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March 23, 2022

Covid-19 in 0-4 Year Old Children

I rarely follow the Covid-19 information about children younger than my grandchildren, but I thought it was important to review the data recently collected and published by the CDC about Covid infections in 0-4 year old children.  These children are not yet eligible for the Covid vaccine.  It is regularly said that children are less frequently infected with Covid and usually have milder cases.  But as Omicron cases began to increase rapidly, so did the cases and hospitalizations in children 0-4 years of age.

Covid Net is a surveillance group that collects data from Covid infections from 99 counties in 14 states.  They just published information collected on children 0-4 years and analyzed it from March 2020 through Feb  19, 2022.  The total number of children 0-4 years who were hospitalized was 2,562.  The number of hospitalized cases from Dec. 19, 2021 to Feb 19, 2022 (Omicron period) was 5 times higher than the cases from June 27-Dec. 18, 2021 when Delta was the dominant variant.  And the number of ICU admissions were 3.5 times higher.  63% of the hospitalized children had no underlying medical conditions, and 44% of the children were <2 months which breaks my heart.  There were 2 in-hospital deaths.  Thankfully hospitalization rates have decreased since the Feb. 8th peak.

See Below


The Omicron BA.2 variant is increasing in the US; in NY and NJ it was 39% as of the last report.  This variant is 1.5x as transmissible as Omicron BA.1, and as the case numbers increase there may be another peak in this unvaccinated group of children.  Babies born to vaccinated mothers can be protected by transplacental transfer of antibodies during pregnancy  - which will help those <6mos.  The remainder of the unvaccinated children 6mos-4 years should be surrounded by vaccinated parents and other adults.  Their vaccines are anticipated to be approved by late April. 

February 19, 2022

Heart Disease After Covid-19 in Unvaccinated People

Not only pregnancy outcomes are worse if unvaccinated women develop Covid-19.  In a recent study of more than 150,000 health records of US Veterans with documented Covid-19 (who lived more than 30 days after their infection), there was an alarming incidence of cardiovascular disease one year after they had Covid-19.  They were compared to approximately 5000 Veterans who did not have Covid and a similar size group of veterans from 2017.  The study was conducted on Veterans who had Covid before vaccines were available.  Patients were young or old and obesity, diabetes, and smoking were seen in equal numbers of infected and uninfected subjects.    

There were 20 different cardiovascular complications seen but the most common abnormalities were myocarditis, stroke. heart attack, heart failure, blood clots, and abnormal heart rhythm. The cardiovascular sequelae could occur following mild infections, but the risk increased with more severe infections.  To just look at one cardiovascular complication, patients who had Covid 19 had a 72% higher risk of developing heart failure than those who did not have Covid.  The Veteran population is skewed toward men, and 75% of subjects were white.  Patients average age was in their 60s.  


All of these cardiovascular disorders can be very severe and lifelong.  It is important that these data are distributed so some of the unvaccinated may decide to get vaccinated.  A similar study is now being conducted in a vaccinated population - and those results may be like the differences in pregnancy, in which mothers and babies have less comorbidities and death if they are vaccinated.

September 18, 2021

FDA Meeting Re: Pfizer Booster

The scientific advisory committee to the FDA listened to a full day of presentations about the Pfizer vaccine - its vaccine efficacy against infection and its safety.  Data was presented by a scientist from the UK, scientists from Israel, the CDC, FDA, and Pfizer.  The vaccine is still effective against severe infections, hospitalizations, and deaths.  By the end of the day agreement was reached that there was some data demonstrating that vaccine efficacy was waning in older patients with exposure to the delta variant.  When given a 3rd dose their relevant Covid antibodies increased 10-fold. In each of these studies it was still unclear whether vaccine efficacy was waning or the arrival of the delta variant, or a combination of both.   

Safety information was also reviewed in these presentations, and the advisory committee members didn't think they had enough data yet on third boosters in the younger groups of males who are at increased risk of developing myocarditis-pericarditis.  There were no new safety issues, and even though the heart side effect was rare and mild, the committee recommended that the 3rd dose be held until there is more data. Other side effects were very similar to those associated with 2nd doses.  


The original question to be answered was whether a 3rd dose of the Pfizer vaccine should be given 6 months after dose 2 to people 16 years or older.  That vote didn't pass.  But each member of the committee felt that the 3rd dose should be given to 1.) fully vaccinated people 65+ years old, at least 6 months after dose 2.  2.)  People who were at high risk because of their occupational exposures. This proposal passed unanimously.  Meanwhile more data will be accumulated and analyzed - both to see if the vaccine efficacy is dropping and to make sure that 3rd doses are safe in younger people.  That proposal passed unanimously.

It is so interesting to watch a full day of scientific data presentations and to learn from experts on vaccine efficacy and safety.  I watch every one of these advisory committee meetings and will get my 3rd dose (because I'm 65+) as soon as the CDC advisory committee meets next week to review the data and approve the FDA decision.


February 7, 2020

More Paris Sketchbook Pages: October 24

I am very slow getting sketchbook pages posted from our Fall Paris Vacation.  I love Degas, and as my husband and friends were going through the D'Orsay, I stopped at the Degas sculptures - and sketched.  The patina on this wonderful sculpture was very unusual, and I'm not sure that I captured it in paint.  


I vividly remember loving his sculptures of dancers at the Metropolitan Museum of Art when I was a college student, in part because most of my life I have taken dance classes and in college was a member of the dance group 


After the D'Orsay we walked along the Blvd San Michel to Luxembourg Gardens and the Sorbonne.  A wonderful day! 


January 28, 2020

Paris 3: October 2019

I'm still working on drawings I did when we were on vacation in Paris.  This first sketchbook page was done quickly from our apartment window before we left for the day.  But most of the drawings I did in Paris were done in Museums.  Others have said that it is very hard to keep a travel sketchbook when you are traveling with non-sketchers, and I agree. 

Building across the street and up the block.  Drawn from our apartment window.



Chaim Soutine painted by Modigliani.  Painting seen in the Memorial de la Shoah in the Marais in Paris. 


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