Children and COVID-19 in 2021: The Public Health Impact on Kids

With school back in session but still no COVID-19 vaccine approval for children under 12 years old, many parents are concerned about their children contracting the virus. According to September 2021 data from the American Academy of Pediatrics, children in this age group accounted for nearly 27% of all COVID-19 cases in America — up significantly from 3% at the start of the pandemic in March 2020.

At a recent Path Forward event from the U.S. Chamber of Commerce Foundation, Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and an advisor to the FDA, discussed some frequently asked questions about children and the COVID-19 pandemic. Here is Dr. Offit’s take on how children have been impacted by the virus, why younger Americans are now being so severely affected, the outlook for an approved COVID-19 vaccine for children, and more.

What Is the Current State of the Pandemic Among Children?

Compared to transmission rates among children last year, the COVID-19 pandemic is currently surging within the school-aged population.

“The last few weeks, we've had 200,000 cases a week, 250,000 cases a week, and as many as 2000 hospitalizations a week,” Dr. Offit said. “We are seeing a lot of children in our hospital with this virus [at rates] consistent with the national average, including a handful in the intensive care unit.”

Why Are Children Being Affected So Severely?

When asked why children were being affected by the virus more than in the past, Dr. Offit brought up a few different factors, including the Delta variant and the return to school.

“The Delta variant is far more transmissible, which I think means that you probably don't need to have as long of a contact with someone who is excreting the virus,” said Dr. Offit.

Bringing unvaccinated children back into the classroom — sometimes without a mask mandate — has also contributed to a faster spread of COVID-19 within this age group.

“Now they're all together [in school] … [as] a large group of susceptible people in one place with a virus that's highly transmissible, especially in communities where the virus is spreading because of ... under-vaccination in that community,” Dr. Offit explained.

Dr. Offit believes the increase in pediatric COVID cases is in part due to loosened restrictions now that the majority of adults are at least partially vaccinated.

“Last year [at] this time when we didn't have a vaccine and we had a fully susceptible population, we were, I think, much better at protecting our children than we are now,” he said. “We sort of loosened things up and in many ways that's good, but I do think we're paying a price for our behavior.”

When Will a Vaccine for Children Under 12 Be Available?

Millions of children over the age of 12 have already been vaccinated and many are continuingly getting vaccinated. For children between the ages of five and 12 years old, there is hope that the vaccine could be available by Halloween.

“Hopefully we'll have a vaccine by the end of October for the [over] five-year-olds,” said Dr. Offit. “Pfizer has submitted that data and it will presumably come to the FDA vaccine advisory committee in the next couple of weeks, and then things should happen fairly quickly.”

Dr. Offit also added that the advisory board is taking this data very seriously and that their personal standard is that they would not approve vaccines that they “would not give their own children or grandchildren."

Why Schoolchildren Should Be Masking Up

When asked about what parents should be thinking about today to help protect their children, Dr. Offit offered up two key points. He suggested children should be masking up during the day and preferably being taught by vaccinated teachers.

"If I had a child who was seven years old and going to school, I would feel much better if there was a mask mandate at that school. I would also feel much better if every teacher who was standing in that classroom was vaccinated because masking is all we have for those children. It's amazing to me that there are parents out there who just insist on their child not wearing a mask.

Dr. Offit also pointed to the idea that society at large often helps take care of children with food allergies but does not do what it can to keep children safe from COVID-19, especially when it comes to mask-wearing.

"I wonder if there was a child in the class who was a peanut-allergic. You would like to think that other parents wouldn't say that it is their civil liberty or personal freedom to have their child go to class and eat a peanut-butter-and-jelly sandwich, but that they would care enough about that child to not do that," Dr. Offit said. "This virus, unlike the one child who has a peanut allergy, can affect everybody and can cause serious disease in anybody. And yet, somehow it's a personal right to catch and transmit potentially fatal infection, which it isn't."