Coronavirus Disease 2019 (COVID-19) Vaccination for Children: Position Statement of Indian Academy of Pediatrics Advisory Committee on Vaccination and Immunization Practices

Justification: Data generated after the first wave has revealed that some children with coronavirus 19 (COVID-19) can become seriously ill. Multi-inflammatory syndrome in children (MIS-C) and long COVID cause significant morbidity in children. Prolonged school closures and quarantine have played havoc with the psychosocial health of children. Many countries in the world have issued emergency use authorisation (EUA) of selected COVID-19 vaccines for use in children. In India, a Subject Expert Committee (SEC) has recommended the use of Covaxin (Bharat Biotech) for children from the ages of 2-18 years. The recommendation has been given to the Drugs Controller General of India (DCGI) for final approval. Objective: To provide an evidence-based document to guide the pediatricians on the recommendation to administer COVID vaccines to children, as and when they are available for use. Process: Formulation of key questions was done by the committee, followed by review of literature on epidemiology and burden of COVID-19 in children, review of the studies on COVID vaccines in children, and the IAP stand on COVID-19 vaccination in children. The available data was discussed in the ACVIP focused WhatsApp group followed by an online meeting on 24 October, 2021, wherein the document was discussed in detail and finalized. Recommendations: The IAP supports the Government of India’s decision to extend the COVID-19 vaccination program to children between 2-18 years of age. Children with high-risk conditions may be immunized on a priority basis. The IAP and its members should be a partner with the Government of India, in the implementation of this program and the surveillance that is necessary following the roll-out.

Idiopathic Hypoparathyroidism in a Cerebral Palsy Child Presenting with Extensive Intracranial Calcifications: A Rare Case Report

Introduction: Hypoparathyroidism is a rare endocrinedisorder characterized by low serum calcium and parathyroidhormone levels. The most common cause is iatrogenic surgicalremoval. However, idiopathic primary hypoparathyroidismis to be kept in mind especially in children as a cause ofhypoparathyroidism. Since PTH is important in calciumhomeostasis, this condition may cause ectopic calcifications,including intra cerebral calcifications, though rare.Case report: 11 year old MCH,with history of birth asphyxiaand global developmental delay was presented to emergencywith seizures. The child had seizures since the age of 5years,and wasn’t on regular treatment. The patient was admittedwith a provisional diagnosis of Cerebral Palsy with seizuredisorder with polymorphic seizures was made and treatedconservatively. Neuroimaging showed bilateral symmetriccalcification in basal ganglia,thalami and capsule. A completeworkup showed low serum calcium, high serum phosphorusand low parathormone. Calcium supplementation was givenand seizures was made under control.Conclusion: Idiopathic hypoparathroidism, though rarely, asit was in our case, may cause exuberant cerebral presentationswith extensive intracranial calcifications and extremehypocalcemia which may or may not correlate with severity ofsymptoms. Not only this is a treatable disorder that may havedangerous implications if untreated, but also its symptomsmay be completely reversed with prompt treatment.