New challenges as vaccine rollout enters next phase

Andrew Leech

10/01/2022 1:20:23 PM

Vaccinating children aged 5–11 is of vital importance but also brings a whole other round of potential issues, writes Dr Andrew Leech.

GP talking to young patient and mother.
Encouraging families to vaccinate their children is at the core of what GPs do best.

As we enter a new phase in the COVID vaccination rollout, we also enter some new challenges in encouraging and informing our families with children aged 5–11.
We know that the impact on children has already been significant.
Some children have spent most of the past two years home-schooling. We can’t underestimate the effect of this on a child’s mental health and wellbeing.
While some will thrive in this environment, others will have struggled to both apply themselves to schoolwork and cope in an semi-isolated world, without their school friends around them.
There has been a shift in childhood mental illness over the past 12 months, made obvious by the lack of availability at present of paediatric psychologists, psychiatrists and occupational therapists.
This new phase brings with it a whole new round of potential problems.
Encouraging families to vaccinate their children is at the core of what GPs do best.
We are health advocates and often the first point of call in regard to this.
COVID vaccination in children is throwing up a lot of questions for parents, as they consider whether to vaccinate their children. And, for perhaps the first time in history, we are also up against the very powerful, influential world of social media.
Our discussions tend to require more effort and take much longer as a result, helping families understand that while some of this information online can be very convincing, it is in fact misleading and dangerous at best.
Children know a lot about COVID but will have many questions as well.
As much as we want to shield our children from what the news is telling us, there are important discussions to also have with them.
For example, I try to include them in the consultation and discussion around vaccination – it is their body after all.
In simple terms I will explain the benefit of having a vaccine in protecting them against catching a virus. This might include discussions on their healthy bodies and immune systems also playing a role, but also the fact that vaccines give them even greater strength in being safe against COVID-19.
Parents who wonder about the long-term effects of COVID vaccination should be reminded that the vaccine exists temporarily in the body to stimulate an immune response that is long lasting. In contrast, I also like to explain that COVID-19 has an unpredictable, potentially long-lasting effect on children as we are seeing in other countries currently dealing with outbreaks.
Being open and honest with families and children is a good way to reduce anxiety over any unknowns. 
The impact on children’s mental health should not be underestimated.
There will be a range of situations occurring in classrooms as we enter a new school year. Children who have been vaccinated against COVID-19, children who are waiting on vaccination due to short supplies and delays and children who have parents who have declined the vaccine.

This will no doubt lead to discussions among the children, along with questions asked of parents and teachers as to why there are differences. I don’t see this as any different to the flu vaccine where there is often a range of choices made about vaccinating children; however, being much more talked about and with such strong views, it may be more challenging to talk to children and address their questions. 
It would be expected that because of this, anxiety, worry and fear area all higher, especially in the primary school aged children who are still developing an understanding of what is going on around them.
Anxiety is often contagious as well, especially among friendship groups at school.
This anxiety could affect day to day learning and concentration. Children may be noticeably more irritable at home as often anxiety presents with behaviours and physical symptoms in the younger age groups, rather than words or expressions.
Parents could be encouraged to help children verbalise these feelings and what is going on for them, and to provide a calm, reassuring tone when it comes to discussions around COVID-19.   
GPs should be aware of these potential changes in children, and provide a listening ear to parents, reassuring them that this is a lot for children to understand and each child will interpret what is going on differently.
It is also important to reassure the children themselves, that while COVID-19 is spreading, they are generally going to be OK if they catch it.
Finally, if the anxiety is affecting their learning or relationships with others, it might be worthwhile involving a psychologist or occupational therapist using a mental health care plan.  
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