Thousands of students are settling in across Oregon for the first few weeks of school and many classes are back in person, but the COVID-19 pandemic is still on and flu season is just around the corner. Monkeypox also continues to spread throughout the state. Multnomah County Public Health Officer Dr. Jennifer Vines spoke with OPB’s All Things Consopped host, Crystal Ligori, on Monday about what students and parents need to know when we return to class.
This conversation has been edited for length and clarity.
Crystal Ligure: The latest virus of concern in the state is monkeypox, also known as hMPXV. The Oregon Health Authority has already confirmed more than 100 cases in the state. But how concerned are parents and schools about the spread of this disease among children and adolescents?
Jennifer Vines: Sure, kids can get monkeypox just like everyone else. Skin contact is required for the rash. But we hope so far we haven’t seen much [pediatric] cases. [There’s been] Only one kid in Oregon [younger than 18].
This is where public health investigation and contact tracing are very effective. When we identify cases, we can do prevention within the family, hopefully identify anyone at risk, get them vaccinated, and keep them out of schools. And even if she was in school, [we can] Do the same kind of case investigation and contact tracing to prevent it from spreading at school. So while it can certainly be introduced into school, we are optimistic that it is unlikely to spread widely in schools this fall.
Ligurian: Let’s move on to COVID-19. Masks are not needed in schools anymore and the Oregon Health Authority releases COVID data less frequently. But school officials are asking families to screen their children for symptoms of COVID. So what should parents and students think when deciding whether or not to wear masks at school?
Vines: Families should think about returning to some kind of pre-COVID approach to the disease. If your child is sick for any reason, they should be home from school until they feel better or feel completely themselves for at least 24 hours. If they have COVID, the isolation period will remain 5 days. If they are ok [after that], they can go back to school with a mask. If they were exposed to COVID, the recommendation would be 10 days of hiding in school.
If you simply don’t know, making sure they are safe before they return will be key. I think parents have vaccines as options now for kids of all ages, including boosters for 5 years and older and the new booster for 12 and over. I think these are steps in addition to staying home when you are sick.
Vaccinating your family will help slow the spread within your family and possibly the community. These are all tools that can stabilize schools, keep children in school, and make them learn. Concealment will be in effect, but I think it will be on a voluntary, individual basis unless we see a lot of cases in the school and then public health will be there to support the school district and make any decisions about broad masking. [requirements].
Ligurian: The CDC has signed off on those updated versions of the Pfizer and Moderna enhancers that specifically target the BA.4 and BA.5 omicron subvariant. The Pfizer booster dose is approved for people age 12 or older, while Moderna is approved for people over 18. How quickly do you think students and families need to prioritize the next dose of the vaccine?
Vines: Omicron boosters will be most important for the elderly and most important for those with underlying health conditions. I think it’s available to healthy young people as a way to promote short-term risk reduction as far as infection. It’s an important option and people should get good information and talk to their healthcare provider about whether they think this is a good option for them.
By far the most important vaccines are the first two doses, what we call the initial series of Moderna and Pfizer in general. This is where we see the largest reduction in risk in terms of severe illness and in some of the worst COVID outcomes. So these additional boosters play a bigger role for adults at risk, but for those who want to reduce their risk of infection in the short term and would like an omicron booster in the fall, [getting it] It would be wise some time over the next month with the release of the flu vaccine in terms of COVID case numbers.
Ligurian: What do you think we can expect as we approach fall and winter?
vines: We are in remission now with COVID. We are at one of the nadirs among these waves of disease that we have experienced over the past several years. I broadly think the expectation is that as people head indoors and as immunity fades from spring and summer infections, we’ll see more COVID-19 infections heading into this winter. This will be one of the first [winters] Without broad public health protections.
This will be the first time our population has contracted influenza that has similar symptoms and can also be prevented through vaccinations. So this is an uncertain time.
Winter is expected to be harsh, but hopefully the vaccine will be absorbed, with people staying home when they are sick and voluntary use of masks will help mitigate the effects on our daily lives and hopefully our hospitals. We know that fall is usually flu season.
Ligurian: What can parents and students expect with influenza, RSV, and other viruses?
Vines: An important thing for parents to remember about influenza is that unlike COVID, influenza can be dangerous among children under the age of five and especially those under two years old.
Sure, COVID can be dangerous in those age groups, but they are generally not considered groups at high risk of contracting COVID. They are for influenza. So vaccinating the youngest among us and making sure families are vaccinated against influenza is an important strategy. It’s not a new strategy, but we shouldn’t forget it when we start living with the flu and the new coronavirus during the fall and winter.
Ligurian: Recently, the polio virus was found in New York wastewater. Last week, the city declared a state of emergency to ramp up vaccination efforts. Are we seeing anything similar here in Oregon in terms of vaccination rates?
Vines: The situation in New York is somewhat unique, but it certainly rings alarm bells for public health departments across the country to be on the lookout. I don’t know that a statewide wastewater program is looking for polio at this point, but polio is completely preventable with routine childhood vaccination. To the extent that our public health efforts focus on catching up with children who receive routine school-required vaccinations, they will fare better from a polio prevention standpoint.
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