a great extent rally the US public behind him in the direction of democratic development. In the event of the latter happening, the US could come to experience a democratic rejuvenation.
The latter possibilities need to be borne in mind by politicians of the South in particular. The latter have come to inherit a legacy of Non-alignment and this will stand them in good stead; particularly if their countries are bankrupt and helpless, as is Sri Lanka’s lot currently. They cannot afford to take sides rigorously in the foreign relations sphere but Non-alignment should not come to mean for them an unreserved alliance with the major powers of the South, such as China. Nor could they come under the dictates of Russia. For, both these major powers that have been deferentially treated by the South over the decades are essentially authoritarian in nature and a blind tie-up with them would not be in the best interests of the South, going forward.
However, while the South should not ruffle its ties with the big powers of the South it would need to ensure that its ties with the democracies of the West in particular remain intact in a flourishing condition. This is what Non-alignment, correctly understood, advises.
Accordingly, considering the US’ democratic resilience and its intrinsic strengths, the South would do well to be on cordial terms with the US as well. A Black presidency in the US has after all proved that the US is not predestined, so to speak, to be a country for only the jingoistic whites. It could genuinely be an all-inclusive, accommodative democracy and by virtue of these characteristics could be an inspiration for the South.
However, political leaders of the South would need to consider their development options very judiciously. The ‘neo-liberal’ ideology of the West need not necessarily be adopted but central planning and equity could be brought to the forefront of their talks with Western financial institutions. Dexterity in diplomacy would prove vital.
Features
Grown: Rich remnants from two countries
Whispers of Lanka
I was born in a hamlet on the western edge of a tiny teacup bay named Mirissa on the South Coast of Sri Lanka. My childhood was very happy and secure. I played with my cousins and friends on the dusty village roads. We had a few toys to play with, so we always improvised our own games. On rainy days, the village roads became small rivulets on which we sailed paper boats. We could walk from someone’s backyard to another, and there were no fences. We had the freedom to explore the surrounding hills, valleys, and streams.
I was good at school and often helped my classmates with their lessons. I passed the General Certificate of Education (Ordinary Level) at the village school and went to Colombo to study for the General Certificate of Education (Advanced Level). However, I did not like Colombo, and every weekend I hurried back to the village. I was not particularly interested in my studies and struggled in specific subjects. But my teachers knew that I was intelligent and encouraged me to study hard.
To my amazement, I passed the Advanced Level, entered the University of Kelaniya, completed an honours degree in Economics, taught for a few months at a central college, became a lecturer at the same university, and later joined the Department of Census and Statistics as a statistician. Then I went to the University of Wales in the UK to study for an MSc.
The interactions with other international students in my study group, along with very positive recommendations from my professors, helped me secure several jobs in the oil-rich Middle Eastern countries, where I earned salaries unimaginable in Sri Lankan terms. During this period, without much thought, I entered a life focused on material possessions, social status, and excessive consumerism.
Life changes
Unfortunately, this comfortable, enjoyable life changed drastically in the mid-1980s because of the political activities of certain groups. Radicalised youths, brainwashed and empowered by the dynamics of vibrant leftist politics, killed political opponents as well as ordinary people who were reluctant to follow their orders. Their violent methods frightened a large section of Sri Lanka’s middle class into reluctantly accepting country-wide closures of schools, factories, businesses, and government offices.
My father’s generation felt a deep obligation to honour the sacrifices they had made to give us everything we had. There was a belief that you made it in life through your education, and that if you had to work hard, you did. Although I had never seriously considered emigration before, our sons’ education was paramount, and we left Sri Lanka.
Although there were regulations on what could be brought in, migrating to Sydney in the 1980s offered a more relaxed airport experience, with simpler security, a strong presence of airline staff, and a more formal atmosphere. As we were relocating permanently, a few weeks before our departure, we had organised a container to transport sentimental belongings from our home. Our flight baggage was minimal, which puzzled the customs officer, but he laughed when he saw another bulky item on a separate trolley. It was a large box containing a bookshelf purchased in Singapore. Upon discovering that a new migrant family was arriving in Australia with a 32-volume Encyclopaedia Britannica set weighing approximately 250 kilograms, he became cheerful, relaxed his jaw, and said, G’day!
