The United States (US) Food and Drug Administration (FDA) recently authorized the Pfizer-BioNTech COVID-19 vaccine for children ages 5 to 11 years old. The Centers for Disease Control and Prevention (CDC) also recommended the vaccine in this age group. There are 28 million children in the US ages 5 to 11 years old. This age group makes up 39% of COVID-19 cases in those under the age of 18 years. While children are less likely to develop severe COVID-19 than adults, severe illness, hospitalization, and death have occurred in younger ages. Now that there is a COVID-19 vaccine option for ages 5 to 11 years, here are answers to vaccine questions that are top of mind for many parents.

1. How effective is Pfizer’s vaccine in children ages 5 to 11 years?

• According to results from the ongoing study in ages 5 to 11 years, the vaccine has been 90.7% effective in preventing COVID-19 measured 7 days after the second dose. The study has been going on with delta as the prevalent strain.
• Immune responses in this age group were comparable to 16 to 25-year-olds.

2. What are the common side effects?

• The most common side effect was injection site pain (sore arm). Some of the other common side effects include fatigue, headache, redness and swelling, fever, chills, and muscle pain.
• Side effects were generally more common after the second dose. Side effects were mostly mild to moderate, started within 2 days of the second dose, and resolved within 1 or 2 days.
• There have been no cases of myocarditis (heart inflammation) reported in this age group.
• The study is ongoing, and the FDA and CDC will continue to monitor for vaccine safety and look for rare or serious side effects.
• The vaccine should not be given to anyone who has a history of anaphylaxis (severe allergic reaction) to any part of Pfizer’s vaccine.

3. How is Pfizer’s vaccine dosed in ages 5 to 11 years? What type of vaccine is it?

• The dose for 5 to 11-year-olds is a two-dose regimen of 10 mcg given 21 days apart.
• It is a messenger RNA (mRNA) vaccine, but the dose is one-third of the adolescent and adult doses (30 mcg).

4. Can the flu and COVID-19 shots be given at the same visit?

• COVID-19 vaccine can be given at the same visit as routine childhood immunizations, including flu.

5. Where is Pfizer’s vaccine available?

• Pfizer’s vaccine for ages 5 to 11 years is available in pediatrician offices, pharmacies, health departments, hospitals, and other sites.  Vaccines.gov lists vaccine availability at different locations.

Disclaimer: The content in this blog article is NOT a substitute for professional medical advice. For questions regarding COVID-19 vaccines, any medical condition, or if you are in need of medical advice, please contact your healthcare provider. Given the fluid nature of the pandemic, information in this article is subject to change and may not be current.

Sources

• VRBPAC FDA Briefing Document. October 26, 2021. https://www.fda.gov/media/153447/download
• Pfizer EUA Press Release. October 29, 2021. https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-receive-first-us-fda-emergency-use-0.
• FDA Press Release. October 29, 2021. https://www.fda.gov/news-events/press-announcements/fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use-children-5-through-11-years-age
• CDC Interim Clinical Considerations. November 3, 2021. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#children
• Pfizer EUA Fact Sheet. Revised October 29, 2021. https://www.fda.gov/media/153714/download
• AAP Policy Statement. November 2, 2021. https://www.aap.org/en/pages/covid-19-vaccines-in-children-and-adolescents-policy/
• Vaccines.gov.

The COVID-19 pandemic led to abrupt and massive changes. We have learned to adapt to new routines and protocols in the workplace, at home, at school, and in public settings. However, we still wonder how we will function as a society as we continue to fight the pandemic and find our “new normal” all while dealing with potential feelings of burnout. All these changes and unknowns can make us feel stressed and anxious.

Practice these tips to help you get through the transition:

Be mindful of emotions. During times of stress, it is common to have a wide range of emotions. We may be anxious, frustrated, angry, or sad. These are normal human reactions. Emotions provide us with information that causes us to react so that we can take care of ourselves.

