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It is RSV immunity debt that worries me. I think it's an example of our poor capability for risk analysis. I talk to so many parents here in California that are

It is RSV immunity debt that worries me. I think it's an example of our poor capability for risk analysis. I talk to so many parents here in California that are terrified of covid for their kids. So they still limit activities. But statistically kids have very, very low risk. RSV, and even flu, on the other hand are more dangerous for kids and any immunity debt may make that worse. It reminds me of how few parents realize the statistical risk of kids in cars versus how rare abduction is (if kid walks alone to school as an alternative to a car, for example). Again it is emotional/anecdotal thinking rather than data.

choko 4y ago
Did you know that children in daycare have almost a 100% chance of contracting RSV within the first year of attendance (even pre-pandemic)?
- carlivar 4y ago
  No, but that doesn't surprise me. So if daycare is inevitable, the child needs to go in "armed" with antibodies (including from the mother during pregnancy). Should pregnant women isolate? Does not seem like it. Our family dog probably does a good job diversifying antibodies as well (I think there are studies showing the immunity advantages certain pets provide).
  - chinathrow 4y ago
    > No, but that doesn't surprise me. So if daycare is inevitable, the child needs to go in "armed" with antibodies (including from the mother during pregnancy). Not sure how this works. Where to you get "armed" with antibodies if not from a vaccination (unavailable for some viruses) or prior infection? Antibodies from the mother vane over time as far as I recall.
    - carlivar 4y ago
      From the article here: "And babies born during the pandemic may have entered the world with few antibodies passed on by their mothers in the womb, because those mothers may have been sheltered from RSV and other respiratory pathogens during their pregnancies, said Hubert Niesters, a professor of clinical virology and molecular diagnostics at the University Medical Center, in Groningen, the Netherlands."
      - graeme 4y ago
        Those antibodies are transient. Baby doesn’t produce them itself, they just protect it while nursing. Nursing ends well before preschool
        carlivar 4y ago
        Daycare does not end before nursing. And I'm not so sure about preschool either... perhaps you haven't lived in some, er, "crunchier" areas.
        graeme 4y ago
        I was incorrect, it isn’t through nursing. The antibodies last about a year https://www.nhs.uk/common-health-questions/childrens-health/how-long-do-babies-carry-their-mothers-immunity/ https://www.nhs.uk/common-health-questions/childrens-health/...
    - treis 4y ago
      There's also a bit of herd immunity for the new kids. Kids that have lots of prior exposure to a virus are less likely to bring it to daycare if they're exposed outside daycare. Also less likely to be a link in the infection chain for intra daycare spread.
  - chiefalchemist 4y ago
    Pets. More family members. Even natural birth shows gut / immune positives over C Section.
- nmfisher 4y ago
  I've been tussling with my wife about putting our kid into daycare when he's 6 months old. I feel it's way too early, partly due to concerns about contracting a virus (though from the perspective that it would cause more hassle for us, rather than concerns about him getting sick per se, which I figure is inevitable). That being said, I hadn't even thought that RSV would be a bigger problem due to the pandemic.
  - leetrout 4y ago
    Its a real concern. Kids going in to daycare will be sick a ton based all the anecdata. It SUCKS having to keep paying $250+ a week to keep them home while you or a partner are missing work on top of it.
    - semi-extrinsic 4y ago
      Solution: move somewhere else where workers are not treated as cattle by big corporations. Like, say, anywhere in Europe. Seriously, we pay $380 per month for childcare and each parent gets 20 days of paid your-child-is-sick leave, on top of the 20 days of regular sick leave and mandatory 25 days of holidays each year. All of the above is according to law and applies to everyone, whether you work in tech or you're the school janitor. I have never seen a hospital bill above $100, and I have a chronic autoimmune disease. With a population larger than Alabama we have never had a school shooting in the entire history of firearms. I can keep going like this, but you get the picture.