Settling in Sydney
We settled in Epping, Sydney, and enrolled our sons in Epping Boys’ High School. Within one week of our arrival from Sri Lanka, we both found jobs: my wife in her usual accounting position in the private sector, and I was taken on by the Civil Aviation Authority (CAA). While working at the CAA, I sat the Australian Graduate Admission Test. I secured a graduate position with the Australian Bureau of Statistics (ABS) in Canberra, ACT.
We bought a house in Florey, close to my office in Belconnen. The roads near the house were eerily quiet. Back in my hometown of Pelawatta, outside Colombo, my life had a distinct soundtrack. I woke up every morning to the radios blasting ‘pirith’ from the nearby houses; the music of the bread delivery van announcing its arrival, an old man was muttering wild curses to someone while setting up his thambili cart near the junction, free-ranging ‘pariah’ dogs were barking at every moving thing and shadows. Even the wildlife was noisy- black crows gathered on the branches of the mango tree in front of the house to perform a mournful dirge in the morning.
Our Australian neighbours gave us good advice and guidance, and we gradually settled in. If one of the complaints about Asians is that they “won’t join in or integrate to the same degree as Australians do,” this did not apply to us! We never attempted to become Aussies; that was impossible because we didn’t have tanned skin, hazel eyes, or blonde hair, but we did join in the Australian way of life. Having a beer with my next-door neighbour on the weekend and a biannual get-together with the residents of the lane became a routine. Walking or cycling ten kilometres around the Ginninderra Lake with a fit-fanatic of a neighbour was a weekly ritual that I rarely skipped.
Almost every year, early in the New Year, we went to the South Coast. My family and two of our best friends shared a rented house near the beach for a week. There’s not much to do except mix with lots of families with kids, dogs on the beach, lazy days in the sun with a barbecue and a couple of beers in the evening, watching golden sunsets. When you think about Australian summer holidays, that’s all you really need, and that’s all we had!
Caught between two cultures
We tried to hold on to our national tradition of warm hospitality by organising weekend meals with our friends. Enticed by the promise of my wife’s home-cooked feast, our Sri Lankan friends would congregate at our place. Each family would also bring a special dish of food to share. Our house would be crammed with my friends, their spouses and children, the sound of laughter and loud chatter – English mingled with Sinhala – and the aroma of spicy food.
We loved the togetherness, the feeling of never being alone, and the deep sense of belonging within the community. That doesn’t mean I had no regrets in my Australian lifestyle, no matter how trivial they may have seemed. I would have seen migration to another country only as a change of abode and employment, and I would rarely have expected it to bring about far greater changes to my psychological role and identity. In Sri Lanka, I have grown to maturity within a society with rigid demarcation lines between academic, professional, and other groups.
Furthermore, the transplantation from a patriarchal society where family bonds were essential to a culture where individual pursuit of happiness tended to undermine traditional values was a difficult one for me. While I struggled with my changing role, my sons quickly adopted the behaviour and aspirations of their Australian peers. A significant part of our sons’ challenges lay in their being the first generation of Sri Lankan-Australians.
The uniqueness of the responsibilities they discovered while growing up in Australia, and with their parents coming from another country, required them to play a linguistic mediator role, and we, as parents, had to play the cultural mediator role. They were more gregarious and adaptive than we were, and consequently, there was an instant, unrestrained immersion in cultural diversity and plurality.
Technology
They became articulate spokesmen for young Australians growing up in a world where information technology and transactions have become faster, more advanced, and much more widespread. My work in the ABS for nearly twenty years has followed cycles, from data collection, processing, quality assurance, and analysis to mapping, research, and publishing. As the work was mainly computer-based and required assessing and interrogating large datasets, I often had to depend heavily on in-house software developers and mainframe programmers. Over that time, I have worked in several areas of the ABS, making a valuable contribution and gaining a wide range of experience in national accounting.
I immensely valued the unbiased nature of my work, in which the ABS strived to inform its readers without the influence of public opinion or government decisions. It made me proud to work for an organisation that had a high regard for quality, accuracy, and confidentiality. I’m not exaggerating, but it is one of the world’s best statistical organisations! I rubbed shoulders with the greatest statistical minds. The value of this experience was that it enabled me to secure many assignments in Vanuatu, Fiji, East Timor, Saudi Arabia, and the Solomon Islands through the World Bank and the International Monetary Fund after I left the ABS.