Identify and validate feelings. It’s hard to control emotions when you don’t know what you’re feeling. Sometimes, when you’re busy, distracted, or don’t have much time for yourself, you may not be aware of what or how you’re feeling. Try going for a walk, talking to a friend, or just sitting quietly. If you can pinpoint the feeling, you can acknowledge it. That doesn’t mean you have a bad attitude, or that the feeling lasts forever. It just means you have an emotional reaction and, like the weather, the feelings will eventually pass.

Engage with supportive people. Talk to a trusted person, such as a friend, family member, or counselor. If we openly share our feelings without being judged, we feel less overwhelmed. Sharing with others can make us feel more supported and less alone. Look for opportunities to be that supportive person for people you care about. Mutually supportive relationships are the most rewarding.

Practice stress-reduction techniques. One of the most challenging things about emotions is learning to express them constructively. For example, you may be angry about something, but it is inappropriate to transfer that anger to someone else. Manage and express emotions in a healthy way with activities that bring you joy, release negative energy, and incorporate exercise. Such activities may be journaling, painting, singing, dancing, exercising, or meditating.

Be kind to yourself. Instead of condemning yourself for having certain feelings that make you feel worse, be compassionate to yourself. Being kind to yourself when you have emotional reactions provides a calming quality that puts us back on the path to feeling better.

Look for possibilities. Look for what is possible despite the current circumstances. Do not dwell on how things used to be, focus more on what is possible. Change is difficult and resistance is a natural human response. You can change your mindset with practice. If you find yourself focusing on the negative, stop and make a conscious effort to find the good in the situation.

Help is available. Your program is completely confidential and here to help you and your household members 24/7/365. No situation is too big or too small. Give us a call or visit your program website to get started.

Source: Verywell Mind

Explore tips and information to protect your mental health and deal with grief and loss of loved ones due to the worldwide impacts of COVID-19.

When else in our lifetime can we say all people in all countries of the world have directly experienced grief and loss due to the same traumatic event? Now that we are living through the COVID-19 pandemic, this is the sad reality. Our very sense of normalcy has been turned upside down, we have lost loved ones, missed milestones and other life events, and faced social isolation. We all hear about the traumas that occur across our globe – 9/11, weather events, war – and we may be affected; but COVID-19 has profoundly touched and changed each of our lives in many similar ways. As our world is adjusting to a now improving, but still evolving, pandemic, here are some tips to protect our mental health.

Dealing with grief and loss from COVID-19

While it’s never easy when we lose a loved one, grief and loss during the pandemic has been exacerbated by the confusion, fear, and social isolation we have all experienced. The novel coronavirus, COVID-19, did not come with an instruction manual and we had to learn, very quickly, how it was spread, how it affected those who got infected, and how to avoid being infected. Confusion around all of these things, and how a family member or friend could have died from this virus, was inevitable. At the same time, fear of the unknown and for one’s own health and safety was inescapable. Due to the critical social distancing measures, we could not even visit our loved ones in the hospital, even if the worst was expected. We could not begin our grieving process by honoring those we lost with traditional funeral services. As we’re navigating the stages of grief during COVID-19, here are some things to remember:

• You may hear about the “stages of grief,” but it’s normal to bounce back and forth between the stages and not experience them in a linear way.
• No matter what you’re feeling, your feelings are valid, and you are entitled to them; avoid telling yourself you should be feeling one way or another.
• Grieving doesn’t mean you are forgetting or totally letting go.
• It’s important to build a support system.
• With grief comes growth.