      - deleted 4y ago
        [deleted]
      - deleted 4y ago
        [deleted]
      - google234123 4y ago
        You will get paid 1/2 to 1/8 as much as an software engineer in Europe.
      - 4y ago
- gnicholas 4y ago
  We put our then 2-year-old in preschool last fall. Even though the whole classroom was supposedly masked (toddlers are not great at this, though our child is actually very consistent), she got RSV within a couple months. It cannot be avoided.
  - jhugo 4y ago
    Are there any data on masks to prevent RSV? Even for Covid the data is pretty patchy, and anecdotally they don't seem to be highly effective, at least in actual use. Countries where mask usage has gone from very high to low in a short space of time have seen virtually no change to infection rates.
chinathrow 4y ago
> RSV immunity debt What is this exactly supposed to mean? There is no vaccination for RSV where I live so the only way to get it is via child care or other contacts with toddlers.
- carlivar 4y ago
  To quote this article, "extended periods of low exposure to a particular pathogen." https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00333-3/fulltext https://www.thelancet.com/journals/lanchi/article/PIIS2352-4... As I understand it, just being out and about in the world gives an immune system (whether a baby or its family members indirectly) some practice.
  - graeme 4y ago
    But the child gets it eventually. Is RSV substantially worse to get at 3 vs 2? Should we be coughing on children? Lots of kids in countries with more ventilation have fewer respiratory pathogens and seem to do fine.
    - carlivar 4y ago
      I'm not sure about fine. Probably just undiagnosed? According to this, RSV kills 100k babies and kids between 0-5 per year. 97% of them are in low and middle income countries. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00478-0/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
      - graeme 4y ago
        Well, this paper suggests I’m wrong and that lower and middle income countries get more infections and more death. So….why again would avoiding infections be bad? The added infections appear to increase deaths.
- argonaut 4y ago
  The article mentions that mothers give toddlers antibodies from exposure to viruses during pregnancy.
CalRobert 4y ago
The car thing is very frustrating. It's the most dangerous thing most parents do with their kids (myself included) but for the most part we're blind to it. Of course, pedestrian deaths have shot through through roof in the US and that makes it harder to justify walking to school.
- smt88 4y ago
  In the US, firearms are more likely to kill your child than car accidents are[1]. 1. https://www.nejm.org/doi/full/10.1056/NEJMc2201761 https://www.nejm.org/doi/full/10.1056/NEJMc2201761
  - maxerickson 4y ago
    Regarding the "your", I bet vehicle collision related deaths are more randomly distributed than homicides and unintentional shootings of children (and probably firearm suicides too, for that matter).
  - monocularvision 4y ago
    If you take out 18 and 19 years old, that is no longer true. We have way too many firearm deaths in this country but the way these studies choose their age ranges always feel like folks are in search of the conclusion they desire.
    - GenerocUsername 4y ago
      - CalRobert 4y ago
        Firearm deaths and vehicle deaths, particularly vehicles killing pedestrians, both are more likely to befall poor people, which is correlated with certain ethnic groups in the US. Though a well-designed city is nearly the safest you can be in terms of places to walk.
taeric 4y ago
It really has been hard explaining to fellow parents that their unvaccinated kids are still way lower risk than they are with their vaccines. Edit: Leaving the original wording, but the "they are with the vaccines" is referring to the parents. Not the kids. I agree that vaccinated people are better off than unvaccinated, other items equal.
- Broken_Hippo 4y ago
  Edit: I have misread the comment. The poster and I agree fully. (Original comment follows) This is just false. The risk of vaccines is lesser than the risk from the diseases they prevent.
  - _Microft 4y ago
    I had to re-read GPs comment several times but I think they want to say that even unvaccinated kids are at lower risk than vaccinated adults.
