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Covid-19 vaccines for children: Latest medical information

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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.

Joint Editor, Sri Lanka Journal of Child Health

Section Editor, Ceylon Medical Journal

In these days of evident uncertainty regarding the likely progress of the SARS-CoV-2, the causative virus of COVID-19, there is a state of apprehension and intense anxiety amongst the general populace of our country. With the added complication of several mutant variants, all designated by the letters of the Greek alphabet, the melting pot actually boils and even overflows.

In addition to scientific data and proper pedagogic assessments, there is a lot of misinformation and disinformation, particularly regarding the COVID-19 vaccines in all kinds of print and electronic media. Some totally unsubstantiated allegations, stipulations, postulations and prophesies of gloom, are being made and widely circulated for the consumption of the general public, particularly through social media. People who flatly refuse to take the vaccine, those who are hesitant to receive it and confirmed anti-vaxxers are having a field day in trying to dissuade the general public from taking the vaccine.

This situation is of particular concern when such false proclamations tend to intensely discourage children being given the vaccine. In this paradise isle, firstly it was the front-line healthcare workers and the tri-forces who were prioritised to receive the vaccine. Then came the over 60-year-olds, especially those who have on-going comorbid diseases. Following that, young adults and those under 60 years with coexisting other diseases were lined up. Then the authorities started to vaccinate all those from 19 to 60 years of age followed by students in the higher classes of 15 to 19 years of age and those over 12 years with coexistent diseases that make them vulnerable. The latest initiative of the government, based on medical advice, is to vaccinate all children from 12 to 15 years of age, starting from 07th January 2022.

The anti-vaxxers and their ilk have put forward many ‘faults and complications’ of the vaccines to dissuade others from taking the vaccine and also desist from giving it to their children. They, the antivaxxers, first blew up, out of all proportions, the issue of clotting disorders after COVID vaccinations. True enough it could occur but it is a very rare phenomenon. An erudite article published in the reputed journal Nature on 24th August 2021 estimated these clotting problems to occur in or less than 1 in 50,000 of those under 50 years of age who have received the Oxford-AstraZenica vaccine.

Then came the canard of reduced sexual prowess and sub-fertility induced by the vaccine in young people. This is a total myth and there is no scientific evidence whatsoever for this miserable contention. There is no authentic research communication to the veracity of it at all. This ‘rumour’ totally discouraged a lot of youth, young people and young adults from taking the vaccine, without any justification for that action at all.

The most recent adverse effect that has been brought to light is the occurrence of myocarditis and to a lesser extent, pericarditis, following the vaccine. The human heart is a muscular pump and myocarditis refers to inflammation of the specialised muscle fibres in the human heart. Pericarditis denotes inflammation of the membrane, the pericardium, that covers the external surface of the human heart. These inflammatory complications are seen in young adults and children and are extremely rare. An article in a Pre-print journal medRxiv, posted on 05th December 2021, estimated that these complications occurred in 297 out of a total of 19,740,741doses of the m-RNA vaccines administered. This gives a rate of 15 per million doses or 1.5 per one hundred thousand. Symptomatic myocarditis is relatively mild and does not cause long-term heart damage. Many scientific articles that have looked at this complication have not reported any deaths. In fact, COVID-19 disease itself could cause myocarditis, with an incidence of 28 percent (28,000 per 100,000) of all hospitalised patients with COVID-19. The considered opinion of the scientific community is that the complication rate of the disease itself is much more than the adverse effects such as myocarditis that could occur with the vaccine itself.

Yet for all that, one must always keep in mind that these complication rates cannot be superimposed on to given individuals. In other words, if for example, the hypothetical incidence is one in 50,000, when one looks at a single person who is to be given the vaccine, we have no way of knowing for sure whether that individual may or may not be the one to get the complication. The scientifically quoted rates only confirm their rarity or higher incidence and prevalence, as the case may be. Safe, effective vaccines against coronavirus disease 2019 (Covid-19) are urgently needed in children younger than 12 years of age. There are some recent developments regarding the feasibility of vaccinating children under 12 years. A phase 1, dose-finding study and an ongoing phase 2–3 randomised trial are being conducted to investigate the safety, immunogenicity, and efficacy of two doses of the BNT162b2 Pfizer vaccine administered 21 days apart to children six months to 11 years of age.

From the results of that study, in a scientific paper published in the most prestigious New England Journal of Medicine on 06th January 2022, the researchers have shown that a Covid-19 vaccination regimen consisting of two 10-microgram doses of the Pfizer vaccine, administered 21 days apart, was found to be safe, immunogenic and efficacious in children 5 to 11 years of age. It is noteworthy that the 10-microgram dose is one third of the adult dose of 30 microgram and two doses that are 21 days apart are needed.

In addition, the United States Centers for Disease Control and Prevention’s (CDC’s) latest Morbidity and Mortality Weekly Report details the preliminary safety findings for the administration of Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine among children aged five to 11 years.

