COVID-19 cases in children continue to rise at an alarming rate in the United States. And, while adults continue to account for the majority of COVID-19 infections (including the vast majority of severe illness cases), the country recently reached a record number of new pediatric COVID-19 cases as the back-to-school season began.
According to the most recent report from the American Academy of Pediatrics (AAP) and Children’s Hospital Association, there were an astounding 251,781 new COVID-19 cases in children during the week ending September 2. According to the AAP, this is the highest weekly rate of new cases in children since the pandemic began, and the first time that more than 250,000 children tested positive in a single week. With that addition, the country also passed a sobering milestone in terms of cumulative child cases, which surpassed 5 million on September 2. (While states and territories define what constitutes a child case of COVID-19 differently, all begin with newborns and most set the cutoff at age 18 or 19. The report incorporates data from the websites of 49 state public health departments (plus New York City, the District of Columbia, Puerto Rico, and Guam).
This dramatic increase caps a month in which COVID-19 cases in children increased “exponentially” following a dip in the early summer, the AAP reports, with more than 750,000 new cases reported between August 5 and September 2. Additionally, the AAP reports that in the two weeks preceding September 2, there was a 10% increase in the total number of child COVID-19 cases counted since the pandemic began.
Fortunately, as the new AAP report notes, hospitalization and death from COVID-19 are still uncommon in children. In the 24 states that reported child hospitalization rates (plus New York City), only 0.1 percent to 1.9 percent of all children with COVID-19 were hospitalized.Furthermore, death rates ranged from none to 0.03 percent of all COVID-19 cases in children among the 45 states that reported data on child mortality (plus New York City, Puerto Rico, and Guam).(Seven states reported that no children died as a result of COVID-19 during the week in question.)
According to AAP data, nearly all COVID-19 hospitalizations and deaths continue to be in adults, with children accounting for only 1.6 percent to 4.1 percent of total hospitalizations and 0 percent to 0.27 percent of total deaths (among reporting states).
Since July, the increase in pediatric COVID-19 cases has coincided with the dominance of the highly infectious delta strain and a general increase in cases in the United States. Now that the school year has begun, an increasing number of students are returning to class in person, many of them unmasked, despite the AAP’s recommendation that schools require universal masking.
Additionally, many of these students lack vaccination protection, as there are currently no vaccines approved for use in children under the age of 12. (Recently, the Centers for Disease Control and Prevention published a study linking 26 infections to an unvaccinated teacher, including half of the teacher’s students.) While the Pfizer/BioNTech COVID-19 vaccine has been approved for emergency use in children ages 12 to 15, the vast majority of school districts do not require vaccination of eligible students. (However, this may change once the vaccine is approved for this age group in its entirety.) And only a few districts, such as those in California and New York City, require teachers and staff to be vaccinated.
This winter, Covid-19 vaccines may become available to children under the age of 12. Meanwhile, the most effective way to protect children is for everyone who is able to get vaccinated to do so.