  - christophilus 4y ago
    He’s saying, that unvaccinated kids are at a lower risk for serious COVID than is a vaccinated adult. It’s true as far as I can tell. So far, COVID has proved to be quite low on the list of things that kill kids. The ratio of fear to danger is / was way out of whack vs other things on that list.
    - HarryHirsch 4y ago
      COVID has proved to be quite low on the list of things that kill kids The leading causes of child mortality are accidents, homicide, suicide, cancer and congenital diseases. Children are not supposed to die, we are trying to control these factors, they won't let you take your newborn home from the hospital unless you show them car seat. There is law enforcement, counseling for parents and children, genetic counseling and all that. But when it comes to COVID we are told not to worry, the risk is low. It doesn't make sense.
timcavel 4y ago
woliveirajr 4y ago
Daycare: and then you have this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100471/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100471/ > Epidemiologic studies indicate that infections in early childhood may protect against pediatric acute lymphoblastic leukemia (ALL).
thraway3837 4y ago
Lots of comments on kids getting covid and it not being lethal. But it’s not as binary (life vs death). There are lots of reports of permanent lung scarring, reduced cognitive abilities, changes in breathing patterns, the list is long. If you can avoid these things, it’s for the better.
- rco8786 4y ago
  This is the exact attitude that OP is talking about. Kids are at very, very, very low risk for all of those issues, and it's highly likely that the overprotection/overconcern from the exceedingly small chance of them happening is having very real second order effects that are net worse than covid. RSV in particular is way more dangerous for kids than covid. Plus it's a huge PITA, I had to nebulize my ~4mo old multiple times a day for weeks.
- nradov 4y ago
  You can't avoid these things. There are lots of endemic respiratory viruses, including SARS-CoV-2 (COVID-19). Unless you live as a hermit, you should expect to get exposed. It's better to catch those infections when we're young and our immune systems are most effective; the resulting cellular immunity then protects us as we age. https://www.medpagetoday.com/opinion/vinay-prasad/94646 https://www.medpagetoday.com/opinion/vinay-prasad/94646
mschuster91 4y ago
The problem with kids is, again, statistics. When you have, say, 5 million children and all of them get covid because that is what happens when a virus races on unimpeded, even a 0.1% severe/long term complication is 500 kids with a ruined life - ME/CFS is not a joke. And then you have the kids with geriatric parents. It is no rarity to have 10 year old kids with 60-70 years old fathers and 50 year old mothers these days, and both with diabetes or smoking-associated COPD on top of their advanced age which is both known to be a massive increase in risk. Or they're already fighting some sort of cancer. For these kids, the knowledge that politicians do nothing to prevent them from catching covid while at the same time they have to worry about their parents is incredibly stressful.
dv_dt 4y ago
As far as I've read, there is no effect of immunity debt. On the other hand, there are Covid interactions with reduction or destruction of certain classes of immune cells. This can have the effects which appear to be common viruses out of control. One example is the serious liver hepatitis cases with kids.
foxyv 4y ago
I remember as a kid in 1st grade (California 1991) I would walk to school from my Grandma's house. There would be streams of kids coming from the surrounding neighborhoods. Now, when I ride by elementary schools, I see lines of cars a mile long waiting to drop off their kids in huge noisy modified cars and trucks. Even the one I used to go to. Now they are tearing out playgrounds to add parking and places to queue up to drop off kids... Ironically the area is no longer safe for kids because of these cars. Occasionally I see lifted trucks hopping curbs and minivans blowing through occupied crosswalks at 10 over the speed limit. Crosswalks are a deathtrap because of right on red. Lights are timed with zero consideration to pedestrian traffic. Residential streets are wide and used as short cuts. Cars have become a plague in America.

