The officials also collected large fines from couples who broke the rules. One senior researcher at the Central Party School estimated in 2015 that the fees amounted to between $3 billion and $5 billion annually.

In recent years, the government has been reassigning family-planning employees to roles including in population research and tackling Covid-19. But local governments retain the power to enforce birth limits as they see fit, which has led to inconsistencies.

The central government said in May last year that civil servants did not have to lose their jobs for violating birth limits, yet months later, a village committee in the eastern city of Hangzhou fired a woman after she had a third child — prompting a public outcry.

Ultimately, the fate of China’s family-planning policies may change little. A generation of highly educated women are putting off marriage and childbirth for other reasons, including a rejection of traditional attitudes that dictate women should bear most of the responsibility of raising children and doing housework.

Liu Qing, a 38-year-old editor of children’s books in Beijing, said getting married and having children were never in her future because they would come at too great a personal cost.

“All the things that you want — your ideals and your ambitions — have to be sacrificed,” Ms. Liu said.

Ms. Liu said Chinese society imposed a motherhood penalty on women, pointing to the discrimination that mothers often faced in hiring.

“I’m furious about this environment,” she said. “I’m not the kind of person who would accept this reality and compromise. I just won’t.”

For other Chinese, having fewer children is a matter of necessity when holes in the country’s social safety net mean that a major illness can lead to financial ruin.

Ms. Fan, the woman in Hubei who was spared a fine, said that she and her husband, a laborer, were getting increasingly desperate. Public health insurance had covered half the cost of her daughter’s treatment for leukemia, but they were on the hook for $76,000.

She had a third child only because she heard that a sibling’s cord blood could help in the treatment of leukemia. But she later learned that such treatment would cost more than $100,000.

“I don’t dare think about the future,” Ms. Fan said. She added that if her daughter’s condition deteriorated or they went broke, they would have to give up treatment.

“We can only leave it up to her fate,” she said.

Research was contributed by Claire Fu, Liu Yi, Albee Zhang and Elsie Chen.

View Source

To Vaccinate Younger Teens, States and Cities Look to Schools, Camps, Even Beaches

Not all teenagers long for the vaccine. Many hate getting shots. Others say that because young people often get milder cases of Covid, why risk a new vaccine?

Patsy Stinchfield, a nurse practitioner who oversees vaccination for Children’s Minnesota, has stark evidence that some cases in young people can be serious. Not only have more children with Covid been admitted to the hospital recently, but its intensive care unit also has Covid patients who are 13, 15, 16 and 17 years old.

The F.D.A.’s new authorization means all those patients would be eligible for the shots, she noted. “If you can prevent your child ending up in the I.C.U. with a safe vaccine, why wouldn’t you ?” she said.

Mr. Quesnel, the East Hartford, Conn., superintendent, said the most powerful message for reaching older adolescents would probably appeal just as much to younger ones. Rather than focusing on the fact that the shot will protect them, he said, they seize on the idea that it will keep them from having to quarantine if they are exposed.

“They’re not so afraid of the health care dangers from Covid but the social losses that come along with it,” he said, adding that 60 percent of his district’s seniors, or about 300 students, got their first dose at a mass vaccination site run by Community Health Center on April 26. “Some of our greatest leverage right now is that social component — ‘You won’t be quarantined.’”

Michael Jackson of North Port, Fla., can’t wait for his 14-year-old son, Devin, to get the vaccine. During the past year, he said, his son’s beloved Little League games went on hiatus and the family had to suspend their regular Sunday suppers with grandparents And Devin, an eighth grader, had to quarantine three times after being exposed to Covid.

View Source

FDA Authorizes Pfizer-BioNTech Vaccine for Children 12 to 15

Vaccinating children is crucial to building up population levels of immunity and curtailing the spread of the coronavirus. Though children spread the virus less efficiently than adults do, they make up about 23 percent of the population.

Experts have said that the country is unlikely to reach the “herd immunity” threshold — the point at which virus transmission essentially stalls — but vaccinating children will be important for getting as close as possible.

Ty Dropic, 14, one of the trial participants, urged others his age to be vaccinated so they could build up widespread immunity and protect themselves. He had no side effects, leading him to suspect that he got the placebo. If that turns out to be the case, he plans to be immunized as soon as possible.

