Is the delta variant more dangerous for kids? When will the COVID vaccine be available for children?

With most Iowa students — from new kindergartners to college-level learners — headed to classrooms later this month, families are finding themselves filled with questions and concerns.

“We receive inquiries every day,” University of Iowa Hospitals and Clinics epidemiologist Melanie Wellington said in an emailed response to questions from The Gazette.

“By far the most common question is, ‘When will it be available?’” she said of a COVID-19 vaccine for kids under age 12, followed by, “’Are you sure we can’t vaccinate my 11-year-old?”’

WATCH: UIHC pediatrician gives advice for back to school

Wellington tackled those questions and others for parents and kids about to embark on another unpredictable school year as virus cases and hospitalizations rise nationwide.

Q: What’s the status of vaccine research for kids younger than 12?

A: Major studies still are recruiting patients.

Q: How close do you think the U.S. Food and Drug Administration is to approving vaccines for younger kids on an emergency basis — like it has for those 12 and older?

A: Pfizer has indicated it expects to submit safety data for 5- to 11-year-olds to the FDA by the end of September, she said. Moderna anticipates it will have data sent to the FDA mid-fall. The FDA then will need to analyze the data and make recommendations.

Q: Has UIHC formed any kid-specific vaccine plans — like community clinics?

A: When the FDA was reviewing data on vaccinating 12- to 16-year-olds, UI Health Care took about a week to organize special vaccination clinics for that population. Once authorized, they were able to begin vaccinating 12- to 16-year-olds within 24 hours, Wellington said. As soon as they know data for kids under 12 has been submitted and will be reviewed, UIHC will take a similar approach to get these vaccines available to children as soon as the data review process is complete, she said.

Q: Are indications so far the vaccine is safe for everyone — including kids?

A: The vaccine is safe and effective for kids 12 and older, Wellington said. Data still is being gathered for younger kids.

“The vaccines have proved to be remarkably safe, and the benefits far outweigh the risks associated with getting the vaccine.”

Q: Absent a vaccine, do you think masks make the most sense for kids in schools and extracurricular settings this fall?

A: In general, we know masks are effective at preventing transmission of COVID-19 and other respiratory illnesses, she said. Wearing a mask can help keep children and those they interact with safe and healthy.

Q: Has UIHC seen any change in pediatric patients, with the delta variant now circulating? Is the variant more dangerous for kids?

A: Just like with adults, UIHC is seeing a significant increase in pediatric patients testing positive for COVID-19. So far, Wellington said, there is no indication the disease caused by the delta variant is more severe than previous variants. There is indication it’s more transmissible.

To be clear, she said, delta is spreading much faster in people of all ages.

“We don’t see anything that suggests that delta is ‘targeting’ children differently than previous variants,” Wellington said. “Rather, because community transmission rates remain high and the vaccine is only authorized for kids age 12 and older, children who may be exposed to COVID-19 are quite vulnerable.”

Q: I’ve noticed UIHC has seen an uptick in COVID-19 pediatric inpatients — reporting three last weekend and four on Friday. Is that higher than normal?

A: There isn’t a “normal” number — it depends on community transmission levels. It’s higher than UIHC had in recent months, but it’s consistent with what could be expected given the recent community transmission rates.

Q: Do you think children should still be wearing masks in public settings — like grocery stores — until they can get vaccinated?

A: Masks remain an effective tool at preventing COVID-19 transmission. While the community remains at a substantial or high rate of transmission, she said, practicing safety measures such as masking and social distancing in public settings are important steps in preventing spread.

Q: Regarding quarantine procedures — do you think children in classroom settings with a child who tests positive should be quarantined for two weeks? Does it matter if the other kids were wearing masks?

A: Wellington said she advises working with the school and the county public health department to determine who should be quarantined.

Q: Is UIHC doing the type of COVID-19 testing capable of determining whether patients are infected with the delta variant? And, if so, are they?

A: The Centers for Disease Control and Prevention, the state and UI Health Care are monitoring this closely. Almost all SARS-CoV-2 transmitted in this region right now is the delta variant. The most recent data on the CDC website shows 98.4 percent of virus circulating in Region 7 — Iowa, Kansas, Missouri, and Nebraska — is delta.

Beyond kids

With COVID-19 rates rising nationally and in Iowa — which added 4,872 new cases between Aug. 4 and Wednesday, for a seven-day average of 696 new cases a day, the highest since Feb. 10 — hospitalizations also are increasing.

Over that week period, COVID-19 hospitalizations in Iowa jumped from 201 to 355, the highest since Feb. 4; intensive care patients increased from 61 to 103, the most since Jan. 10; and patients on ventilators doubled from 24 to 49, the most since Feb. 4.

On Friday, UIHC was caring for 17 adult COVID-19 inpatients and four pediatric inpatients, and officials said more than 90 percent of its COVID-19 inpatients are unvaccinated.

Kevin Doerschug, medical director of the UIHC medical intensive care unit, answered questions about what the university is seeing with this wave of inpatients.

Q: Are today’s adult COVID-19 inpatients sicker than inpatients in the past?

A: This is hard to quantify. But we are certainly seeing more young people — in their 30s and 40s — and seeing more young people dying than earlier this year.

Q: How many are on ventilators?

A: This number changes by the hour. As of Wednesday evening, about 10 COVID-19 patients there were on ventilators.

Q: How many are on extracorporeal membrane oxygenation — or ECMO — a form of life support?

A: Four patients currently are on ECMO, he said.

Q: What are survival odds once a person goes on ECMO?

A: This number also is changing. There was a 60- to 65-percent survival rate last fall at UIHC, consistent with an international registry, Doerschug. Now, over the past six months, everyone has seen decreased survival rates. International data suggests survival rates now hover between 45 and 50-percent, which is what Doerschug said UIHC is seeing.

“The reason behind this is not clear,” Doerschug said. “And it’s probably not just because of the delta variant (we were seeing survival rates decrease before delta). Some of it may be subtle changes in who we put on ECMO. Some of it may be that we continue to improve our non-ECMO COVID care.

“Thus the patients that still need ECMO are likely sicker with a higher chance of dying than what we saw last year.”

Q: What needs to happen for a patient to get off ECMO?

A: ECMO is a support tool that helps the patient breathe but does nothing to alter the disease process itself. So, to get off ECMO, the patient’s lungs must get better such that a standard ventilator, or perhaps just oxygen, is sufficient.

“In some cases, it’s clear the lungs will not get better and we have pursued lung transplant.”

Q: Does UIHC still have enough equipment, like ventilators and ECMO machines, for its inpatient demands?

A: “Yes! ECMO is a scarce resource and we are watching this very carefully,” he said. “But currently we have enough. In terms of ventilators, we are nowhere near where we were last winter, so currently we are fine.”

Comments: (319) 339-3158; vanessa.miller@thegazette.com