An interview appointment with Carolin Lang can only be arranged in the evening, during the day the Tölz pediatrician is too busy. Corona tests and vaccinations, the RS virus, the winter flu-like infections – the pediatric practices are currently extremely busy. Since the European Medicines Agency (EMA) recommended the approval of the Biontech vaccine for children from the age of five last week, there is a need for additional explanation. What are the advantages of vaccinating children and what are against them?
SZ: Ms. Lang, what does the EMA recommendation mean for your practice?
Carolin Lang: First of all, we are waiting for the decision of the Standing Vaccination Commission, because we are basically sticking to their recommendations. The problem is that the registration studies of the Covid vaccines were quite small. Rare side effects do not necessarily have to appear. In the case of myocarditis, for example, a probability of 1:16,000 is assumed, which does not necessarily occur in a study with 1,500 children. I would wait for the numbers from Israel and the USA, where many children have already been vaccinated. In principle, however, I assume that the vaccine is also well tolerated by this age group.
In principle, does the EMA’s decision mean that German paediatricians are now also allowed to vaccinate children from the age of five with Biontech?
Yes, we are not bound by the recommendation of the Standing Vaccination Commission. I could already imagine vaccinating children from the age of five who have serious previous illnesses. But it must also be said that the vaccine for children, which has a lower salary, has not yet made it into practice. I guess it will be the end of the year before the pharmacies can deliver this.
Would you have your own children vaccinated?
My children are twelve and 13 years old and both vaccinated.
Why? In your opinion, what are the advantages of a vaccination?
In children aged twelve and over, there is clear evidence that the vaccination protects against a severe course. It is true that children are generally less ill than adults, but they can also develop more severely. In addition, children can develop PIMS syndrome, a post-viral inflammation syndrome. Not many children get it, but when it does, it is very severe and can have serious long-term consequences. Incidentally, this syndrome can also occur in children who previously had no or only weak Covid symptoms. At the moment one simply has to say: The risks that children have from vaccination are lower than those that they would have from the disease.
What about children under the age of twelve?
With the younger children, as I said, I would first wait until there are more numbers. In general, however, I also think here that the risk of the vaccination is lower than the risk of the disease. We know that small children generally have less severe disease, but we cannot yet say what long-term consequences they may face in ten or twenty years. The disease also attacks the nervous and vascular systems.
Compared to the previous corona waves, she is currently seeing more infected children than ever before. Doctor Lang considers the risks of a vaccination to be lower than those of an illness.
(Photo: Hartmut Pöstges)
How many children with the corona infection are you currently treating in your practice?
Compared to the previous waves, we now have more infected children than ever before. We actually have new positive cases every day.
How do these diseases work?
Asymptomatic, i.e. without any symptoms, are actually almost no children with us, and if so, then the very little ones. Many have the symptoms of a flu-like infection, i.e. runny nose, cough, sore throat. Some also have diarrhea and abdominal pain. We tend to observe the loss of the sense of taste and smell in older children.
Did you also have children who had to be hospitalized?
Fortunately, we only had to admit a few children as inpatients. Well below ten, I would estimate. Some of them were very young babies, so you had to be on the safe side. I remember a child with severe pneumonia and children who needed IV fluids because they had stopped drinking. But nobody had to go to the intensive care unit.
Again and again there is talk of daycare centers and schools as drivers of pandemics. How do you see it
Most of the children I treated got infected from their parents. With the Delta variant, the entire family is usually infected immediately. Of course, children in daycare centers and schools are also infected, but I wouldn’t speak of the drivers of the pandemic. These are still the people who won’t get vaccinated. Unfortunately, the children now have the misfortune that they become infected.
So it would help the children if more adults got vaccinated?
In view of the current figures, we all have to limit ourselves in the end and make sure that we no longer jump around happily everywhere. But of course it would help the children if more adults get vaccinated. The primary goal must be to leave the schools and daycare centers open.
Which episoden the previous lockdowns have you noticed with the children in your practice?
Many children simply have massive problems at school. Many parents have split up because of difficulties with the home office or financial problems. We see many children with depressive disorders, many have fears, and some have developed obsessive-compulsive disorder. The number of referrals to child psychologists has increased significantly. And we are seeing an increase in overweight children due to a lack of exercise, closed sports clubs and increased media consumption. It has to be said that the children are the ones who were forgotten in the pandemic. Politicians have not given any thought to the consequences. We cannot expect them to spend another year without school and social contacts.