“I know it can be kind of scary, but it’s really not as bad as it seems,” he said. “If you do get Covid, it’ll be a lot worse than getting stuck with a needle for, like, two seconds.”

Ty’s three siblings, ages 8, 10 and 16, are also enrolled in vaccine trials for their age groups. Their mother, Dr. Amanda Dropic, a pediatrician in northern Kentucky, said that in her practice, most parents were eager to have their children vaccinated so they could regain some semblance of normalcy.

“The anxiety and depression that we’re seeing with kids, the social delays, has been tremendous,” she said.

Dr. Dropic said her children understood the risks and were willing to volunteer because they saw it as a civic duty. Every medicine available today came to be because “somebody was willing to go first,” she added.

View Source

Parents Are Reluctant to Get Their Children Vaccinated for Covid-19, Poll Shows

The American public’s willingness to get a Covid vaccine is reaching a saturation point, a new national poll suggests, one more indication that achieving widespread immunity in the United States is becoming increasingly challenging.

Only 9 percent of respondents said they hadn’t yet gotten the shot but intended to do so, according to the survey, published in the April edition of the Kaiser Family Foundation’s Vaccine Monitor. And with federal authorization of the Pfizer vaccine for adolescents ages 12 through 15 expected imminently, the eagerness of parents to let their children be vaccinated is also limited, the poll found.

Overall, slightly more than half of those surveyed said they had gotten at least one dose of the vaccine, a finding that matches data from the Centers for Disease Control and Prevention.

“We’re in a new stage of talking about vaccine demand,” said Mollyann Brodie, executive vice president of Kaiser’s Public Opinion and Survey Research Program. “There’s not going to be a single strategy to increase demand across everyone who is left. There will be have to be a lot of individually targeted efforts. The people still on the fence have logistical barriers, information needs, and lots don’t yet know they are eligible. Each strategy might move a small number of people to get vaccinated, but all together, that could matter a lot.”

With a growing number of scientists and public health experts concluding that it is unlikely that the country will reach the threshold of herd immunity, the Biden administration has stepped up efforts to reach those who are still hesitant. On Tuesday, the administration announced steps to encourage more pop-up and mobile vaccine clinics and to distribute shots to primary care doctors and pediatricians as well as local pharmacies.

The survey also showed that confidence in the Johnson & Johnson vaccine had suffered a significant blow after the 10-day pause in dispensing it while the authorities examined rare incidents of life-threatening blood clots in people who had taken it. While 69 percent of people said they had confidence in the safety of the vaccines made by Pfizer and Moderna, only 46 percent felt confident about the safety of the Johnson & Johnson vaccine. Among adults who have not been vaccinated, one in five said that the news about the Johnson & Johnson shot had prompted them to change their minds about getting a Covid-19 vaccine.

The survey did show that there had been some progress among Republicans, who have been among the firmest holdouts. Among that group, 55 percent said they had gotten a shot or intended to do so, up from 46 percent in March. The percentage who will “definitely not” get the vaccine is shrinking as well, down to 20 percent from 29 percent in March.

The results were based on telephone surveys of a nationally representative sample of 2,097 adults from April 15 through April 29.

A consortium of universities that includes Harvard, Northeastern and Rutgers has been conducting online polls during the pandemic and recently focused on parents. The group’s latest survey, conducted throughout April and reaching 21,733 adults across 50 states, found that the divide between mothers and fathers in views about the vaccine for children had widened.

Fathers are becoming more accepting, with their resistance falling to 11 percent from 14 percent since February. But over a quarter of mothers, researchers said, still say they are “extremely unlikely” to vaccinate their children. Both genders are more resistant to the vaccine for younger children than for teenagers. Other research shows that mothers tend to have more sway over the final decision than fathers.

The responses from parents may well change over time, experts say. Just as adults were far more reluctant last summer when the vaccine was still a concept, parents surveyed several weeks ago, when imminent authorization for children under 16 had not been widely discussed, might also have been reacting to a hypothetical situation rather than a reality.

But pediatricians and others who are seen as trusted sources of information are already aware that they have considerable work to do to instill vaccine confidence in this latest cohort.

Dr. Sean O’Leary, a pediatrician in Denver who is vice chairman of the committee on infectious diseases for the American Academy of Pediatrics, predicted that just as adults had swarmed Covid vaccine providers during the initial weeks of distribution, parents and pent-up young teenagers would rush for it at the start, too.

