What are the health impacts of COVID-19 on young children?

Families/Kids Long COVID Vaccines

What are the health impacts of COVID-19 on young children? How does the burden of COVID-19 compare to other vaccine-preventable diseases?

COVID-19 is usually mild and short-lived in young kids. Yet, a small fraction of cases result in severe outcomes like Multisystem Inflammatory Syndrome, long-term symptoms, or even death. These tragedies strike children with and without pre-existing health conditions. The burden of COVID-19 on young children exceeds that of many other vaccine-preventable diseases like chickenpox (varicella).

A Centers for Disease Control and Prevention (CDC) presentation at the recent FDA meeting on vaccines for young children shed light on the substantial toll of COVID-19 on young children in the United States.

Here are some key stats:

Since 2020, COVID-19 has caused the following in US children aged 6 months to 4 years:

✖️At least 2 million cases* (1,913,969 age 1-4 and 567,535 under 1 year)
✖️202 deaths (1.7% of all deaths in this age group)
✖️1,990 cases of Multisystem Inflammatory Syndrome in Children (MIS-C)
✖️120 hospitalizations per 100,000 US kids (~1.2 in 1,000 young kids!)
*Cases are most certainly an underestimate due to under-testing / under-reporting

During the US Omicron wave, COVID-19 caused:

✖️535 hospitalizations in children aged 6 months to 4 years
✖️49% of these children had no pre-existing health conditions
✖️23% of these children ended up in the intensive care unit (ICU)

Post-COVID impacts:

In the UK, where the long term impacts of COVID-19 are being closely tracked, roughly 7-8% of children report symptoms beyond 12 weeks. The CDC did not provide a US-based estimate of the long-term burden of COVID-19 in kids.

Common post-COVID symptoms include fatigue, trouble concentrating, insomnia, muscle and joint pain, and more. These issues can dramatically alter quality of life, spanning physical activity, mental health, and school attendance / participation.

❓How does the burden of COVID-19 compare to other diseases that we vaccinate children against?

Hospitalizations per year among US children aged 6 months to 4 years:

🦠COVID-19: 89 per 100,000 kids
🦠Invasive Pneumococcal Disease: 40 per 100,000 kids (prior to vaccines)
🦠Varicella (Chickenpox): 29-42 per 100,000 kids (prior to vaccines)
🦠Hepatitis A: 1 per 100,000 kids (prior to vaccines)* in ages 5-14
🦠Flu (influenza): Hospitalization rates from the worst flu year in the last 5 years were similar to COVID-19 hospitalization rates from Oct 2021 to Apr 2022. All other recent flu years had lower hospitalization rates than this.

Deaths per year among US children aged 6 months to 4 years:

🦠COVID-19: 86 deaths
🦠Hepatitis A, Meningococcal, Varicella, Rubella, and Rotavirus: 3-20 deaths each (prior to vaccines)

* See figure for breakdown by disease

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The Bottom Line:

⚠️The risks posed by COVID-19 are small in most young children – but not so small that they should be dismissed. These risks are similar or greater than those that young children face from other diseases that we routinely vaccinate against.

💉Serious illness and death in children is always tragic, and is even more so when it’s preventable. Since exposure to COVID-19 is virtually guaranteed for most young children, a decision not to vaccinate is a decision to gamble with the known and unknown harms of this virus.

💪Our goal is not to scare you – it’s to empower you to make informed choices from vaccinations, to school, to birthday parties and visits with grandparents.

Additional Links:

Should I vaccinate my kids even if they’ve already been infected with COVID-19?

FDA approves Moderna & Pfizer COVID vaccines for kids under 5