Dr. Darien Sutton is an emergency medicine physician and trusted voice in the NNN community. On this week’s News Not Noise Podcast, I asked him all the questions you’ve wanted answered about Omicron, boosters, and keeping kids safe. Here’s part of what he had to say, edited for clarity:
A lot of people are asking, how long should you wait to get your booster shot? If you've had two shots, and then you get COVID, is there a specific window following you should get boosted?
If it's more than five months after the Pfizer shot, you should get your booster. If it's more than six months after the Moderna shot, you should get your booster. If it's more than two months after your Johnson and Johnson shot, you should get your booster. If you have an infection of COVID-19, you can get a vaccination or a booster as soon as you're done with your isolation period and your symptoms have resolved. So at any point after that infection, you can get that shot. You don't have to wait.
What do we know about long COVID and could Omicron cause it?
We don't have specific evidence to show the relation between the Omicron variant and long COVID simply because the Omicron variant hasn't been in existence long enough. Long haul symptoms associated with an initial COVID-19 infection can sometimes happen weeks to months after the initial infection and can include a lot of different symptoms.
I get a lot of patients, especially young patients, who come in with anxiousness and palpitations. I think that's the most common thing I see in young people. Of course, this is my anecdotal experience. For older patients, [many] come in saying they still feel short of breath, even though their oxygen saturation is a hundred percent and their chest x-ray looks normal. We don't have specific reasons why this happens, but unfortunately it seems like more than 35% of patients can have symptoms like this.
The beauty is that we've seen that vaccinations and completing your primary series can decrease the risk of long COVID. But again, I think that this is one of those things that we need to pay attention to. When we look at past infections, pandemics, outbreaks, [etc.] there's always something that comes up later on, a chronic condition [associated] with an infection. And that's what we try to protect against.
We need more information to nail down exactly what is long COVID and why certain people are getting it and certain people aren't. It just reminds us again, vaccines are not only protective in the initial infection, but also its complications.
Hospital admissions for children with COVID are rising, especially for kids under five who are unvaxxed. They are up 48% since early December. Is Omicron worse for kids, or is this a question of scale – it’s more transmissible, more people are getting it, so more kids will get a bad case?
In my anecdotal experience, I have not seen that the Omicron variant is posing an increased risk for children in terms of risk of hospitalizations and deaths. That still remains incredibly uncommon and low for those really poor outcomes. There will always be children who get infected with the virus when it's surging around.
I think it's more of a question of scale. As this pandemic surges, it's going to target those who are unvaccinated and most susceptible to infection, which unfortunately includes the 25 million children under the age of five who are not eligible for vaccination. And then if you look at the rates of hospitalization for pediatric patients, for example, in New York, half of the pediatric patients who are admitted are under the age of five.
If you look at the age groups from 5 to 11, 100% of them are not fully vaccinated. These are the patients who are admitted to the hospital. And then if you look at the age groups from 12 to 17, 75% of them are not fully vaccinated. So it shows us a clear trend that we've seen in adults, which is that vaccines are not only proving to be beneficial in terms of preventing transmission, but also infection and harm. And now we're starting to see more [concerning] results from children, things like association to a viral infection and a chronic illness, like diabetes, as we're seeing some [pediatric] patients who were infected with COVID-19 develop.
If you have an unvaccinated child under the age of five, what would you do? Would you send them to school? Would you keep them home? How do you keep them safe?
I think everyone's level of comfort with risk is very different. It's hard for me to speak to that, because I think that every parent makes their decisions based off their experiences within their community. If I had to make that decision, I would ask myself the question: What is the rate of transmission in my community? Is it above 5 or 10% right now? Because that's what the WHO and the CDC utilize to identify what is an outbreak.
Then my next question is: What are the rates of hospitalizations in my community? Do I have access to care if I were to need it?
My third question is: What protection is being done in these places? Whether that be pre-K or kindergarten. And by that, I mean, are children wearing masks? Are teachers vaccinated? Is there some form of contact tracing? Are there regular series of testing? I would probably logically think through all those factors before I made a decision, whether or not my child should go outside or not.