But Dr. O’Leary, who often gives talks to pediatricians about how to motivate patients to accept vaccinations, worries that a slowdown will inevitably follow. To persuade hesitant parents, he said, “we have to make the vaccine available in as many places as possible.”

He added, “If parents and patients are in the pediatrician’s office and the doctor can say, ‘Hey, I’ve got it,’ that may be enough of a nudge for them to say, ‘Let’s go ahead and do this.’”

View Source

Many Families Torn Apart at the Southern Border Face a Long and Uncertain Wait

HUEHUETENANGO, Guatemala — In a small village in the Guatemalan highlands, a father smiled into the tiny screen of a cellphone and held up a soccer jersey for the camera, pointing to the name emblazoned on the back: Adelso.

In Boca Raton, Fla., on the other end of the video chat, his son — Adelso — started to cry.

“I’ll send it to you,” the father, David, said during the call in March. “You need to be strong. We’re going to hug and talk together again. Everything’s going to be fine.”

migrant children who are in the United States but separated from their parents, according to lawyers working on the issue. There are at least another 445 who were taken from parents who have not been located.

The separated families received a jolt of hope in early February when President Biden signed an executive order to reunify the migrant families by bringing the deported parents into the United States.

This week, as migrant apprehensions at the southwest border approach a near 20-year high, the Department of Homeland Security announced that it would bring a handful of separated parents to the U.S. in the coming days. The process of reunifying them all could take months or years, and questions remain about what benefits will be offered to each of those families.

Adelso has lived the last three years with his aunt, Teresa Quiñónez, in Boca Raton, Fla., where she works as a real estate agent. She had come to the United States herself at 17, without her parents.

a 2020 investigation by Physicians for Human Rights, many children separated from a parent at the border exhibited symptoms and behavior consistent with trauma: post-traumatic stress disorder, anxiety disorder and major depressive disorder. In some cases, the trauma stemmed partly from experiences in the child’s home country, but researchers found it was likely linked to the separation itself.

Dr. Falcón-Banchs currently treats eight children between the ages of 6 and 16 who were separated from a parent in 2017 and 2018. Five of those children received a diagnosis of PTSD, anxiety and-or depression. Adelso is faring better and has shown resilience and coping skills, she said.

In one case, a boy from Honduras who is now 13 suffered severe anxiety and PTSD after being separated from his mother for several months and placed in foster care. Being reunited with her didn’t improve his condition right away, Falcón-Banchs said.

“When his mom first took him to school in the U.S., his brain responded in such a way that he began screaming and panicking and wanted to leave,” she said. “When he was separated, he was told that he was ‘lost in the system’ and wouldn’t be able to be reunited with his mom. So he was just crying, perhaps because of that association.”

the Trump administration did not track after separation.

And many families whose whereabouts were known have since moved or changed phone numbers, compounding the challenge of possible reunification.

Further complicating the task is that most migrants come from Central America, and three countries there — Guatemala, Honduras and El Salvador — have experienced lockdowns during the pandemic, as well as widespread internal displacement from two hurricanes, Eta and Iota.

“We must find every last family and will not stop until we do,” said Lee Gelernt, the lead attorney for immigrant rights at the A.C.L.U.

But the process has been “extremely difficult and slow,” he said, adding that “many of the parents can only be found through on-the-ground searches.”

During a visit to a small Guatemalan town, a Times reporter learned of three parents who said they were forcibly separated from their children by U.S. border officials in 2018 and then deported. Two had already made the perilous return trip to the U.S., spending $15,000 on a journey to reunite with their children in Florida.

“They returned for the kids, because they were left alone there,” said Eusevia Quiñónez, whose husband, Juan Bernardo, left with his older brother for Fort Lauderdale, Fla., on Jan. 8. “Thank God, they arrived OK.”

Another father, Melvin Jacinto, was contacted by KIND, a children’s defense group, more than a year ago, but he doubts they will be able to help him. He again wants to try to enter the United States to reunite with his son, Rosendo, in Minneapolis and to find work to support his family. He said talking on the phone with his son, who turned 18 last month and from whom he has been separated for three years, is emotionally difficult for him. He can’t help but cry.

