Can children help achieve herd immunity in India?

NEW DELHI: As the government seeks suggestions from the parents regarding the reopening of schools in the near future, health experts on Monday entered a debate whether reopening schools and colleges will bring herd (community) immunity in India in the absence of a vaccine.

While a school of thought put forth the idea that children are very good candidates to achieve herd immunity because their immunity is strong and they fast develop strong antibodies compared to the elderly, another questioned the theory, saying while the children might get infected and recover, those around them may never recover at all.

Professor (Dr) JC Suri, Director and HOD, Pulmonology, Critical Care and Sleep Medicine, Fortis Hospital Vasant Kunj, said that this is a very contentious issue. "You have to very clearly understand pros and cons. First of all, you must understand what herd immunity is. It is when a large percentage of the population becomes infected, is cured and has developed immunity against the infection, then the remaining population is also protected," said Suri.

If around 60-70 per cent of the population becomes immune to COVID-19 infection, then the remaining population can also be protected.

"That is the concept of herd immunity. Overall if you look at COVID's progression in India, 100 people get infected, 20 people are in the hospital and become seriously ill, and about 5 per cent are in the ICU. The younger population, even if infected, is not becoming seriously ill, and there is very little mortality," said Suri.

While the children might get infected and will recover, those around them, especially the elderly will have issues if the virus is transmitted to them. "And the spread will be quick. The number of people getting seriously ill would increase and at a rapid pace, overwhelming the hospital capacity. Therefore, it is a double-edged sword," he contended.

Schools across the country have been shut down since mid-March and millions of students are busy taking online classes in the academic year.

The Ministry of Human Resource Development (MHRD) last week sought suggestions from parents regarding the reopening of schools in the near future. It wants the parents' opinion on whether to open schools in August, September or October and Education Secretaries of all state and Union Territories have been directed to submit the suggestions from parents.

According to some health experts, herd immunity is definitely playing a role in the country.

"Children have a robust immunity as compared to elderly population. The kids respond to any new pathogen (bacteria, antigen, virus and stimulus etc.) in a far better way. And once that response is mounted by the kid, it can be passed on to the others as well," said Dr Gaurav Kharya, senior consultant at Paediatric Haematology, Oncology and Immunology, Indraprastha Apollo Hospitals.

According to Dr PS Narang, Associate Director, Pediatrics, Max Super Specialty Hospital in Shalimar Bagh, herd immunity helps protect the people in the community indirectly who haven't taken vaccines. "Children are very good candidates because their immunity is strong and develops immunity and strong antibodies. We have seen this with pneumococcal and flu vaccination," Narang claimed.

Taking a cue from recent studies that examine COVID-19 transmission by and among children, researchers in the US said last week that children infrequently transmit COVID-19 to each other or to adults; and schools can and should reopen while adhering to social distancing guidelines. "The data are striking. The key takeaway is that children are not driving the pandemic," said William V Raszka, pediatric infectious disease specialist at University of Vermont's Larner College of Medicine.

"After six months, we have a wealth of accumulated data, showing that children are less likely to become infected and seem less infectious; it is congregating adults who aren't following safety protocols who are responsible for driving the upward curve," Raszka added in a commentary published in the journal 'Pediatrics'.

Herd immunity is basically community immunity. For example, the argument is that if a large number of children are immune to a particular disease in a community, then this immune status of such a large population would help prevent that disease in that particular community.

However, Dr Manoj Goel, Director, Pulmonology, Fortis Memorial Research Institute said: "This is a war-like situation. Herd immunity develops passively and for that, you do not allow people to get infected actively. Therefore, infection prevention control measures have to be taken at all levels." (IANS)

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