choko 4y ago

Did you know that children in daycare have almost a 100% chance of contracting RSV within the first year of attendance (even pre-pandemic)?

carlivar 4y ago
No, but that doesn't surprise me. So if daycare is inevitable, the child needs to go in "armed" with antibodies (including from the mother during pregnancy). Should pregnant women isolate? Does not seem like it. Our family dog probably does a good job diversifying antibodies as well (I think there are studies showing the immunity advantages certain pets provide).
- chinathrow 4y ago
  > No, but that doesn't surprise me. So if daycare is inevitable, the child needs to go in "armed" with antibodies (including from the mother during pregnancy). Not sure how this works. Where to you get "armed" with antibodies if not from a vaccination (unavailable for some viruses) or prior infection? Antibodies from the mother vane over time as far as I recall.
  - carlivar 4y ago
    From the article here: "And babies born during the pandemic may have entered the world with few antibodies passed on by their mothers in the womb, because those mothers may have been sheltered from RSV and other respiratory pathogens during their pregnancies, said Hubert Niesters, a professor of clinical virology and molecular diagnostics at the University Medical Center, in Groningen, the Netherlands."
    - graeme 4y ago
      Those antibodies are transient. Baby doesn’t produce them itself, they just protect it while nursing. Nursing ends well before preschool
      - carlivar 4y ago
        Daycare does not end before nursing. And I'm not so sure about preschool either... perhaps you haven't lived in some, er, "crunchier" areas.
        graeme 4y ago
        I was incorrect, it isn’t through nursing. The antibodies last about a year https://www.nhs.uk/common-health-questions/childrens-health/how-long-do-babies-carry-their-mothers-immunity/ https://www.nhs.uk/common-health-questions/childrens-health/...
  - treis 4y ago
    There's also a bit of herd immunity for the new kids. Kids that have lots of prior exposure to a virus are less likely to bring it to daycare if they're exposed outside daycare. Also less likely to be a link in the infection chain for intra daycare spread.
- chiefalchemist 4y ago
  Pets. More family members. Even natural birth shows gut / immune positives over C Section.
nmfisher 4y ago
I've been tussling with my wife about putting our kid into daycare when he's 6 months old. I feel it's way too early, partly due to concerns about contracting a virus (though from the perspective that it would cause more hassle for us, rather than concerns about him getting sick per se, which I figure is inevitable). That being said, I hadn't even thought that RSV would be a bigger problem due to the pandemic.
- leetrout 4y ago
  Its a real concern. Kids going in to daycare will be sick a ton based all the anecdata. It SUCKS having to keep paying $250+ a week to keep them home while you or a partner are missing work on top of it.
  - semi-extrinsic 4y ago
    Solution: move somewhere else where workers are not treated as cattle by big corporations. Like, say, anywhere in Europe. Seriously, we pay $380 per month for childcare and each parent gets 20 days of paid your-child-is-sick leave, on top of the 20 days of regular sick leave and mandatory 25 days of holidays each year. All of the above is according to law and applies to everyone, whether you work in tech or you're the school janitor. I have never seen a hospital bill above $100, and I have a chronic autoimmune disease. With a population larger than Alabama we have never had a school shooting in the entire history of firearms. I can keep going like this, but you get the picture.
    - deleted 4y ago
      [deleted]
    - deleted 4y ago
      [deleted]
    - google234123 4y ago
      You will get paid 1/2 to 1/8 as much as an software engineer in Europe.
    - 4y ago
gnicholas 4y ago
We put our then 2-year-old in preschool last fall. Even though the whole classroom was supposedly masked (toddlers are not great at this, though our child is actually very consistent), she got RSV within a couple months. It cannot be avoided.
- jhugo 4y ago
  Are there any data on masks to prevent RSV? Even for Covid the data is pretty patchy, and anecdotally they don't seem to be highly effective, at least in actual use. Countries where mask usage has gone from very high to low in a short space of time have seen virtually no change to infection rates.

chinathrow 4y ago

> RSV immunity debt What is this exactly supposed to mean? There is no vaccination for RSV where I live so the only way to get it is via child care or other contacts with toddlers.

carlivar 4y ago
To quote this article, "extended periods of low exposure to a particular pathogen." https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00333-3/fulltext https://www.thelancet.com/journals/lanchi/article/PIIS2352-4... As I understand it, just being out and about in the world gives an immune system (whether a baby or its family members indirectly) some practice.
- graeme 4y ago
  But the child gets it eventually. Is RSV substantially worse to get at 3 vs 2? Should we be coughing on children? Lots of kids in countries with more ventilation have fewer respiratory pathogens and seem to do fine.
  - carlivar 4y ago
    I'm not sure about fine. Probably just undiagnosed? According to this, RSV kills 100k babies and kids between 0-5 per year. 97% of them are in low and middle income countries. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00478-0/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
    - graeme 4y ago
      Well, this paper suggests I’m wrong and that lower and middle income countries get more infections and more death. So….why again would avoiding infections be bad? The added infections appear to increase deaths.
argonaut 4y ago
The article mentions that mothers give toddlers antibodies from exposure to viruses during pregnancy.

CalRobert 4y ago

The car thing is very frustrating. It's the most dangerous thing most parents do with their kids (myself included) but for the most part we're blind to it. Of course, pedestrian deaths have shot through through roof in the US and that makes it harder to justify walking to school.

smt88 4y ago
In the US, firearms are more likely to kill your child than car accidents are[1]. 1. https://www.nejm.org/doi/full/10.1056/NEJMc2201761 https://www.nejm.org/doi/full/10.1056/NEJMc2201761
- maxerickson 4y ago
  Regarding the "your", I bet vehicle collision related deaths are more randomly distributed than homicides and unintentional shootings of children (and probably firearm suicides too, for that matter).
- monocularvision 4y ago
  If you take out 18 and 19 years old, that is no longer true. We have way too many firearm deaths in this country but the way these studies choose their age ranges always feel like folks are in search of the conclusion they desire.
  - GenerocUsername 4y ago
    - CalRobert 4y ago
      Firearm deaths and vehicle deaths, particularly vehicles killing pedestrians, both are more likely to befall poor people, which is correlated with certain ethnic groups in the US. Though a well-designed city is nearly the safest you can be in terms of places to walk.

taeric 4y ago

It really has been hard explaining to fellow parents that their unvaccinated kids are still way lower risk than they are with their vaccines. Edit: Leaving the original wording, but the "they are with the vaccines" is referring to the parents. Not the kids. I agree that vaccinated people are better off than unvaccinated, other items equal.