Practicing self-care to cope with grief and loss

Grieving is an intensely personal process. We can start to feel better when we reach out to loved ones and professionals for support, but there is no one who knows us better than ourselves, and we can always be our own best advocate. Knowing that our lost loved ones surely would want us to be happy and not suffer, it’s important to prioritize our own self-care and compassion to unlock its immense healing power. Engaging in self-care activities – exercise, journaling, meditation, doing something creative, etc. – can help us build resiliency and mental strength, elevate our mood, process our feelings, and cope effectively. As we strive to take care of and make time for ourselves, the following are some tips to keep in mind:

• Understand that grief is an ongoing process; it requires our self-patience and kindness.
• Realize that helping yourself does not mean you are avoiding the experience, rather that you are embracing it.
• Treat yourself the way you would treat a close friend or family member who is going through the same thing.
• Be deliberate and purposeful in taking breaks to mentally check out and/or do something that makes you happy or laugh.
• Focus on the present to ease the burdens of, and make more palatable, all that must be done that day, week, month, etc.
• Grant yourself permission to feel, as it’s a natural part of the grieving process; understand it’s okay to be vulnerable.

We can find meaning in the losses we have endured through this ordeal. Our lost loved ones gave us many gifts, and we can pick up on those gifts in celebration of their memories. We can embrace life and do the things that make us happy. We can reflect on the changes and losses caused by the pandemic that forced us to reevaluate our priorities, taking with us the good and leaving behind the bad. And we must always remember to seek help when it’s needed.

Think back to New Year’s Eve, Tuesday, December 31, 2019. Maybe you had big plans that night to ring in the new year, or maybe you were spending a quiet evening at home. In either case, you probably had expectations about 2020 and hopes that it would be happy, healthy and prosperous…

Fast forward a couple months to February, 2020 when we began hearing more about a new coronavirus, COVID-19, originating from Wuhan, China that had made its way into the United States and was beginning to spread.

Changes caused by COVID-19

We started to see our world and our lives drastically change, experiencing loss and grief in several forms. For many of us, there were no more commutes to work, as we began to work from home if we were lucky enough to keep our job. There was no more getting the kids off to the bus stop or waiting in the drop-off line, as schools closed and switched to a virtual learning environment.

Parents lost the luxury of being able to fully concentrate on their jobs, as they were forced to take on the roles of teacher or daycare worker and daytime entertainer for their kids. Kids missed out on receiving the first-class education they depended on to feel prepared for the next school year or even college.

Healthcare workers risked their lives and those of their family to care for the people who were getting sick from COVID-19, worried they had been infected and wanted to get tested, or needed regular healthcare. Essential workers in grocery stores, post offices, public transportation, and other industries also became heroes as they continued to come to work to keep the country running, despite fearing for their own health and lives.

And there wasn’t a roll of toilet paper or paper towels to be found.

Social isolation

Across the board, we didn’t get to spend precious in-person time with our extended family and friends because we were doing our part to bend the curve and stop the spread of COVID-19. We didn’t get to go to the gym and may have fallen behind in our physical fitness. Our kids didn’t get to participate in their beloved sporting or other extracurricular events. Medical procedures were cancelled. Vacations were cancelled. Weddings were cancelled. Graduations were cancelled. Everything was cancelled.

Our dreams and plans were put on hold.

COVID-19 mental health toll

We certainly couldn’t have imagined this would be how the year would start off and end. Spring, summer, fall and winter, and all that comes with each, did not happen the way we have all become accustomed to for our entire lives.

And while we have done our best to adapt, the grief and loss of loved ones, financial security and social normality we have experienced over the past year has taken its toll on our mental health.

Where to go from here

We encourage you to watch a recording of our webinar “Coping with grief and loss during COVID-19” with Paula Hensley, MD, Magellan Healthcare senior medical director; Sagar Makanji, PharmD, Magellan Rx vice president, clinical strategy and programs; and Mark Santilli, PharmD, Magellan Rx senior director, clinical strategy and programs, as they share knowledge and tips for persevering after grief and loss due to COVID-19 and answer audience questions.

For additional COVID-19 resources from Magellan Health, click here.

