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June 08, 2021 02:54 PM

Teen COVID hospitalization spike spurs hospital mass vaccination effort

Matti Gellman
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    Michigan's COVID-19 hospitalization rate surged by 311% among ages under 18-years-old from February through April, forcing providers to perform procedures rarely used on children with respiratory infections.

    Dr. Matthew Denenberg, an emergency pediatric physician, and his colleagues at the Spectrum Health Helen DeVos Children's Hospital of Michigan pumped the hearts of multiple kids infected with COVID-19 through an ECMO Machine over the past few months. His hospital is one of three in the state licensed to perform the procedure on children, rarely is it employed, as it is a last resort to provide circulation to the body.

    He said the surge was a reminder that if more are not vaccinated cases will continue to rise.

    Many hospitals across the country are anxious to drive up vaccination rates, and they expect case jumps during the end of the pandemic will particularly affect adolescents, as teens have only recently gained access to vaccines and are returning to school gatherings and summer camps.

    Weekly teen COVID hospitalization rates jumped by 116% from mid-March through April, per a recent U.S. Centers for Disease Control and Prevention report monitoring 10% of the national population. Over one-third of those teens were admitted to intensive care and about 5% required a ventilator to breathe. Hispanic and Black teenagers made up two-thirds of those hospitalized. To combat future surges, facilities are investing in mass vaccination clinics and other outreach to encourage teen vaccinations.

    At Michigan's peak, nearly 70 pediatric patients were hospitalized for COVID-19. That's the state's largest pediatric surge since the pandemic began in March 2020. This accompanied a near 400% increase in COVID hospitalization among adults.

    While teens are not being hospitalized at the rate of adults, the uptick is indicative of the increased exposure adolescents have to other unvaccinated persons with the reopening of social gatherings, according to John Karasinski, communications director at Michigan's Health and Hospital Association.

    As of Feb. 8 Michigan resumed high school sports and offered more in-person learning opportunities to classes made remote during the pandemic.

    Hospitals are investing in education and outreach to encourage more jabs. Spectrum Health is offering vaccinations to teens through different practices, including pediatrics. They also collaborated with Vaccinate West Michigan and other local health systems to present a three-part video series showing an infectious disease physician discussing the importance of vaccination with two local teens.

    "We are starting to see a slow of pediatric admissions to hospitals with COVID. Though we only have 30% vaccinated. We have a long way to go," Denenberg said.

    Since April, Michigan's vaccination rate increased by over 20%, which Karasinski said led to significantly lower hospitalizations.

    Currently 59% of the state is fully vaccinated, in large due to state government efforts to get more doses to primary care doctors.

    At Children's National Hospital in Washington D.C, which also experienced a spike in teen COVID hospitalization, mass vaccination clinics are effectively reaching more groups hesitant to get the vaccine. The clinics are dispersed across the D.C area and specifically reaching out to teens.

    Hospitals often see two peaks in adolescent COVID-19 hospitalizations, due to severe complications from the virus. This second peak will only get worse if more teens are not vaccinated, according to Dr. Bernhard Wiedermann, an infectious diseases specialist at Children's National Hospital.

    "We see the children who get sick from initial COVID infection, but only a few weeks later they come in with this severe inflammatory syndrome, so its kind of two peaks that we see everytime there's a surge," he said.

    Multi-symptom inflammatory syndrome, (MIS-C), appears a few weeks following COVID infection in children at the age of 12 and younger. When a child is asymptomatic for COVID-19 — nearly 45% according to a July 2020 study — MIS-C can be hard to identify, complicating existing data on adolescents hospitalization. The disease affects nearly every part of the body, causing everything from rashes and swollen lymph nodes to an inflamed heart or brain. Hospitals across the country released notices in April to engage with parents on MIS-C, fearing it may cause hospitalizations in those too young to be vaccinated. The condition can be fatal. There were five cases at Children's National during the April surge.

    The D.C. area vaccinated over 50% of its population, as of Monday, with 15.5% of teens aged 12-15 receiving at least one dose. Over 14% of adolescents aged 16-17 are fully vaccinated.

    "Clearly we're in such a better place than we were 6 months ago, we just can't forget what got us here and have to hang on a little bit longer," Wiederman said.

    CDC Director Dr. Rochelle Walensky urged parents to talk to their teens about virus prevention and getting vaccinated.

    "I am deeply concerned by the numbers of hospitalized adolescents and saddened to see the number of adolescents who required treatment in intensive care units or mechanical ventilation," she said Friday. "Vaccination is our way out of this pandemic. I continue to see promising signs in CDC data that we are nearing the end of this pandemic in this country; however, we all have to do our part and get vaccinated to cross the finish line."

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