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Willows Pediatrics Blog - We Know Kids
We Know Kids
Willows Pediatrics News
January 11, 2022

Covid-19: Weekly Update #1

Who is eligible for a Covid-19 vaccine booster?

There have been some changes to COVID vaccine & booster eligibility guidelines.

  1. Booster eligibility now begins 5 months after your primary series for Pfizer and Moderna.
  2. 12-15 year olds are now eligible for boosters with Pfizer, 5 months after they complete the primary series.
  3. Anyone who received J&J for the primary vaccine, is eligible for a booster of any vaccine 2 months after the primary shot.

I just had COVID, when can I get my vaccine?

You can get your primary COVID vaccine or your booster as soon as you have met the criteria to leave isolation: 5 days, fever free for 24 hours and symptoms improved.

My child tested positive for COVID, what do I do?

First of all, don’t panic! For the vast majority of children, COVID is a mild illness. Just monitor and manage symptoms as they come.

There have also been some changes to isolation recommendations.

If You Test Positive for COVID-19: Everyone, regardless of vaccination status.

  • Stay home for 5 days. If your child cannot wear a mask, then they should stay home for 10 days.
  • If you have no symptoms or your symptoms are resolving after 5 days, you can leave your house.
  • Continue to wear a mask (ideally a good mask such as N95, KN95- since you are likely still contagious) around others for 5 additional days. Again, if your child cannot wear a mask, then 10 days of isolation.

If you have any symptoms, continue to stay home until your symptoms resolve.

My child was exposed to COVID, what do I do?

Again, don’t panic!

If they: have been boosted or completed the primary series of a vaccine and are not due for a booster yet:

  • Wear a mask around others for 10 days.
  • Test on day 5, if possible.
  • If you develop symptoms get a test and stay home.

If they: are overdue for a booster or unvaccinated or too young to be eligible for a vaccine

  • Stay home for 5 days. After that continue to wear a mask around others for 5 additional days. If your child cannot wear a mask, then they should isolate for 10 days.
  • Test on day 5 if possible.
  • If you develop symptoms get a test and stay home.

Overarching guidelines– stay home if sick, wear a (high-quality) mask, and get tested if possible

Should I trust a Covid rapid test?

We have become increasingly aware that rapid tests have some limitations. The rapid tests may provide false negatives with Omicron, early in the course of illness, and in asymptomatic people. This is because rapid tests are less sensitive.

What do we mean by sensitive? Sensitivity statistically means the likelihood that the test will give you a positive result when you actually have the disease. If a test has a lot of false negatives, then the sensitivity is low. For example, what do we see if we test 10 patients in the office with a rapid test, some asymptomatic but exposed, some with 1 day of mild symptoms, some with 3 days of symptoms and then also do a PCR these patients and compare the results? Anecdotally, we will get a few negative results on the rapid test that then come back positive on the PCR (when we get the PCR back 2-4 days later).

What does this mean practically?

If you are symptomatic and your rapid test ends up being positive, you have COVID. If your test is negative, we don’t know if you have COVID or not based on the rapid alone, although most likely you have a non-COVID illness or virus. In these cases, parents can go back to things we know are effective – getting children vaccinated, stay home if sick, and wear a high-quality mask.

What type of mask is best?

The Omicron variant is more contagious than prior variants. Consider using a more effective mask while we have such a high community caseload. Consider an effective mask particularly when you are in crowded settings, if it is not possible to maintain distance, or if you are indoors for long periods of time.

In order of increasing protection: least protective are cloth masks, then surgical masks then KN95s, KF94s and N95s.

When can my child return to sports after a COVID infection?

After a COVID infection, there is a very small risk of myocarditis, which is inflammation of the heart muscle. Children who play organized sports are required to get a clearance from their physician to return to playing sports. Please make an appointment with us when your child has completed their required isolation time (5 days and symptoms improved including fever resolved for 72 hours). Younger children are at lower risk since their sports are less competitive, and they are allowed to simply self-regulate their activity. If your child had mild symptoms: minimal fever, no severe cough or shortness of breath and total COVID symptoms for less than a week, then the risk of myocarditis is very low, so don’t worry! If at any point, your child develops: chest pain, shortness of breath, new heart palpitations, or near-fainting/fainting, stop exercise and call us.

Other FAQs:

My family recently all had COVID, do we still need to be careful?

Most likely you have a few months of protection from COVID. That is unless a new variant comes around in the meantime. However, we urge caution; don’t forget about the other viral illnesses that are around in the winter. If you have an infant, an immunocompromised family member, or a child with asthma then consider that RSV, influenza, and other viruses are also circulating, so please don’t throw all caution to the wind!

I completed my 5 day isolation after COVID, can I go see my kids now? How do I know if I am still contagious?

The short answer is, you could be still contagious on Day 6. Some people use a rapid test as a proxy for contagiousness, but there is no solid evidence for this. We recommend wearing a high quality mask (KN95, KF94, N95) for days 5-10 of your isolation when around others.

I completed my 5-day isolation but I still feel really awful with ongoing symptoms. What should I do?

Please stay home. You are still sick and need to continue to isolate.

What are you seeing clinically in children who have COVID?

Common symptoms in young children with Omicron have been fever, a croupy (barky) cough, sometimes diarrhea and vomiting. In older children, school-aged kids, we often hear about a headache, sore throat, body aches, and occasional vomiting. We are also seeing some influenza cases; these patients often have fever, vomiting, and body aches. This is not an exhaustive list of symptoms, just our general perspective in the office.

Please do not hesitate to call your doctor, PA, or nurse if you have any questions!