By: Linda Y. Evans and Greg Dicharry

Before the COVID-19 pandemic started wreaking havoc on various aspects of our “normal” lives, including our mental health, 1 in 6 children aged 2-8 years in the United States was diagnosed with a mental, behavioral or developmental disorder.[1] While these children have endured the impacts of drastic changes over the past year, so too have others who did not previously have a mental health diagnosis; some children have been newly diagnosed with a mental health condition as a result of COVID-19. When considering how to nurture the mental health of our children during a pandemic, we must understand their pre-pandemic mental state and monitor how they are coping.

Children diagnosed with a mental health condition before COVID-19

For children who experienced mental health challenges before COVID-19, the pandemic may have imposed new complications. In many cases, before COVID-19, families practiced a routine in their daily lives, which helped everyone manage their feelings and behaviors. When routines changed – kids were no longer going to school, adults were working from home, or not at all, and in-person interactions with friends, extended family, and even doctors were cut off – that familiarity and rhythm, and the associated therapeutic effects, were lost. Another part of the pre-pandemic routine for many children with a mental health diagnosis was the special help received by trained teachers and therapists in schools. While this support could be a vital lifeline, it was completely cut off for the kids who depended on it. Other treatment options, through primary care and other outpatient settings, also dwindled due to office closures caused by COVID-19. As a result, an increasing number of children were seen for mental health-related care in emergency departments (EDs). From mid-March to October 2020, the Centers for Disease Control and Prevention reported an increase in the proportion of mental health-related ED visits among children aged 5-11 years (24%) and 12-17 years (31%) compared with the same period in 2019.[2]

Serious mental health impacts for children as a result of COVID-19

Children and youth who started off 2020 without a mental health diagnosis may not have ended the year in the same way, as newly developed depression and other mental health conditions were caused by the pandemic. A CDC report on mental health, substance use, and suicidal ideation during the COVID-19 pandemic shows that while 11% of adults seriously contemplated suicide in June 2020, the same was disproportionately reported by young people aged 18 to 24 (26%).[3] The serious effects on younger children include delays in social and emotional development, as their brains are forming amidst irregular human activity. In some cases, when parents weren’t adjusting or handling the increased stress and uncertainty well, maltreatment in the form of child neglect or abuse has resulted.

Negative mental health consequences of COVID-19 for all children

Because of COVID-19, all children are coping with unprecedented change and loss. Children feel the family stress of economic hardships, health concerns, social isolation, exhaustion, bereavement, and worsening mental health and substance use. And children have stressors of their own. When healthy outlets, like school, sports, and social engagements, are lost, that energy may become more negative and unproductive. The impacts of missed once-in-a-lifetime childhood events, like birthdays, graduations, and family vacations, may not even be fully realized until later in life. Children and youth may also experience their own anxiety and stress about what the future looks like.

The state of mental healthcare for children

There have always been barriers for children to access mental healthcare. Among them are stigma, availability, misinformation, and lack of information. While these factors impact access to care for adults, as well, they may be more pronounced for children. Parents are afraid or do not want to accept that their child is affected by a mental illness. There is a shortage of child and adolescent psychiatrists and therapists trained to work with children in our country. In addition, many parents and caregivers are misinformed about child psychiatric services that are meant to improve a child’s mental state, and not necessarily their behavior, although the latter may be a secondary effect.

With the pandemic, parents may be so preoccupied that they cannot see potential conditions in their children. The advent of a pandemic has stretched an already thin system of specialized mental healthcare for children at a time when it may be needed the most. And misinformation continues to plague our news sources and social media.

Where to go from here

There are many things that parents and caregivers can do to support and nurture their child’s mental health. We encourage you to learn more in a recording of the webinar, “How are your kids doing?” where I was joined by Greg Dicharry, CPRP, youth empowerment director, to share knowledge and our years of experience working with children to improve mental health and wellness and answer audience questions.

[1] https://www.cdc.gov/childrensmentalhealth/data.html

[2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6945a3.htm

[3] https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm

Anxiety is a normal response to a constant barrage of bad news. Headlines and notifications related to recent events are taking their toll on mental health in what some call “headline stress disorder.”