“It’s like I’m traumatized or something,” Mr. Jacinto said. “I’m not good. I don’t sleep, not at all.”

Psychologists working with separated families say that family reunification is just one step in the healing process, and that the parents have as much need for mental health counseling as the children. Many parents blame themselves for the separation, and after reunification the children, too, often blame the parents.

David, who has suffered from stress-induced gastritis and other health complications since the separation, said he had also considered hiring a smuggler to get back to the U.S. to reunite with Adelso.

“I need to see my son,” he said. “And he needs me.”

View Source

F.D.A. Set to Authorize Pfizer Vaccine for Adolescents by Early Next Week

WASHINGTON — The Food and Drug Administration is preparing to authorize use of the Pfizer-BioNTech coronavirus vaccine in adolescents 12 to 15 years old by early next week, according to federal officials familiar with the agency’s plans, opening up the U.S. vaccination campaign to millions more people.

Some parents have been counting down the weeks since Pfizer announced results from its trial in adolescents showing that the vaccine is at least as effective in that age group as it is in adults. Vaccinating children is key to raising the level of immunity in the population and bringing down the numbers of hospitalizations and deaths.

The clearance, in the form of an amendment to the existing emergency use authorization for the Pfizer vaccine, could come as early as late this week. If it is granted, the Centers for Disease Control and Prevention’s vaccine advisory panel is likely to meet the following day to review the clinical trial data and make recommendations for the vaccine’s use in adolescents.

The expansion would be a major development in the country’s vaccination campaign and welcome news to some parents who are anxious to protect their children during summer activities and before the start of the next school year. It also poses another challenge to policymakers who are struggling to vaccinate a large percentage of adults hesitant to get the shot. Many more could refuse to inoculate their children.

Pfizer reported several weeks ago that none of the adolescents in the clinical trial who received the vaccine developed symptomatic infections, a sign of significant protection. The company said that volunteers produced strong antibody responses and experienced about the same side effects seen in people ages 16 to 25.

Stephanie Caccomo, a spokeswoman for the Food and Drug Administration, said she could not comment on the timing of the agency’s decision.

“We can assure the public that we are working to review this request as quickly and transparently as possible,” she said.

Over 100 million adults in the United States have been fully vaccinated. But the authorization would arrive in the middle of a delicate and complex push to reach the 44 percent of adults who have not yet received even one shot.

With much of the world clamoring for the surplus of vaccines made in the United States, the Pfizer-BioNTech shot’s use in adolescents will also raise questions about whether the supply should be targeted to an age group that so far appears to be mostly spared from severe Covid-19.

increasing pressure to give away some of the country’s supply of vaccines. Some federal officials have also urged the administration to decide soon how much vaccine is needed, lest doses expire or be shipped to states and go unused. The federal government has bought 700 million doses of three federally authorized vaccines to be delivered before the end of July, well beyond what would be needed to cover every American.

White House officials said last week that it intended to make up to 60 million doses of the AstraZeneca vaccine available to other countries, so long as federal regulators deem the doses safe. The vaccine has not yet received clearance from American regulators. But global health groups and public health experts said that commitment was not enough.

Dr. Rupali J. Limaye, a Johns Hopkins University researcher who studies vaccine use and hesitancy, said that the United States should donate excess Pfizer-BioNTech shots — and any surplus from other manufacturers — to India and other countries that have had severe outbreaks and pleaded for help.

“From an ethical perspective, we should not be prioritizing people like them over people in countries like India,” Dr. Limaye said of adolescents.

If the United States holds onto its supply of Pfizer-BioNTech, she said, it should be reserved for adults while health officials grapple with the phase of the vaccination campaign that requires more personalized, local outreach.

“We still need to go over hesitant adults, while simultaneously maybe starting at 14- or 15-year-olds,” Dr. Limaye said. “But the priority should still be adults.”

according to figures collected by the C.D.C.

The Pfizer and Moderna vaccines both require two doses. Pfizer is authorized for ages 16 and up, while Moderna is authorized for ages 18 and up.

Tens of millions more Pfizer-BioNTech doses — about three weeks’ worth, according to one federal official — have been manufactured and are in various stages of readiness, awaiting final tests before being shipped.

Moderna expects results soon from its own clinical trial involving adolescents ages 12 to 17, followed by results for children 6 months to 12 years old later this year.

