June 7, 2021 — Kate Oakes, a Chicago mother, says she finds this point in the pandemic especially confusing. She and her husband are vaccinated against COVID-19, but the vaccines aren’t yet available for children under the age of 12, so their 7-year-old daughter hasn’t gotten one yet. Oakes says that makes figuring out what they can safely do now as a family very challenging.
“Now that my husband and I are vaccinated, we feel all sorts of new freedoms to do things like dine indoors at a friend’s house or at a restaurant, maybe even go see some live music or to a movie,” Oakes says. “But what are the risks associated with these activities as far as what we could potentially expose our daughter to?”
Oakes says she and her husband find they’re now faced with a seemingly never-ending list of questions about what they can safely do with whom and who needs to wear masks in a variety of settings. Can her daughter go to the sleepover she was invited to? Does she need to wear a mask? What if the other kids aren’t wearing them — does she stay? Can unvaccinated kids ride in the car with them? Can her family get on a plane yet? If a loved one flies into town does being on a plane make them higher risk around her unvaccinated daughter?
“Overall trying to figure this all out is so nerve-racking,” Oakes says.
Linda Friehling, MD, an assistant professor in the division of pediatric general medicine at the University of West Virginia, says she has great sympathy for parents and caregivers trying to navigate this moment in the pandemic. “There’s a lot of confusion because this pandemic is still evolving and our knowledge and understanding of it is constantly changing, too,” Friehling says. “We in the medical profession don’t have all the answers yet. That is the honest truth. We’re trying to figure out what’s best for everyone too.”
Kids and COVID: What We Know
Let’s start with the good news. The CDC says COVID cases are down 94% since June 2020, and as of May 27, 2021, the American Academy of Pediatrics (AAP) data showed the lowest number of weekly cases of COVID in children (34,500) since October.
The AAP says nearly 4 million children have tested positive for the virus since the beginning of the pandemic, but hospitalization rates of kids are low. Children make up 1.3%-3.2% of total reported hospitalizations and just 0.1%-1.9% of children with COVID-19 are hospitalized. COVID deaths among children are low too — making up 0.23% of all COVID-19 deaths.
“We do seem to be at the point where cases are decreasing. That is certainly the hope,” Friehling says. “What we don’t know is whether seasons and variants will change that.”
The CDC says fewer children have been sick with COVID-19 compared with adults and most have mild symptoms, although children can get severely ill from the virus and require hospitalization.
There is increased protection to unvaccinated children and adolescents as adults get vaccinated And now, more than 6.7 million children age 12-17 have received at least one vaccine dose. But new data is also raising concern about hospitalization rates in teens, compelling CDC Director Rochelle Walensky, MD, to urge parents to get all teens and adolescents vaccinated if they are eligible.
Walenksy said new CDC data released Friday shows after initially declining in early 2021, teen hospitalization rates from COVID rose in March and April. The CDC looked at more than 200 adolescent hospitalizations and found that none died, but nearly one-third were admitted to intensive care (ICU) and 5% needed “invasive mechanical ventilation.”
“CDC observed troubling data regarding the hospitalizations of adolescents with COVID-19. More concerning were the number of adolescents admitted to the hospital who required treatment in the intensive care unit with mechanical ventilation,” Walensky said at a White House briefing last week. “It is these findings … that demonstrate the level of severe disease, even among youth, that are preventable, that force us to redouble our motivation to get our adolescents and young adults vaccinated.”
“I strongly encourage parents to get their teens vaccinated, as I did mine,” Walensky added.
Vaccines are proving very effective against COVID so far in teens. Pfizer says two doses demonstrated 100% efficacy among teens and young adults as of May 27. The CDC says more than 165 million people have received at least one dose of the vaccine and serious side effects are rare. Another reason to vaccinate adolescents is that vaccines aren’t foolproof. Breakthrough infections are rare but do happen. Of more than 130 million people fully vaccinated as of May 24, 2,454 people were later hospitalized or died from vaccine breakthrough cases, according to the CDC.
The agency is investigating a very small number of reports of heart inflammation in teen and young adult vaccine recipients, calling them “rare.” The American Academy of Pediatrics says most cases have been among male teens and young adults over the age of 16 and most have responded well to rest and medicine and “quickly felt better.”
So which children are most at risk to COVID-19 in general? The CDC says babies under the age of 1 and children with underlying health conditions may be more likely to have severe illness if they get the virus. Conditions that put children at increased COVID risk include: