My daughter, Coral, is six years old living with Type 1 diabetes. T1d is a life-threatening autoimmune condition where the body has destroyed the insulin-producing beta cells in the pancreas, making that person insulin dependent for life. Having T1d also puts her and millions of fellow Type 1 diabetics at increased risk for severe Covid illness and/or hospitalization per CDC’s updated guidelines. We have been in strict self-isolation, follow all health advisories since March 2020, and husband’s fortunate enough to work from home. If she were to contract Covid-19 and survive, the virus would likely significantly affect her blood glucose levels. Making her insulin resistant much like the common cold and she would require increased insulin to cover high BGs and more frequent monitoring than usual.
*Non-diabetics: Thank you for clicking and reading this far to learn more how this pandemic uniquely affects our lives. FYI, Type 1 diabetics need insulin for high BGs and fast-acting carbs like juice or a glucose tab(s) for low BGs. T1ds like Coral would die without insulin and it’s price has increased more than 1200% over the past 10 years. More details on access and affordability of insulin at T1international.com. Hence, why the slow Covid vaccine rollout is driving us nuts.
Decent case scenario
Her BGs remain as they usually are with careful monitoring, regular activities and foods, but she unknowingly spreads the virus to our younger daughter, Kaila, almost two years old, and the remaining three of us also get Covid. We’re strong and healthy and take all necessary health precautions as usual. Maybe we also become asymptomatic carriers with mild symptoms (nose congestion, loss of taste and smell, see more at CDC.gov). How the heck are we each supposed to quarantine while caring for Coral’s T1d and tending to our toddler’s needs? We have no one else fully qualified to take care of them in the mainland during this raging real pandemic.
Note: Again, we have been in strict self-isolation, follow all health advisories, and husband’s fortunate enough to work from home since March 12, 2020. The only way we’d become exposed to Covid is when we’re out for essentials (ex: Medication, food, gas), during new home inspections/renovations, and doctor’s appointments almost every other month between her endocrinologist, gastroenterologist, and dermatologist – when not able to do telehealth appointments.
Best Case Scenario
We continue strict self-isolation, go a little crazy and depressed, maybe put a tear in the blanket of our marriage, and just survive disinfected for many more months until the FDA finally approves a safe and effective vaccine for children with any chronic medical conditions and their caregivers. When that FINALLY happens – as in each of us are able to get BOTH doses of the vaccine, we can put our major anxiety at ease a bit. Hard truth: This pandemic ain’t over until more than “70% of the world’s population is fully vaccinated,” per NIAID Director Dr. Anthony Fauci on Good Morning America, broadcasted December 15, 2020. See that video here or below. He also mentioned on Good Morning America on December 22, 2020, “We likely will be able to start vaccinating people who are in the broader category somewhere around the end of March, beginning of April. How long it takes to get everyone who needs to be vaccinated…it really varies. It depends on the efficiency of the process.” Translation and cautiously optimistic: End of Summer 2020 for general public like my hubs and I depending on each state’s governors. See that interview from GMA here. Read Call to Action section below.
Good Morning America, Fauci on What to Know About the Covid-19 Vaccine. 15 December 2020.
Quick Facts About Pfizer and Moderna’s Vaccines
If you’ve been staying informed with vaccine updates and listening to science, then you’re well-aware that Pfizer’s vaccine is proven 95% effective and FDA approved for children over 16 years old. It must be stored in very cold temperatures which makes it more costly and difficult to transport for suppliers. Pfizer’s vaccine will likely be effective against the new highly contagious variations of the virus known as B117 from the U.K. and 501.V2 from South Africa per medical studies published on LiveScience.com. Whereas Modern’s vaccine is 94.5% effective and FDA approved for children over 18 years old. Pfizer’s second dose must be given around the 21st day and Moderna’s the 28th day from first dose (see vaccine chart below). Please visit FDA.gov to learn more about the vaccines on your own. Both are mRNA vaccines which are like little instructions that enter your cells, help your body recognize the virus, and build a better response to fight it.
Adenovirus-Based Vaccines
Whereas adenovirus-based vaccines use a harmless virus to get genetic material that encodes SARS-CoV-2 genes into your cells and get your cells to make the virus proteins offering protection. See videos below from California based ER Dr. Seheult of MedCram below for further explanation.
Even more concerning, based on a recent study by the CDC published in JAMA Network Open, asymptomatic adults and children account for more than 59 percent of spreading the virus either because:
A) They weren’t “aware” they had it and weren’t showing any symptoms.
B) Their symptoms showed up after they hung out with people NOT in their household despite any Stay-at-Home orders.
C) They still refuse to follow ALL health advisories like simply wearing a mask correctly over their nose and mouth while maintaining physical distancing of at least eight feet. Yes, airborne virus per CDC and hundreds of health experts.
