ÌìÃÀÊÓƵ

The last two years have been hard on all of us.

As Hawaii grapples with yet another Covid-19 spike, it’s especially important to recognize how aspects of the pandemic fall on our children — not only the physical stress of infection or the well-documented epidemic of loneliness affecting so many young people today, but also the (often-overlooked) emotional toll on children who have lost a parent, grandparent or other caregiver to Covid-19.

A published in the peer-reviewed journal Pediatrics found that in the three months from April through June of this year, more than 140,000 children in the United States experienced the death of a parent or grandparent caregiver due to Covid-19. The consequences of such a loss can be enormous, including mental health problems like depression, eating disorders and substance abuse, as well as long-term social problems like housing instability, poor nutrition and poverty.

In my own practice as a child and adolescent psychiatrist, I am seeing the impact of these losses more and more often: the high school senior who had a 4.0 GPA and was in the midst of applying for college scholarships, but now hasn’t been to school more than a handful of times since his grandmother died of Covid in September; the middle school student who developed depression and an eating disorder after her auntie passed away last year; the 7-year-old boy who suddenly and seemingly out of the blue became oppositional and argumentative at school, and then his teacher learns that his auntie has been hospitalized for the last month.

Much of this suffering is preventable — though prevention requires a shift in thinking. I often speak with individuals who are struggling with decisions about Covid-19 vaccination. These are highly emotional decisions, particularly where our children are concerned. I find it helps to think about vaccination as a matter that affects the whole family — a decision about the ohana, rather than just any one individual family member.

According to current research, the risk of serious illness and death from Covid-19 in young children is believed to be lower than it is among older adults. For that reason, some parents weigh the decision about vaccinating their young children differently than the decision about vaccinating themselves, other adult family members, or even their teenaged children.

Yet despite this lower risk in young kids, it is also important to recognize that the highly contagious omicron variant can very quickly spread from asymptomatic children to other family members, for whom the risk of serious illness and death are greater.

These are difficult decisions. As a physician, I took an oath to first do no harm — and yet when encountering circumstances like those we find ourselves in today, figuring out exactly what that means can be tricky.

Vaccination isn’t just about protecting the individual.

The number of children orphaned by Covid-19 is accelerating, and with it, the potential for serious mental health consequences. Postponing and avoiding vaccination decisions will only make matters worse. For the sake of our children, we cannot allow fear to prevent us from taking action.

Rather, we must engage in conversations about vaccination with the people we trust: our families and our health care providers. And in doing so, we must gather the courage to ask the unthinkable — what would the impact be on my child if she should lose her parent, grandparent or other caregiver to Covid-19?

Vaccination isn’t just about protecting the individual; it’s about protecting our families, protecting the physical and emotional well-being of all the people close to us — from the oldest to the youngest, and everyone in between.