While this is not a medical diagnosis, the continued anxiety or stress from headlines may cause things like heart palpitations and chest tightness or insomnia. Further progression may lead to physical and mental conditions such as anxiety disorders, depression, endocrine disorders or hypertension.¹ The combination of civil unrest, political instability and COVID-19, and the resulting economic uncertainty, has led to an increase in stress and anxiety in society. Both adults and children may struggle to process their feelings and maintain a sense of normalcy.

Here are some tips to help you understand and manage your fears, how to help children deal with traumatic events and how to know when you or someone close might need help.

Understanding the emotional and physical reactions to traumatic events

Emotional reactions

When the initial shock of a traumatic event subsides, normal emotional responses in the hours and days that follow may come in waves and at unpredictable times. These responses include:

• Fear and anxiety
• Sadness and depression
• Guilt, shame or despair
• Anger and irritability
• Emotional numbness
• Feelings of separation from others

Physical reactions

Physical reactions are the result of stress hormones flooding the nervous system. Common physical symptoms include:

• Difficulty sleeping
• Fatigue
• Headache, abdominal pain or other physical pain
• Racing heart
• Dizziness or fainting
• Change of appetite

How to help yourself

• Take care of yourself first. Eat healthy foods, get enough rest and exercise regularly. Physical activity can reduce anxiety and promote well-being.
• Talk to people you trust about your concerns. A supportive network is important for emotional health.
• Take time for hobbies and fun activities or find interesting volunteer activities. This can be a healthy distraction from everyday stress.
• Limit your exposure to disruptive TV, radio and social media coverage.
• Practice mindfulness and relaxation techniques such as deep breathing and meditation.

How to help children cope with traumatic events

• Be aware of your own reactions to the event and manage your own stress. Stay calm and offer hugs and reassurance to restore your child’s sense of safety and security.
• Share information about the event and answer your child’s questions honestly. Listen to your child’s fears and let them know that it is okay to share their feelings at any time.
• Restrict or prevent contact with disturbing news and social media coverage of the event. Children who see graphic images or hear disturbing news can be re-traumatized.
• Maintain as many stable routines as possible, including regular meals, bedtimes and exercise.
• Engage in fun activities to help the children relax and get the feeling that life is back to normal.
• Watch for signs of trauma, even after weeks have passed. Children, like adults, cope with trauma in different ways, and may show signs of sadness, anxiety or disruptive behavior weeks or months after the event.

Know when to get help

• Common signs that you or your child may need professional help can include: excessive worrying or fear, extreme mood swings, avoidance of friends, difficulty understanding or relating to other people, changes in eating and sleeping habits and inability to engage in daily activities or deal with daily problems and stress.
• If you are suffering from stress reactions that affect your ability to lead a normal life for six weeks or more, you may need help from a mental health professional. While everyone is different and heals at their own pace, some people develop Post-Traumatic Stress Disorder (PTSD) after a traumatic event.
• Signs of PTSD include: disturbing memories, nightmares or flashbacks, suicidal thoughts or feelings, disconnection from others, and trouble functioning at home and work. It is important to seek help if you think you might have symptoms of PTSD.

¹https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104635/

As the new COVID-19 vaccine is being administered across the country, many people are feeling a mix of emotions. There is hope that the vaccine will normalize life and relief that the vaccine will save lives.  There is also anxiety about its potential side effects, long-term effectiveness and availability. For some, the stress and uncertainty caused by the pandemic are being exacerbated by vaccine concerns.

Vaccine safety

Although the two vaccines currently available were rapidly developed, they meet the safety and efficacy standards of the U.S. Food and Drug Administration (FDA). The data from the manufacturers and research from large clinical trials show that the benefits of the COVID-19 vaccines outweigh the risks of side effects and coronavirus infection. There are also other COVID-19 vaccines in development that must meet stringent safety standards before they can be released.