Of that 59%, 39% were infected by people who later showed symptoms (aka “presymptomatic” spreaders). 24% were infected by those who never showed symptoms. It’s important to note that this study also emphasized the need for greater research on younger age groups because children can carry higher viral loads of Covid, remain asymptomatic or have mild symptoms or develop MIS-C, and still transmit the virus to others more vulnerable.
JDRF and the ADA are aware of the need for a safe Covid vaccine for very young T1d children. JDRF will likely provide an update on their blog post, Answering Your Questions about the COVID-19 Vaccines. Keep checking it to stay informed. Per an ADA study received in September 2020, “People with Type 1 diabetes had adjusted odds ratios of 3.90 (95% CI 1.75–8.69) for hospitalization and 3.35 (95% CI 1.53–7.33) for greater illness severity [to Covid-19], which was similar to risk in Type 2 diabetes. Among patients with Type 1 diabetes, glycosylated hemoglobin (HbA1c), hypertension, race, recent diabetic ketoacidosis, health insurance status, and less diabetes technology use were significantly associated with illness severity.” In short: Both T1d and T2d are at similar increased risk of three to four times higher than those without any type of diabetes.
Call to Action
If you’ve read this far, then pat yourself on the back! Given the information above, it’s clear what we MUST do in the diabetes community especially those of us with T1d children under the age of 16 and are either in-school learning or continuing exhausting distance learning like us in LAUSD:
- Contact your state governors, mayors, city councilman/women, and even President-elect Joe Biden and VP Kamala Harris on all online platforms. For those of us living in CA, Governor Newsoms office can be reached via mail or online here or troll him on Instagram @cagovernor or @gavinnewsom and Twitter with the same handle (aka username). Phone: (916) 445-2841 / Fax: (916) 558-3160. Note: I’ve noticed more interaction and stronger advocacy efforts on Twitter, but every little bit helps.
- Use this form created by the American Diabetes Association (ADA) to contact your local governor and be sure to add your personal story in the space provided.
- Sign this petition started by a fellow T1d (mom) based in California on Change.org and please share to all your social media platforms. Be sure to tag @gavinnewsom with #prioritizeT1d #Covidvaccine when posting to social media. Thanks in advance!
- Use this letter signed by several professors at multiple universities and endocrinologists to write to the ACIP. Add your personal Covid story or how the pandemic has affected your lives as someone who is high-risk to severe Covid illness and attach the letter or Google Drive link in your emails to your governors and senators. Note: If you send the letter, please remove all organization names. You can indicate that you are a volunteer advocate with the California #insulin4all Chapter of T1International (if applicable).
- Find your local representatives at Common Cause.
- Contact your local county health department “Based on growing evidence, children with Type 1 and/or Type 2 diabetes – and their caregivers, should be a HIGH PRIORITY for the Covid-19 vaccine.” Use the Letter specified above.
- Contact CDPH here.
- California residents, download the Department of Developmental Sciences (DDS) letter for families of high-risk youth here and READ details in the Further Reading section below for further instructions. You will need to save, print and bring the DDS letter along with medical records of your child’s condition/disease and specific devices they depend on and currently use, at the time of your vaccination appointment.
- Urge diabetes organizations to continue representing all types of diabetics in hopes of FDA, Pfizer Inc., and Moderna completing clinical trials for an effective Covid vaccine for ages under 12 years. Top diabetes organizations are JDRF, American Diabetes Association, Beyond Type 1, and T1international. Click through each of their websites for more contact details and follow them on social media.
- Individual responsibility – please don’t rely on anyone else, including me, to provide you with up-to-date info regarding new Covid-19 and vaccine developments. Keep checking FDA.gov and Clinicaltrials.gov to find out when any vaccine will be accepting and completing trials for children less than 16 years of age. Note: As of this writing, both Pfizer and Moderna are starting trials for 12 years old and up.
Watch these videos about the Covid vaccine
Good Morning America. Here’s Every Public Figure Who Has Gotten a Covid-19 Vaccine So Far. Published January 11, 2021. Accessed 11 January 2021.
NBC Boston. People With No Symptoms Spread Nearly 60% of Covid Cases, CDC Study* Finds. Published January 8, 2021. Accessed 10 January 2021.
Seheult, Roger, MD. Medcram: Coronavirus Update 116: Pfizer COVID 19 Vaccine Explained (Biontech).
Seheult, Roger, MD. Coronavirus Update 117: Moderna vs. Pfizer COVID 19 Vaccine (mRNA vaccines).
Seheult, Roger, MD. Coronavirus Update 118: AstraZeneca DNA COVID 19 Vaccine Explained (vs. Pfizer / BioNTech, Moderna).