The Food and Drug Administration’s authorization is likely to substantially ease concern among middle school and high school administrators planning for the fall. If students are able to be vaccinated by then, that could allow more normal gatherings and let administrators plan further ahead in the academic year.

View Source

College Accounts at Birth: State Efforts Raise New Hopes

Braylon Dedmon was 3 days old when his mother, Talasheia, was offered $1,000 to open a college savings account in his name.

“I was like, ‘What?’” Ms. Dedmon recalled. Her skeptic’s antennae tingled. “I was a little scared.” Was this a scam?

It wasn’t. The offer was the beginning of a far-reaching research project begun in Oklahoma 14 years ago to study whether creating savings accounts for newborns would improve their graduation rates and their chances of going to college or trade school years later.

A few weeks after that initial conversation in 2007, the first statement arrived, showing $1,000 in Braylon’s name. “I was shocked,” said Ms. Dedmon, who now lives in Muskogee. “They started sending me statements every three months, and have been sending me them since then.”

Research about the Oklahoma project published this month by the Center for Social Development at Washington University in St. Louis, which created SEED OK, found that families that had been given accounts were more college-focused and contributed more of their own money than those that hadn’t been. And the effects are strongest among low-income families.

The approach breaks with most social policy programs created over the last half-century, which focus on income supplements. Child savings accounts, by contrast, concentrate on accumulating assets over the long term.

Michael Sherraden, the founder of the center at Washington University, said the idea was to give everyone a stake — an investment — in the future. Benefits of the program extend not just to bank accounts but also to behavior. Households with the seed money — especially poorer ones with parents who did not attend college — have greater expectations about higher education, are more optimistic, have lower rates of depression and save more.

College savings accounts known as 529 plans, which restrict withdrawals and grow tax-free, are used by only a tiny share of American households, mostly in the upper reaches of the income ladder.

Assets and the Poor,” has been pushing for savings accounts, also known as development accounts, that would automatically be opened for every child born in the United States. Canada, Israel, South Korea and Singapore have established versions of the idea.

“We need to create structures to enable people to accumulate assets over the long term,” Mr. Sherraden said. He argues that a universal program is necessary to sustain political support, but that it would nonetheless deliver disproportionate gains at the lower end of the economic spectrum.

“You will reduce the difference in the gap between the highest and lowest group over time,” he said.

In Maine, the private Harold Alfond Foundation started offering every child born in the state a $500 grant in 2009. Mr. Alfond, who founded the Dexter Shoe Company before selling it to Warren E. Buffett, had been writing a $500 check to each of his newborn grandchildren.

California has allocated $25 million for a similar program.

Rhode Island and Nevada are among the states that have established child development account programs. There are several other programs of varying scope and size across the United States, according to the nonprofit group Prosperity Now. Several programs include incentives and subsidies for lower-income families, which are disproportionately Black and Latino.

Automatic enrollment in a saving program, with the ability to opt out, turns out to have a much higher participation rate than relying on individuals to take the initiative. In the first years of the Maine program, when families had to open accounts themselves, participation never rose above 50 percent. In 2013, the Alfond Foundation switched to automatic enrollment, and since then, pretty much every newborn in the state has gotten an account.

William Elliott III, a professor of social work at the University of Michigan and a co-author of “Making Education Work for the Poor,” said knowledge about how to administer savings accounts and their impact had jumped over the last decade.

“It’s one of the best delivery systems” to help low-income children build assets and direct them toward college, Mr. Elliott said. He added that there was more rigorous data on the positive impact of child savings accounts than there was on student loans, government Pell grants and free college.

“A savings account for a low-income kid means a lot more to them than it does for a wealthy kid,” Mr. Elliott said, and establishing it early can transform expectations about the future.

Kandynace Boyd, who lives in Oklahoma City, hasn’t been able to contribute any additional money to her son Manuel’s account. She works part time in an acute care facility and is struggling to keep up with bills. But she said Manuel, 13, was already talking about going to culinary school.

“He’s got nearly $2,000 in it,” she said of the account. “I wish I could do it for my other two kids.”

View Source

U.N. Reports Surge of Migrant Children Entering Mexico, Destined for U.S.

MEXICO CITY — The number of migrant children arriving in Mexico and hoping to enter the United States has increased ninefold from January to March this year, the U.N. Children’s Fund said Monday, with an average of 275 minors entering the country every day.