In addition, the Centers for Disease Control (CDC) and FDA have expanded safety monitoring systems to continue to track possible side effects of vaccines. A new easy-to-use, smartphone-based tool called V-safe enables vaccinated individuals to notify the CDC about any side effects. V-safe also texts reminders to get the second vaccine dose.

Anxiety about the COVID-19 vaccine

Anxiety can stem from fears about the vaccine’s safety, getting a shot or not having control over when it will be available.

Here are tips to help manage it:

• Stay informed and research credible sources. There is a lot of misinformation online about vaccinations in general. Follow credible news and information sources. Up-to-date information about the COVID-19 vaccines, side effects and benefits, and answers to frequently asked questions, are available on the CDC website.
• Follow recommended guidelines to keep yourself safe. It will likely take months for the COVID-19 vaccine to be available to anyone who wants it. In the meantime, take precautions to protect yourself and your family by wearing masks, maintaining social distance and washing your hands frequently. Minimize your risk of contracting the virus by following CDC guidelines on travel, gatherings and other activities that can spread the virus.
• Make self-care a priority and consistently practice ways to cope with stress. Anxiety can result from a feeling of lack of control and uncertainty, and the pandemic was the perfect storm of both. Get enough sleep, eat nutritious foods, exercise and take time every day for an activity you enjoy.

Finally, remember that feelings of stress and anxiety during difficult times are normal and will pass. If you find that anxiety continually affects your quality of life and you feel overwhelmed, consider talking to a mental health professional.

To learn more about Magellan Healthcare’s mental and behavioral health resources, click here. 

Source: Centers for Disease Control and Prevention

How we can comfort and support each other when grieving

Grieving the loss of a family member, friend or colleague is difficult. The pandemic has made it even harder for many people to cope. Those who have lost loved ones to COVID-19 or other illnesses may face additional grief and sadness. Infection control restrictions have left them unable to visit or say goodbye. Moreover, traditional wakes and funeral services have been modified or eliminated due to social distancing and limits on the size of gatherings, changing the way people can comfort and support each other.

Many people have experienced multiple losses. For example, the loss of a loved one at the same time as unemployment and social isolation.  The resulting grief may be prolonged and complicated with delays in the ability to heal and move forward.

Common Grief Reactions

Pain associated with grief is a normal response to loss and can be felt on emotional, physical and spiritual levels. Common reactions to grief are:

• Initial feelings of shock, denial, and disbelief, which can be heightened when the death is sudden and unexpected
• Feelings of worry, fear, frustration, anger or guilt
• Physical reactions such as headaches, fatigue, difficulty sleeping, loss of appetite, pain and other stress-related symptoms
• Spiritual expressions of grief, such as questioning the meaning and purpose of life, pain and suffering

There is no normal and expected time for mourning to end. Depending on the relationship with the individual and the circumstances of the loss, grief can last for weeks to years. Grief can ebb and flow at unexpected times, triggered by memories of the deceased person, holidays and anniversaries of loss.

Coping with Loss

It is important to find ways to express grief.

• Connect with other people, such as friends, relatives, support groups, and faith-based organizations if applicable, even if the contact must be virtual or by phone. Sharing your feelings with people who understand what you are going through is comforting and eases loneliness.
• Participate in an activity, such as planting a tree or creating a memory book, to honor the person you lost. Ask family and friends to contribute their memories and stories.
• Take good care of yourself. Maintain a balanced diet, moderate exercise and adequate sleep. Treat yourself to something you enjoy, such as a massage or a walk in nature.
• Avoid the use of alcohol, tobacco or other drugs to escape emotional pain.
• Don’t be afraid to ask others for help. Allow other people to assume some of your responsibilities when you are feeling overwhelmed.

When time has passed, if you are still having difficulty functioning, seek support through grief counseling, your EAP, support groups or hotlines. As writer Vicki Harrison said, “Grief is like the ocean; it comes in waves ebbing and flowing. Sometimes the water is calm and sometimes it’s overwhelming. All we can do is learn to swim.”