Coronavirus and Children

Updated November 2021

Some respiratory illnesses, such as the seasonal flu, put children at risk of serious health complications.

COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, has spread worldwide. It has caused hundreds of millions of illnesses and millions of deaths.

Children can get sick from COVID-19 and spread the virus. But they appear to be at a lower risk of severe illness, hospitalization, and death.

How Many Kids Are Getting COVID-19?

A September 2021 report by the American Academy of Pediatrics and the Children’s Hospital Association examined COVID-19 cases in the United States

According to the report, nearly 5.9 million children had been infected with COVID-19 —about 16.2% of total reported U.S. cases.

However, the number and rate of COVID-19 cases among children have steadily increased throughout the pandemic. Potential causes for that include less vaccine availability for children, as well as the resumption of in-person schooling and other activities.

Data show the rates of hospitalization and death are much lower for children compared to adults.

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What Are the Symptoms of COVID-19 in Children?

Common symptoms of COVID-19 in children include:

  • Fever.
  • Cough.
  • Fatigue.
  • Headache.
  • Muscle pain or weakness.
  • Nasal congestion.
  • New loss of taste or smell.
  • Sore throat.
  • Shortness of breath or difficulty breathing.
  • Abdominal pain.
  • Diarrhea.
  • Nausea or vomiting.
  • Poor appetite or poor feeding.

According to the CDC, fever and cough are the most common COVID-19 symptoms for children. However, many children may have milder symptoms than adults or show no symptoms at all.

COVID-19 symptoms in children are also similar to other illnesses like colds and the flu, which could make diagnosis difficult.

Serious COVID-19 Illness in Children

Like adults, children can get severely ill from COVID-19. They can be hospitalized and die from the disease. However, this happens at a lower rate than adults.

According to the Centers for Disease Control and Prevention (CDC), some children may be more at risk from COVID-19 than others. Children more at risk include infants (under 1 year old) and children with underlying medical conditions like heart disease, chronic lung disease (such as asthma), diabetes, and more.

If a child is showing symptoms such as fever, cough, and difficulty breathing, please contact a health care provider immediately.

If a child is showing cold symptoms or had exposure to someone suspected to have COVID-19, it’s best for them not to be around higher-risk people, such as older adults, people with underlying medical conditions, or unvaccinated people.

COVID-19 also can lead to more serious health complications like pneumonia.

Some children have developed a complication from COVID-19 known as multisystem inflammatory syndrome in children (MIS-C). This condition can cause inflammation in the heart, lungs, kidneys, brain, skin, eyes, gastrointestinal organs, and other parts of the body. MIS-C can be serious and even deadly, but most children recover after treatment.

Can Children Get the COVID-19 Vaccine?

Children ages 5 and older are eligible to receive the COVID-19 vaccine developed by Pfizer-BioNTech.

The vaccine is safe and effective against COVID-19. It is especially effective in preventing severe illness, hospitalization, and death.

The Pfizer vaccine is not currently authorized for children younger than age 5. COVID-19 vaccines developed by Moderna and Johnson & Johnson/Janssen (J&J) are currently only authorized for people 18 and older. However, that could change in the future.

Receiving the COVID-19 vaccine during pregnancy is safe for the fetus, protects the mother from severe COVID during pregnancy, and provides some protection to the infant at birth and through breastfeeding.

Preventing COVID-19 in Children

The COVID-19 vaccine is crucial in preventing children from getting COVID-19. However, there are other important prevention methods — especially if your child is not yet eligible for the vaccine.

COVID-19 prevention methods include:

  • Facemasks. Children ages 2 and older who are not fully vaccinated should wear a facemask that covers their nose and mouth when in indoor public places. The CDC also recommends that children wear facemasks in school, even if they are fully vaccinated. Facemasks are also recommended for children who are immunocompromised or who live in areas of high COVID-19 circulation, even if they are fully vaccinated. Note: Children who are under 2 years old should not wear a facemask due to risk of suffocation.
  • Physical distancing. Avoid close contact (6 feet or closer) with people who are not from your household when in indoor public places.
  • Wash your hands. Use soap and water and scrub for at least 20 seconds. It’s especially important before eating, after using the bathroom, and after coughing, sneezing, or blowing your nose. If soap and water are unavailable, use a hand sanitizer that’s at least 60% alcohol. Bonus: You can teach your kids the “ABCs”— humming the “ABCs” can help you get those 20 seconds of scrubbing.
  • Avoid people who are sick. Avoid close contact (6 feet or closer) with people showing symptoms like coughing and sneezing.
  • Clean heavily touched surfaces. Sanitize areas like tables, countertops, doorknobs, phones, toys, and more. As appropriate, put washable plush toys through the laundry and follow care instructions.
  • Use a tissue when coughing, sneezing, or blowing your nose. Throw the tissue away and wash your hands after using it.

Children’s Mental Health During COVID-19

The COVID-19 pandemic is an uncertain time, and it may cause children to feel anxious or fearful. Because of that, it’s important to take note of your children’s mental health. Talk to them about COVID-19, explain the situation, and offer reassurance. Encourage them to wear a mask and follow other prevention guidelines. Don’t be afraid to seek professional help if you sense your child is struggling.

Sources
Children and Influenza (Flu) . Centers for Disease Control and Prevention. Frequently Asked Questions and Answers: Coronavirus Disease-2019 (COVID-19) and Children . Centers for Disease Control and Prevention. Zunyou Wu, MD, PhD; Jennifer M. McGoogan, PhD. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China . Journal of the American Medical Association.

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh ranks consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. UPMC Magee-Womens Hospital is a longtime national leader for women and their newborns. We aim to provide the best care for your children, from birth to adulthood and beyond.