I highly suggest following @medcram on all social media platforms like Instagram, Twitter, and/or subscribe to his YouTube channel. Watch all of his Covid-19 and vaccine videos to further educate yourself of this ever changing lethal virus. He is a frontline worker in California. Again, Los Angeles is the latest epicenter with ICU’s full as of December 19, 2020. Too many blatantly ignorant selfish, self-entitled people who refuse to follow all health advisories, and still gathered during any of the holidays.
Thank You Healthcare Heroes and Essential Workers
I want to sincerely thank the hundreds of medical researchers and scientists who helped make these Covid-19 vaccines available in record-breaking time given the dire circumstances across the U.S. and rest of the world. Thank you to all our medical staff whether you’re a doctor, nurse, admin at a hospital and/or nursing home, or EMT. To the essential workers at our grocery stores, food and mail delivery workers – you guys are our heroes! May all those who’ve passed due to Covid rest in peace. Yes, shame on anyone who STILL refuses to follow ALL health advisories.
The sooner families like us are vaccinated, the sooner our high-risk children can go back to school and we can resume our usual busy T1d lives. I have done all of the Call to Action tasks listed above. Will you please make the time to do the same for us? Leave me a comment or drop me a DM on Instagram to let me know if you’ve read this blog post. We must all work together to build herd immunity safely for those who cannot and will not be able to get the vaccine soon or ever (ex: immunocompromised group which make up over 10 million people in the US). Much mahalo for being a good self-educating human. Let’s keep spreading awareness – not the virus.
Stay well,
Shelsea
Further Reading
See California’s vaccination plan here. As of this writing, T1ds and their caregivers are still not specified as high priority and aren’t even included in Phase 1B of vaccinations. The California Department of Public Health (CDPH) and Governor Newsom has prioritized “incarcerated and homeless” people above those with “underlying health conditions or disability which increases their risk of severe Covid.” This is illogical, immoral, and must change asap! See above how to take action and make your voices heard.
California Residents: Download the letter from Nancy Bargmann, Director of the Department of Developmental Sciences (DDS) of CA above or view on your web browser here for eligibility in Phase 1A for families of high-risk youth (DDS did not specify age and/or exclude any medical conditions). Be sure to click through the active links within that letter if viewing from web browser. CA residents will have to get approval of either intellectual or developmental disabilities from the specific list of regional centers. Save, print it out and bring it with your child’s medical records, a letter from your endocrinologist listing all medical devices currently using during your Covid Vaccine appointment. Visit each regional center’s website to read their Covid vaccine updates too. See example of Westside Regional Center’s Covid vaccine update from February 3, 2021 below:
Los Angeles Public Health. Public Health Officials Issue Urgent Plea as 10 People in L.A. County Test Positive for COVID-19 Every Minute – 137 New Deaths and 12,617 New Confirmed Cases of COVID-19 in Los Angeles County. News Released January 11, 2021. Accessed 11 Jan 2021. 12 min read with statistics. See recent KTLA video coverage of SoCal’s desperation as hospitals code patients every minute here. After ICU’s in SoCal reached 0% capacity on December 19, 2020, due to holiday gatherings, LA County quickly became the latest epicenter of this raging pandemic.
As previously mentioned in my “Coronavirus and T1d” blog post, Covid-19 is also an autoimmune attack on the body which may lead to rising cases in newly diagnosed Type 1 diabetics of any age. See that medical study from the National Institutes of Health (NIH) here.
See CDPH’s vaccination meeting schedule here. Find out when it’s your turn to get vaccinated in CA here. All info is on each county and states public health website. Search your individual state to take action, advocate, and stay informed.
See LA County Publich Health’s vaccine rollout plan here. It’s more straightforward and provides details on what committee decides how vaccines are distributed. (Hint: Advisory Committee on Immunization Practices (ACIP) is an independent panel of medical and public health experts). Contact the ACIP and learn more about them here:
1600 Clifton Road, N.E., Mailstop H24-8
Atlanta, GA 30329-4027
acip@cdc.gov
CDC’s Advisory Committee of Immunization Practices’ (ACIP) Updated Interim Recommendation for Allocation of COVID-19 Vaccine — United States, December 2020.
Adam Taylor and Mahalingam, “From adenoviruses to RNA: the pros and cons of different COVID vaccine technologies.” Published September 17, 2020. Accessed 23 January 2021. Good 10min read.
The Hill, “Advocacy groups call for including Type 1 diabetes among prioritized vaccine recipients.” 5 min read.
David K. Li and Berkeley Lovelace, Jr., Special to CNBC.com. FDA chief says states should expand vaccinations to lower-priority groups. Published January 8, 2020. 5 min read without any mention of a Covid vaccine for children under age 12.