The number of migrant children reported in Mexico rose to 3,500 at the end of March from 380 at the start of the year, according to the Children’s Fund, or UNICEF. The number includes data from Mexico’s National Migration Institute and other official sources, and provides a detailed look into the crisis.

“I was heartbroken to see the suffering of so many young children, including babies, at the Mexican border with the U.S.,” said Jean Gough, UNICEF’s regional director for Latin America and the Caribbean, after wrapping up a five-day visit to Mexico, where he toured the northern border with the United States.

The flow of minors is part of a larger migrant crisis that has left American officials struggling to control the border, with the Biden administration expecting more apprehensions at the frontier this year than at any point in the last two decades.

two powerful back-to-back hurricanes that devastated parts of Honduras and Guatemala last fall.

The estimated 275 migrant children arriving to Mexico each day include both those coming from Central America and those who are being expelled from the United States into Mexico, according to UNICEF.

The U.N. agency found that children represented at least 30 percent of the migrant population in many Mexican shelters. Half of all children at the shelters traveled without their parents, one of the highest proportions ever recorded in Mexico, according to UNICEF.

“Most of the shelter facilities I visited in Mexico are already overcrowded and cannot accommodate the increasing number of children and families migrating northward,” Mr. Gough said.

has warned migrants not to make the journey because the border is closed, the message has not reached the average citizen in Central America. Human smugglers across Central America are preying on those desperate enough to make the trek, offering their services and saying that the migrants will be welcomed into the United States.

federal order known as Title 42, introduced by Donald J. Trump’s administration but kept in place by Mr. Biden. The order justifies rapid expulsions as a health measure amid the pandemic, allowing the United States to skirt its obligations to asylum seekers.

The trek from Central America through Mexico is arduous. Families and unaccompanied minors often travel hundreds of miles on foot only to reach Mexico and be robbed, kidnapped for ransom or sexually abused by human smugglers and criminal networks that stalk migrant corridors.

In its statement, UNICEF called for the international community to increase its support to Mexico, to help it expand its shelter network and assistance to migrants.

The U.N. agency also called for member organizations to increase aid to Central America, to improve the living conditions for citizens there so they feel they do not have to migrate. That strategy is also being pursued by Mr. Biden’s administration, which plans to spend $4 billion over the next four years on development programs in the region.

“Central American families aren’t migrating — they are fleeing,” said Mr. Gough.

“The best way to give migrant families a good reason to stay in their communities is to invest in their children’s future at the local level,” he added. “The real child crisis is not at the U.S. border, it’s in the poorest communities of northern Central America and Mexico.”

View Source

Mark Zuckerberg is urged to scrap plans for an Instagram for children.

An international coalition of 35 children’s and consumer groups called on Instagram on Thursday to scrap its plans to develop a version of the popular photo-sharing app for users under age 13.

Instagram’s push for a separate children’s app comes after years of complaints from legislators and parents that the platform has been slow to identify underage users and protect them from sexual predators and bullying.

But in a letter to Mark Zuckerberg, the chief executive of Facebook — the company that owns the photo-sharing service — the nonprofit groups warned that a children’s version of Instagram would not mitigate such problems. While 10- to 12-year-olds with Instagram accounts would be unlikely to switch to a “babyish version” of the app, the groups said, it could hook even younger users on endless routines of photo-scrolling and body-image shame.

“While collecting valuable family data and cultivating a new generation of Instagram users may be good for Facebook’s bottom line,” the groups, led by the Campaign for a Commercial-Free Childhood in Boston, said in the letter to Mr. Zuckerberg, “it will likely increase the use of Instagram by young children who are particularly vulnerable to the platform’s manipulative and exploitative features.”

The coalition of nonprofit groups also includes the Africa Digital Rights’ Hub in Ghana; the Australian Council on Children and the Media; the Center for Digital Democracy in Washington; Common Sense Media in San Francisco; the Consumer Federation of America; and the 5Rights Foundation in Britain.

Stephanie Otway, a Facebook spokeswoman, said that Instagram was in the early stages of developing a service for children as part of an effort to keep those under 13 off its main platform. Although Instagram requires users to be at least 13, many younger children have lied about their age to set up accounts.

