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Reflection on lower rates of COVID-19 in children: Does childhood immunizations offer unexpected protection?
Jinglu Lyu1, Tianyu Miao2, Jiajia Dong2
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China.
Insights
Children exhibit milder COVID-19 symptoms and lower infection rates due to unique immune system characteristics. This suggests potential benefits from existing vaccines like BCG, influenza, and pneumococcal for enhancing immunity in vulnerable populations.
Area of Science:
- Immunology
- Virology
- Pediatrics
Background:
- COVID-19 incidence in children is low (approx. 2%) with generally mild symptoms.
- Children, typically vulnerable to respiratory pathogens, show atypical COVID-19/SARS-like virus severity.
- Differences in cellular immunity between children and adults may explain these clinical observations.
Purpose of the Study:
- To investigate the reasons behind the atypical clinical manifestations of COVID-19 in children.
- To explore the potential of existing vaccines to enhance immunity against COVID-19 in specific populations.
Main Methods:
- Analysis of pathological studies on COVID-19 and SARS focusing on T lymphocyte counts.
- Comparison of cellular immune system differences between children and adults.
- Review of the impact of childhood vaccinations and infections on immune responses.
Main Results:
- Children's immune systems may possess trained immunity, immune fitness, or cross-protection from prior exposures.
- T-lymphocyte reduction is a key factor in severe COVID-19/SARS, but less pronounced in children.
- Existing vaccines (tuberculosis, influenza, pneumonia) may offer protective potential.
Conclusions:
- Children's unique immune profiles contribute to milder COVID-19 outcomes.
- Vaccines like BCG, influenza, and pneumococcal vaccines warrant consideration for healthcare workers.
- Further research is needed to explore leveraging planned immunization for trained immunity in high-risk adults.
Abstract:
The incidence of COVID-19 in children and teenagers is only about 2% in China. Children had mild symptoms and hardly infected other children or adults. It is worth considering that children are the most vulnerable to respiratory pathogens, but fatal SARS-like virus had not caused severe cases among them. According to the pathological studies of COVID-19 and SARS, a sharp decrease in T lymphocytes leads to the breakdown of the immune system. The cellular immune system of children differs from that of adults may be the keystone of atypical clinical manifestations or even covert infection. The frequent childhood vaccinations and repeated pathogens infections might be resulting in trained immunity of innate immune cells, immune fitness of adaptive immune cells or cross-protection of antibodies in the children. Therefore, due to lack of specific vaccine, some vaccines for tuberculosis, influenza and pneumonia may have certain application potential for the front-line health workers in the prevention and control of COVID-19. However, for high-risk susceptible populations, such as the elderly with basic diseases such as hypertension and diabetes, it is necessary to explore the remedial effect of the planned immune process on their immunity to achieve the trained immunity or immune fitness, so as to improve their own antiviral ability.
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