Broken_Hippo 4y ago
Edit: I have misread the comment. The poster and I agree fully. (Original comment follows) This is just false. The risk of vaccines is lesser than the risk from the diseases they prevent.
- _Microft 4y ago
  I had to re-read GPs comment several times but I think they want to say that even unvaccinated kids are at lower risk than vaccinated adults.
- christophilus 4y ago
  He’s saying, that unvaccinated kids are at a lower risk for serious COVID than is a vaccinated adult. It’s true as far as I can tell. So far, COVID has proved to be quite low on the list of things that kill kids. The ratio of fear to danger is / was way out of whack vs other things on that list.
  - HarryHirsch 4y ago
    COVID has proved to be quite low on the list of things that kill kids The leading causes of child mortality are accidents, homicide, suicide, cancer and congenital diseases. Children are not supposed to die, we are trying to control these factors, they won't let you take your newborn home from the hospital unless you show them car seat. There is law enforcement, counseling for parents and children, genetic counseling and all that. But when it comes to COVID we are told not to worry, the risk is low. It doesn't make sense.

timcavel 4y ago

woliveirajr 4y ago

Daycare: and then you have this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100471/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4100471/ > Epidemiologic studies indicate that infections in early childhood may protect against pediatric acute lymphoblastic leukemia (ALL).

thraway3837 4y ago

Lots of comments on kids getting covid and it not being lethal. But it’s not as binary (life vs death). There are lots of reports of permanent lung scarring, reduced cognitive abilities, changes in breathing patterns, the list is long. If you can avoid these things, it’s for the better.

rco8786 4y ago
This is the exact attitude that OP is talking about. Kids are at very, very, very low risk for all of those issues, and it's highly likely that the overprotection/overconcern from the exceedingly small chance of them happening is having very real second order effects that are net worse than covid. RSV in particular is way more dangerous for kids than covid. Plus it's a huge PITA, I had to nebulize my ~4mo old multiple times a day for weeks.
nradov 4y ago
You can't avoid these things. There are lots of endemic respiratory viruses, including SARS-CoV-2 (COVID-19). Unless you live as a hermit, you should expect to get exposed. It's better to catch those infections when we're young and our immune systems are most effective; the resulting cellular immunity then protects us as we age. https://www.medpagetoday.com/opinion/vinay-prasad/94646 https://www.medpagetoday.com/opinion/vinay-prasad/94646

mschuster91 4y ago

The problem with kids is, again, statistics. When you have, say, 5 million children and all of them get covid because that is what happens when a virus races on unimpeded, even a 0.1% severe/long term complication is 500 kids with a ruined life - ME/CFS is not a joke. And then you have the kids with geriatric parents. It is no rarity to have 10 year old kids with 60-70 years old fathers and 50 year old mothers these days, and both with diabetes or smoking-associated COPD on top of their advanced age which is both known to be a massive increase in risk. Or they're already fighting some sort of cancer. For these kids, the knowledge that politicians do nothing to prevent them from catching covid while at the same time they have to worry about their parents is incredibly stressful.

dv_dt 4y ago

As far as I've read, there is no effect of immunity debt. On the other hand, there are Covid interactions with reduction or destruction of certain classes of immune cells. This can have the effects which appear to be common viruses out of control. One example is the serious liver hepatitis cases with kids.

foxyv 4y ago

I remember as a kid in 1st grade (California 1991) I would walk to school from my Grandma's house. There would be streams of kids coming from the surrounding neighborhoods. Now, when I ride by elementary schools, I see lines of cars a mile long waiting to drop off their kids in huge noisy modified cars and trucks. Even the one I used to go to. Now they are tearing out playgrounds to add parking and places to queue up to drop off kids... Ironically the area is no longer safe for kids because of these cars. Occasionally I see lifted trucks hopping curbs and minivans blowing through occupied crosswalks at 10 over the speed limit. Crosswalks are a deathtrap because of right on red. Lights are timed with zero consideration to pedestrian traffic. Residential streets are wide and used as short cuts. Cars have become a plague in America.