COVID-19 and Children

Contributor: Dr. Elise Herman, KVH Pediatrics

Early in the COVID-19 pandemic, it was a relief to see that children were much less likely to get sick, be hospitalized, or die from the virus. Eighteen months later, many things have changed including the risk to kids, especially with the much more transmissible Delta variant. There have been over 5.7 million pediatric cases since the start of the pandemic, and recent reporting showed over 430,000 US child cases in just 2 weeks, from 9/9/21 to 9/23/21. More than a quarter of new cases are in children, and 55,000 kids total have been hospitalized since August 2020, most without prior health issues. Deaths continue to be rare in this age group but there have been 523 deaths in kids 17 years and younger including 168 in those under 4 years.

Kids can have similar symptoms to adults- fever, productive cough, sore throat, muscle aches, fatigue, and loss of taste or smell. Also common are intestinal symptoms like vomiting and diarrhea. Some children may just have mild cold symptoms or even no symptoms though they can still infect others.

One of the most concerning problems is MIS-C, “multi-system inflammatory syndrome in children” which causes inflammation throughout the body including the brain, heart, and kidneys. This severe illness typically occurs about a month after what seems to be a mild case of COVID-19. There have been over 4,000 cases so far of MIS-C according to the CDC (Center for Control for Disease Control and Prevention).

It is now known that “Long COVID” (prolonged symptoms after initial infection has improved) can happen in children as well as adults. Symptoms include cough and shortness of breath, heart inflammation, severe fatigue, and “brain fog” that last for weeks to months.

There are some clear steps we can take to protect our children. Everyone who is eligible for the COVID-19 vaccine should get it; currently that includes kids 12 years and up (and of course adults). As an example of the vaccine’s effectiveness, teens who are unvaccinated are ten times more likely to be hospitalized than those who have received the vaccine. The more people who are vaccinated, the less chance the virus has to mutate into a new and potentially worse strain. Pfizer has just submitted favorable data regarding vaccine trials in kids aged 5-11 years. A smaller dose than in adults was given in a two-vaccine series with strong antibody response and good safety outcomes. It is hoped that the COVID vaccine will be approved for this age range by the end of October.

Masks are essential in the fight against COVID-19, especially with the Delta variant. Masks have been shown to decrease the spread of the virus in schools this year. Outbreaks are much more likely in places where masking in schools is not required or was instituted after the start of the school year. The Washington state indoor mask requirement is for everyone’s protection, and we parents need to model consistent mask wearing to our children. Lower COVID numbers means fewer people needing medical care which also protects our health care workers, a scarce commodity these days.

In World War II, there was a sense of personal responsibility for everyone to pull together and do their part to help the war effort. This is a war, too, though of a different type. We all need to be part of the solution and be good examples to our children.