To characterise safety of the vaccine in children aged 5 to 11 years, the CDC reviewed adverse events after receipt of Pfizer-BioNTech COVID-19 vaccine reported to the Vaccine Adverse Event Reporting System (VAERS), a passive vaccine safety surveillance system co-managed by CDC and United States Food and Drug Administration, from November 3 to December 19, 2021. Approximately 8.7 million doses of Pfizer-BioNTech COVID-19 vaccine were administered to children agedfive to 11 years during this period. They found that 97.6 percent of the adverse reactions reported were not serious. There were 11 children who developed myocarditis and all recovered with no long-term heart problems.

Currently in Sri Lanka, only a single dose of Pfizer vaccine is given to children and young people. This position will need to be re-evaluated and revisions made thereof, if and when more scientific information becomes available. We are continuously learning about COVID-19 on the go and nothing is written in stone to stay like that forever. Flexibility with decisions being made on robust scientific grounds would be the way to go in the future.



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US’ drastic aid cut to UN poses moral challenge to world

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An UN humanitarian mission in the Gaza. [File: Ashraf Amra/Anadolu Agency]

‘Adapt, shrink or die’ – thus runs the warning issued by the Trump administration to UN humanitarian agencies with brute insensitivity in the wake of its recent decision to drastically reduce to $2bn its humanitarian aid to the UN system. This is a substantial climb down from the $17bn the US usually provided to the UN for its humanitarian operations.

Considering that the US has hitherto been the UN’s biggest aid provider, it need hardly be said that the US decision would pose a daunting challenge to the UN’s humanitarian operations around the world. This would indeed mean that, among other things, people living in poverty and stifling material hardships, in particularly the Southern hemisphere, could dramatically increase. Coming on top of the US decision to bring to an end USAID operations, the poor of the world could be said to have been left to their devices as a consequence of these morally insensitive policy rethinks of the Trump administration.

Earlier, the UN had warned that it would be compelled to reduce its aid programs in the face of ‘the deepest funding cuts ever.’ In fact the UN is on record as requesting the world for $23bn for its 2026 aid operations.

If this UN appeal happens to go unheeded, the possibilities are that the UN would not be in a position to uphold the status it has hitherto held as the world’s foremost humanitarian aid provider. It would not be incorrect to state that a substantial part of the rationale for the UN’s existence could come in for questioning if its humanitarian identity is thus eroded.

Inherent in these developments is a challenge for those sections of the international community that wish to stand up and be counted as humanists and the ‘Conscience of the World.’ A responsibility is cast on them to not only keep the UN system going but to also ensure its increased efficiency as a humanitarian aid provider to particularly the poorest of the poor.

It is unfortunate that the US is increasingly opting for a position of international isolation. Such a policy position was adopted by it in the decades leading to World War Two and the consequences for the world as a result for this policy posture were most disquieting. For instance, it opened the door to the flourishing of dictatorial regimes in the West, such as that led by Adolph Hitler in Germany, which nearly paved the way for the subjugation of a good part of Europe by the Nazis.

If the US had not intervened militarily in the war on the side of the Allies, the West would have faced the distressing prospect of coming under the sway of the Nazis and as a result earned indefinite political and military repression. By entering World War Two the US helped to ward off these bleak outcomes and indeed helped the major democracies of Western Europe to hold their own and thrive against fascism and dictatorial rule.

Republican administrations in the US in particular have not proved the greatest defenders of democratic rule the world over, but by helping to keep the international power balance in favour of democracy and fundamental human rights they could keep under a tight leash fascism and linked anti-democratic forces even in contemporary times. Russia’s invasion and continued occupation of parts of Ukraine reminds us starkly that the democracy versus fascism battle is far from over.

Right now, the US needs to remain on the side of the rest of the West very firmly, lest fascism enjoys another unfettered lease of life through the absence of countervailing and substantial military and political power.

However, by reducing its financial support for the UN and backing away from sustaining its humanitarian programs the world over the US could be laying the ground work for an aggravation of poverty in the South in particular and its accompaniments, such as, political repression, runaway social discontent and anarchy.

What should not go unnoticed by the US is the fact that peace and social stability in the South and the flourishing of the same conditions in the global North are symbiotically linked, although not so apparent at first blush. For instance, if illegal migration from the South to the US is a major problem for the US today, it is because poor countries are not receiving development assistance from the UN system to the required degree. Such deprivation on the part of the South leads to aggravating social discontent in the latter and consequences such as illegal migratory movements from South to North.

Accordingly, it will be in the North’s best interests to ensure that the South is not deprived of sustained development assistance since the latter is an essential condition for social contentment and stable governance, which factors in turn would guard against the emergence of phenomena such as illegal migration.

Meanwhile, democratic sections of the rest of the world in particular need to consider it a matter of conscience to ensure the sustenance and flourishing of the UN system. To be sure, the UN system is considerably flawed but at present it could be called the most equitable and fair among international development organizations and the most far-flung one. Without it world poverty would have proved unmanageable along with the ills that come along with it.

Dehumanizing poverty is an indictment on humanity. It stands to reason that the world community should rally round the UN and ensure its survival lest the abomination which is poverty flourishes. In this undertaking the world needs to stand united. Ambiguities on this score could be self-defeating for the world community.

For example, all groupings of countries that could demonstrate economic muscle need to figure prominently in this initiative. One such grouping is BRICS. Inasmuch as the US and the West should shrug aside Realpolitik considerations in this enterprise, the same goes for organizations such as BRICS.

The arrival at the above international consensus would be greatly facilitated by stepped up dialogue among states on the continued importance of the UN system. Fresh efforts to speed-up UN reform would prove major catalysts in bringing about these positive changes as well. Also requiring to be shunned is the blind pursuit of narrow national interests.

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Egg white scene …

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Hi! Great to be back after my Christmas break.

Thought of starting this week with egg white.

Yes, eggs are brimming with nutrients beneficial for your overall health and wellness, but did you know that eggs, especially the whites, are excellent for your complexion?

OK, if you have no idea about how to use egg whites for your face, read on.

Egg White, Lemon, Honey:

Separate the yolk from the egg white and add about a teaspoon of freshly squeezed lemon juice and about one and a half teaspoons of organic honey. Whisk all the ingredients together until they are mixed well.

Apply this mixture to your face and allow it to rest for about 15 minutes before cleansing your face with a gentle face wash.

Don’t forget to apply your favourite moisturiser, after using this face mask, to help seal in all the goodness.

Egg White, Avocado:

In a clean mixing bowl, start by mashing the avocado, until it turns into a soft, lump-free paste, and then add the whites of one egg, a teaspoon of yoghurt and mix everything together until it looks like a creamy paste.

Apply this mixture all over your face and neck area, and leave it on for about 20 to 30 minutes before washing it off with cold water and a gentle face wash.

Egg White, Cucumber, Yoghurt:

In a bowl, add one egg white, one teaspoon each of yoghurt, fresh cucumber juice and organic honey. Mix all the ingredients together until it forms a thick paste.

Apply this paste all over your face and neck area and leave it on for at least 20 minutes and then gently rinse off this face mask with lukewarm water and immediately follow it up with a gentle and nourishing moisturiser.

Egg White, Aloe Vera, Castor Oil:

To the egg white, add about a teaspoon each of aloe vera gel and castor oil and then mix all the ingredients together and apply it all over your face and neck area in a thin, even layer.

Leave it on for about 20 minutes and wash it off with a gentle face wash and some cold water. Follow it up with your favourite moisturiser.

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Confusion cropping up with Ne-Yo in the spotlight

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Ne-Yo: His management should clarify the last-minute cancellation

Superlatives galore were used, especially on social media, to highlight R&B singer Ne-Yo’s trip to Sri Lanka: Global superstar Ne-Yo to perform live in Colombo this December; Ne-Yo concert puts Sri Lanka back on the global entertainment map; A global music sensation is coming to Sri Lanka … and there were lots more!

At an official press conference, held at a five-star venue, in Colombo, it was indicated that the gathering marked a defining moment for Sri Lanka’s entertainment industry as international R&B powerhouse and three-time Grammy Award winner Ne-Yo prepares to take the stage in Colombo this December.

What’s more, the occasion was graced by the presence of Sunil Kumara Gamage, Minister of Sports & Youth Affairs of Sri Lanka, and Professor Ruwan Ranasinghe, Deputy Minister of Tourism, alongside distinguished dignitaries, sponsors, and members of the media.

Shah Rukh Khan: Disappointed his fans in Sri Lanka

According to reports, the concert had received the official endorsement of the Sri Lanka Tourism Promotion Bureau, recognising it as a flagship initiative in developing the country’s concert economy by attracting fans, and media, from all over South Asia.

Nick Carter: His concert, too, was cancelled due to “Unforeseen circumstances

However, I had that strange feeling that this concert would not become a reality, keeping in mind what happened to Nick Carter’s Colombo concert – cancelled at the very last moment.

Carter issued a video message announcing he had to return to the USA due to “unforeseen circumstances” and a “family emergency”.

Though “unforeseen circumstances” was the official reason provided by Carter and the local organisers, there was speculation that low ticket sales may also have been a factor in the cancellation.

Well, “Unforeseen Circumstances” has cropped up again!

In a brief statement, via social media, the organisers of the Ne-Yo concert said the decision was taken due to “unforeseen circumstances and factors beyond their control.”

Ne-Yo, too, subsequently made an announcement, citing “Unforeseen circumstances.”

The public has a right to know what these “unforeseen circumstances” are, and who is to be blamed – the organisers or Ne-Yo!

Ne-Yo’s management certainly need to come out with the truth.

However, those who are aware of some of the happenings in the setup here put it down to poor ticket sales, mentioning that the tickets for the concert, and a meet-and-greet event, were exorbitantly high, considering that Ne-Yo is not a current mega star.

We also had a cancellation coming our way from Shah Rukh Khan, who was scheduled to visit Sri Lanka for the City of Dreams resort launch, and then this was received: “Unfortunately due to unforeseen personal reasons beyond his control, Mr. Khan is no longer able to attend.”

Referring to this kind of mess up, a leading showbiz personality said that it will only make people reluctant to buy their tickets, online.

“Tickets will go mostly at the gate and it will be very bad for the industry,” he added.

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