Ms. Otway said that company would not show ads in any Instagram product developed for children younger than 13, and that it planned to consult with experts on children’s health and safety on the project. Instagram is also working on new age-verification methods to catch younger users trying to lie about their age, she said.

“The reality is that kids are online,” Ms. Otway said. “They want to connect with their family and friends, have fun and learn, and we want to help them do that in a way that is safe and age-appropriate.”

View Source

Some Children With Covid-Related Syndrome Develop Neurological Symptoms

Reports about the mysterious Covid-related inflammatory syndrome that afflicts some children and teenagers have mostly focused on physical symptoms: rash, abdominal pain, red eyes and, most seriously, heart problems like low blood pressure, shock and difficulty pumping.

Now, a new report shows that a significant number of young people with the syndrome also develop neurological symptoms, including hallucinations, confusion, speech impairments and problems with balance and coordination. The study of 46 children treated at one hospital in London found that just over half — 24 — experienced such neurological symptoms, which they had never had before.

Those patients were about twice as likely as those without neurological symptoms to need ventilators because they were “very unwell with systemic shock as part of their hyperinflammatory state,” said an author of the study, Dr. Omar Abdel-Mannan, a clinical research fellow at University College London’s Institute of Neurology. Patients with neurological symptoms were also about twice as likely to require medication to improve the heart’s ability to squeeze, he said.

The condition, called Multisystem Inflammatory Syndrome in Children (MIS-C), typically emerges two to six weeks after a Covid infection, often one that produces only mild symptoms or none at all. The syndrome is rare, but can be very serious. The latest data from the Centers for Disease Control and Prevention reports 3,165 cases in 48 states, Puerto Rico and the District of Columbia, including 36 deaths.

study published last month in JAMA Neurology, 126 of 616 young people with the syndrome admitted to 61 U.S. hospitals last year had neurological issues, including 20 with what the researchers described as “life-threatening” problems like strokes or “severe encephalopathy.”

The new report, presented as preliminary research on Tuesday as part of an annual conference of the American Academy of Neurology, evaluated children under 18 who were admitted to Great Ormond Street Hospital (GOSH) between April and September of last year with the syndrome (it has a different name and acronym, PIMS-TS, in Britain). The data is also included in a preprint of a larger study that has not yet been peer-reviewed.

As was the case with other studies of the syndrome, including in the United States, the researchers said a majority of those afflicted were “nonwhite,” a pattern that public health experts believe reflects the disproportionate way the pandemic has affected communities of color. Nearly two-thirds of the patients were male, and the median age was 10.

All 24 of the patients with neurological symptoms had headaches and 14 had encephalopathy, a general term that can involve confusion, problems with memory or attention and other types of altered mental function. Six of the children were experiencing hallucinations, including “describing people in the room that were not there or seeing cartoons or animals moving on the walls,” Dr. Abdel-Mannan said. He said some experienced auditory hallucinations involving “hearing voices of people not present.”

Six of the children had weakness or difficulty controlling muscles used in speech. Four had balance or coordination problems. One child had seizures and three children had peripheral nerve abnormalities including weakness in facial or shoulder muscles. One patient’s peripheral nerve damage led to a foot-drop problem that required the use of crutches and a recommendation for a nerve transplant, said Dr. Abdel-Mannan, who is also a senior resident in pediatric neurology at GOSH.

Some of the patients underwent brain scans, nerve conduction tests or electroencephalograms (EEGs), including 14 who showed slower electrical activity in their brains, the study reported.

Thirteen of the 24 with neurological symptoms needed to be placed on ventilators and 15 needed medication to improve their heart contractions, Dr. Abdel-Mannan said. By contrast, only three of the 22 children without neurological issues needed ventilators and seven needed such heart medication, he said. None of the children with hallucinations needed psychotropic medications.

Three children had to be hospitalized again after their initial stay, one for another episode of encephalopathy and two for infectious complications, Dr. Abdel-Mannan said, but he added that there were no deaths and “almost all children made a complete functional recovery.”

Dr. Abdel-Mannan said a team led by the study’s senior author, Dr. Yael Hacohen, will be following patients who had the syndrome — both those who had neurological symptoms and those who did not. They will conduct brain scans and cognitive assessments to see if the children experience any long-term cognitive or psychological effects.

View Source