Covid Act Now – Realtime vaccine and Covid data tracker. Check it as often as you like to stay informed of vaccine availability per state and more info. *Note: Data may vary on this new source versus CDC.gov or your local county health department – which should be your first go-to.
CNN – Biden outlines plan to administer Covid-19 vaccines to Americans, updated publication January 15, 2021.
CNN – 15 Most Notable Lies from Trump’s Presidency. Send it to your Trumper “friends” and/or family to spare yourself some time and any remaining sanity after this raging pandemic, pathetic vaccine rollout, and the insurrection of our Capital threatening our democracy. For the record, no, Trump will not make insulin cheap as water because that would require the FDA involvement and dismantling pharmacy benefit managers (PBMs). Learn more at T1international.
References
Adalja, Amesh. Johns Hopkins School of Public Health. New Data on COVID-19 Transmission by Vaccinated Individuals. Published April 8, 2021. Accessed 15 June 2021.
American Diabetes Association. Justin M. Gregory et al. COVID-19 Severity Is Tripled in the Diabetes Community: A Prospective Analysis of the Pandemic’s Impact in Type 1 and Type 2 Diabetes. Accepted November 10, 2020. Accessed 11 Jan 2021.
BioSpace. UPDATED Comparing COVID-19 Vaccines: Timelines, Types and Prices. Published January 13, 2021. Accessed 29 Jan 2021.
Centers for Disease Control and Prevention. Scientific Brief: SARS-CoV-2 and Potential Airborne Transmission. Updated October 5, 2020. Accessed 12 Jan 2021.
*JAMA Network Open. SARS-CoV-2 Transmission From People Without COVID-19 Symptoms. Published January 7, 2021. Accessed online 11 Jan 2021.
LAUSD. Superintendent Austin Beutner and Los Angeles Unified Labor Partners Propose a Plan for the Safe Reopening of Schools. Published January 11, 2021. Accessed 11 Jan 2021.
Centers for Disease Control and Prevention. COVID-19 Pandemic Planning Scenarios. Updated September 10, 2020. Accessed 11 Jan 2021.
Centers for Disease Control and Prevention. People with Certain Medical Conditions. Updated December 29, 2020. Accessed 11 Jan 2021.
Duncan, Charles of the Sacramento Bee. What does ‘immunocompromised’ mean, and what should people at risk of coronavirus do? March 6, 2020. Accessed 12 Jan 2021.
Johnson & Johnson. Johnson & Johnson Announces Single-Shot Janssen COVID-19 Vaccine Candidate Met Primary Endpoints in Interim Analysis of its Phase 3 ENSEMBLE Trial. Published January 29, 2021. Accessed 29 Jan 20221.
Juvenile Diabetes Research Foundation. Answering Your Questions about the COVID-19 Vaccines. Published December 21, 2020. Accessed 11 Jan 2021.
The Lancet: Diabetes & Endocrinology. Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. Published August 13, 2020. Accessed 19 Jan 2021.
The Lancet: Diabetes & Endocrinology. Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study. Published August 13, 2020. Accessed 19 Jan 2021.
National Institutes of Health. Clinical Trials: A Study to Evaluate the Safety, Reactogenicity, and Effectiveness of mRNA-1273 Vaccine in Adolescents 12 to <18 Years Old to Prevent COVID-19 (TeenCove). Updated December 4, 2020. Accessed 11 Jan 2021.
National Institutes of Health. Type 1 diabetes triggered by covid-19 pandemic: A potential outbreak? Published May 20, 2020. Accessed 10 September 2020.
Saplakoglu, Yasemin for LiveScience.com. Pfizer vaccine works against coronavirus mutation in UK and S. Africa variants. Published January 8, 2021. Accessed 14 Jan 2021.
Shipman, Matt of NC State University. “Vaccine Q&A: Vaccines 101, mRNA and Adenoviruses.” Published December 16, 2020. Accessed 12 Jan 2021.
Stepanova, Olessa of NBC Boston. People With No Symptoms Spread Nearly 60% of COVID Cases, CDC Study Finds. Published January 8, 2020. Accessed 11 Jan 2021.
U.S. Department of Health and Human Services. Fact Sheet: Explaining Operation Warp Speed. Reviewed December 21, 2020. Accessed 11 Jan 2021.
U.S. Food and Drug Administration. Coronavirus Disease 2019 (COVID-19). Updated January 8, 2021. Accessed 11 Jan 2021.
Updated: 6/15/21
Disclaimer: I am not a doctor. Nothing I say or do on any of my platforms should be taken as medical advice. If you’re experiencing any Covid symptoms, please follow CDC guidelines and contact your doctor immediately. If it’s a medical emergency, then dial 911 and why the heck are you still reading this? If I were writing an actual essay, I would make sure to properly format my references. This piece took over 7 hours to complete.
T1dLife 