Living in Australia
Studying and living in Australia gave my sons ample opportunities to realise that their success depended not on acquiring material wealth but on building human capital. They discovered that it was the sum total of their skills embodied within them: education, intelligence, creativity, work experience and even the ability to play basketball and cricket competitively. They knew it was what they would be left with if someone stripped away all of their assets. So they did their best to pursue their careers on that path and achieve their life goals. Of course, the healthy Australian economy mattered too. As an economist said, “A strong economy did not transform a valet parking attendant into a professor. Investment in human capital did that.”
Nostalgia
After living in Australia for several decades, do I miss Sri Lanka? Which country deserves my preference, the one where I was born or the one to which I migrated? There is no single answer; it depends on opportunities, prospects, lifestyle, and family. Factors such as the cost of living, healthcare, climate, and culture also play significant roles in shaping this preference. Tradition in a slow-motion place like Sri Lanka is an ethical code based on honouring those who do things the same way you do, and dishonour those who don’t. However, in Australia, one has the freedom to express oneself, to debate openly, to hold unconventional views, to be more immune to peer pressure, and not to have one’s every action scrutinised and discussed.
For many years, I have navigated the challenges of cultural differences, conflicting values, and the constant negotiation of where I truly ‘belong.’ Instead of yearning for a ‘dream home’ where I once lived, I have struggled, and to some extent succeeded, to find a home where I live now. This does not mean I have forgotten or discarded my roots. As one Sri Lankan-Australian senior executive remarked, “I have not restricted myself to the box I came in… I was not the ethnicity, skin colour, or lack thereof, of the typical Australian… but that has been irrelevant to my ability to contribute to the things which are important to me and to the country adopted by me.” Now, why do I live where I live – in that old house in Florey? I love the freshness of the air, away from the city smog, noisy traffic, and fumes. I enjoy walking in the evening along the tree-lined avenues and footpaths in my suburb, and occasionally I see a kangaroo hopping along the nature strip. I like the abundance of trees and birds singing at my back door. There are many species of birds in the area, but a common link with ours is the melodious warbling of resident magpies. My wife has been feeding them for several years, and we see the new fledglings every year. At first light and in the evening, they walk up to the back door and sing for their meal. The magpie is an Australian icon, and I think its singing is one of the most melodious sounds in the suburban areas and even more so in the bush.
by Siri Ipalawatte
Features
Big scene for models…
Modelling has turned out to be a big scene here and now there are lots of opportunities for girls and boys to excel as models.
Of course, one can’t step onto the ramp without proper training, and training should be in the hands of those who are aware of what modelling is all about.
Rukmal Senanayake is very much in the news these days and his Model With Ruki – Model Academy & Agency – is responsible for bringing into the limelight, not only upcoming models but also contestants participating in beauty pageants, especially internationally.
On the 29th of January, this year, it was a vibrant scene at the Temple Trees Auditorium, in Colombo, when Rukmal introduced the Grey Goose Road To Future Model Hunt.

Tharaka Gurukanda … in
the scene with Rukmal
This is the second Model Hunt to be held in Sri Lanka; the first was in 2023, at Nelum Pokuna, where over 150 models were able to showcase their skills at one of the largest fashion ramps in Sri Lanka.
The concept was created by Rukmal Senanayake and co-founded by Tharaka Gurukanda.
Future Model Hunt, is the only Southeast Asian fashion show for upcoming models, and designers, to work along and create a career for their future.
The Grey Goose Road To Future Model Hunt, which showcased two segments, brought into the limelight several models, including students of Ruki’s Model Academy & Agency and those who are established as models.
An enthusiastic audience was kept spellbound by the happenings on the ramp.

Doing it differently
Four candidates were also crowned, at this prestigious event, and they will represent Sri Lanka at the respective international pageants.
Those who missed the Grey Goose Road To Future Model Hunt, held last month, can look forward to another exciting Future Model Hunt event, scheduled for the month of May, 2026, where, I’m told, over 150 models will walk the ramp, along with several designers.
It will be held at a prime location in Colombo with an audience count, expected to be over 2000.
Model With Ruki offers training for ramp modelling and beauty pageants and other professional modelling areas.
Their courses cover: Ramp walk techniques, Posture and grooming, Pose and expression, Runway etiquette, and Photo shoots and portfolio building,
They prepare models for local and international fashion events, shoots, and competitions and even send models abroad for various promotional events.
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