WITH a low take-up rate for the Covid-19 vaccine among children between the ages of five and and the lingering presence of the Omicron variant worldwide, health experts fear children could become more vulnerable as Malaysia begins the transition to the endemic phase of the virus from April 1.

Statistics showed that only 34.4% of primary school children have had their first Covid-19 jab, as of March 18.

In China, the number of new cases daily exceeded 10,000 and children have become victims in the new surge.

“I can hardly imagine what it will be like after April 1,” Dr Gan Chin Seng, a consultant paediatrician and associate professor at the Department of Paediatrics, Universiti Malaya (UM), told The Malaysian Insight.

In the transition to the endemic phase, many standard operating procedure (SOP) put in place to curb the spread of the virus will be relaxed or lifted and the country’s borders would also be reopened.

Gan said adults need three doses to have any degree of protection against Covid-19, but so far the majority of children have only had one.

“It’s not enough to fight Omicron,” he said.

To compound the problem, Gan said there are many parents who still have not decided whether their children should be vaccinated.

He said, unlike the adults, many children in the clinical category 2 (mild symptoms) are often hospitalised for dehydration, if they suffer from a bout of vomiting. They could also experience breathing difficulties.

The current SOP on hospital admission is for category 3 patients, diagnosed with a lung infection.

Gan said children, especially under the age of five, suffer from different symptoms with the Omicron and Delta variants.

He pointed out that vaccinated adults can still eat and drink as usual, even after contracting the virus but not children who are not yet or fully vaccinated.

Children with mild infection suffer from a loss of appetite and dehydration (from diarrhoea and vomiting), he said, adding that they need to be admitted for intravenous (IV) drip and observation.

“The situation now is different. The chances of children becoming infected have also increased by 50%”.

Gan said these children, who normally stay at home, are infected by their working parents.

“Their parents go to work, get infected and pass the infection at home,” he said.

“The Omicron strain will not show a positive result if the test is taken on the first day of the infection and tested with the rapid antigen test kit (RTK-antigen). It only shows up on the second or third day.”

Gan said this gives a false sense of the situation and parents often let their guard down.

“They naturally relax thinking it’s OK and go home without masks, only to test positive after a few days. The children are definitely infected by then.”

Gan said even when the Delta variant was the prevalent variant, 90% of children who were infected got it at home.

With the transition to the endemic phase looming closer, the big question mark for experts like Gan is if parents will take the proper precautions when they return home from work.

“What we’re worried about most is the children having multisystem inflammatory syndrome (MIS-C) or are already dying when they are brought to hospital.”

He said there are many confirmed cases of children on the verge of death when admitted.

“Although entering the transition phase is something that will take place sooner or later, the fear now is the unvaccinated children.

“Unless the number of vaccinated children reaches a certain target where they don’t need to be admitted to the hospital even if they are infected, it’s really hard to imagine what it will be like once we get into the transition phase,” Gan said.

Penang Adventist Hospital consultant paediatrician Dr Tan Pek Yong also appealed to parents not to make their children “part of the statistics”.

He said every day for the past month, many children from one month-old to over 10 years-old, have been infected.

“This may be due to Omicron being more infectious. There are many cases where one person would infect the whole family,” Tan said.

He said even though children might recover from their fever in two to three days, a second-degree bacterial infection could trigger a relapse and they will have a fever again after five to seven days.

“They will need antibiotic treatment, but then parents need to be on their toes for the next two months and see if their children suffer the multisystem inflammatory syndrome (MIS-C) which typically occurs between two and six weeks after the infection.”

He said more than 80% of children with MIS-C require intensive care treatment, and the chances of death are between 3% and 5%.

His advice to parents is to have all their children over the age of five vaccinated.

For those under five and cannot be vaccinated yet, Tan said parents need to be vigilant and wear a mask if they are unwell.

“Attention to hygiene until full recovery is most important. If a child develops any symptoms, it is important to seek immediate medical attention.

“I recommend the oral test kit for children ages two to five years old. Children under two, on the other hand, are better off going to a clinic or hospital to have their doctor test them.

He also said parents should get children to wear masks all the time, even when playing.

“As far as possible, don’t take children who have not been vaccinated out in public. If you have to, go to less crowded places, and never take things lightly.”

Tai Sue Mei, a mother of four, shared with The Malaysian Insight what her family went through when they were infected.

Her children are ages one month to eight years old.

Tai said the family rarely left the house. The last time they did was to go to a vaccination centre and clinic.

She said, on returning home, her husband and youngest daughter complained of sore throat and fever.

“They were confirmed to be positive and were ordered to be quarantined at home. Then, my brother and sister were infected.

“They had a fever and their temperature reached 40C.”

“My daughter’s fever lasted three days, during which time we monitored her oxygen level in her blood.

“These are also the most difficult days with my husband and me taking her body temperature and measuring her blood oxygen level every two hours including in the middle of the night.”

She said, even with her husband down with fever, he still took time to care for their sick daughter.

Meanwhile, despite her daughter’s recovery, Tai said she is still worried about the MIS-C.

With many SOP set to be relaxed, if not lifted, Tai said it is therefore important for parents to remain alert.

“The only way to accept living with the virus is to take the vaccination for life to gradually get back on track.” – March 25, 2022.