How sick can kids get from COVID-19? A Swedish pediatric infectious disease doctor has answers.

June 21, 2022

Swedish Pediatrics Team

Jan. 5, 2022 update: The CDC's Advisory Committee on Immunization Practices voted to expand eligibility for booster doses of the Pfizer-BioNTech COVID-19 vaccine for children and adolescents, 12 to15 years of age. The CDC also now recommends that adolescents 12 to 17 years old should receive booster shots 5 months after their initial Pfizer-BioNTech vaccination series. We will keep you updated as more information becomes available.

March 29, 2022, update: The U.S. Food and Drug Administration (FDA) has amended the Emergency Use Authorizations for the Pfizer-BioNTech and Moderna COVID-19 vaccines to include a second booster dose for people 50 years of age or older and certain immunocompromised individuals. For immunocompromised individuals, Moderna is available for those 18 years of age and older, Pfizer is available for those 12 years and older. The Centers for Disease Control and Prevention said it would update its vaccine guidance to reflect the FDA’s decision.

May 23, 2022, update: Following the May 19, 2022 meeting of the Advisory Committee on Immunization Practices the Centers for Disease Control and Prevention (CDC) is expanding eligibility of COVID-19 vaccine booster doses to everyone 5 years of age and older. The CDC now recommends that children ages 5 through 11 years should receive a booster shot 5 months after their initial Pfizer-BioNTech vaccination series.

June 21, 2022, update: On June 18, The Centers for Disease Control and Prevention unanimously recommended the Pfizer-BioNTech vaccine for children ages 6 months through 4 years, as well as the Moderna vaccine for children ages 6 months through 5 years. The approval followed the U.S. Food and Drug Administration’s amendment of both vaccine makers emergency use authorizations to include the youngest age group. On June 19, the Western States Scientific Safety Review Workgroup announced completion of its review and unanimously concluded that the Pfizer-BioNTech and Moderna vaccines are safe for children as young as 6 months old.

The U.S. Centers for Disease Control and Prevention has recommended that everyone ages 5 years and older should get a COVID-19 vaccination as soon as possible. We know that parents and guardians have questions and Swedish is working to provide you with the most up-to-date information possible. To help answer some of your questions about pediatric COVID-19 vaccines and why it’s important to get your child vaccinated, we spoke with Frank Bell, M.D., a pediatric infectious disease specialist here at Swedish and board member of the Washington Chapter of the American Academy of Pediatrics.

“Getting our kids vaccinated not only protects them, but it also protects our families and communities,” says Dr. Bell. “It’s also important for their emotional well-being; children have had a particularly difficult time throughout the COVID-19 pandemic given the detrimental effects of isolation and the lack of ability to learn and play together. COVID vaccines offer our children and teens the chance to get back to a more normal life and the activities that they enjoy, to get the most from their young lives as we come out of the pandemic together.”

Are the signs and symptoms of COVID-19 in infants and children different from those in adults?

Younger children tend to have milder illness with COVID-19 compared with teens and particularly compared with illness in adults. Many of their symptoms are similar but younger children tend to have headache, tiredness and fatigue as or more often than sore throat, congestion, runny nose and fever seen more typically in older individuals. A greater proportion of children are asymptomatic meaning they seem to have no detectable illness.

What should I do if my child has symptoms?

Children with symptoms suggesting possible COVID-19 should be kept away or isolated from friends and other non-household members as much as possible. Those who have been in recent contact should also keep away or quarantine from others. It’s good to get your child tested for COVID-19 as soon as you can, to know for how long you need to take precautions, and also to help others to make decisions about getting themselves or their family tested. This is particularly important for children who are attending in-person learning at school. If testing is difficult, your family should stay at home, keep to yourselves and to quarantine for 14 days without testing.

What are some of the more serious effects of COVID-19 in kids and infants?

Although serious illness is unlikely in children at any age, a significant number of children and teens with COVID-19 will need to be looked after in the hospital, including some with breathing difficulties, pneumonia and other complications. We are learning more about later, rarer complications from COVID-19 disease, such as multisystem inflammatory syndrome, or MIS-C.

What is MIS-C and how will I know if my child has it? Can I get it?

Children and teens with MIS-C have high fever, often running for several days and are usually obviously unwell, with a variety of additional problems including rash, dizziness, fatigue and abdominal pain. These children are almost always identified when it is clear that they need to be admitted to the hospital for care and treatment. A similar ‘MIS-C-like’ condition has been described in young adults following COVID-19 but the disease appears to be even rarer than in children and adolescents.

Can kids get MIS-C from other illnesses?

MIS-C was first described last year during the early months of the COVID-19 pandemic. Although the illness sometimes looks a little like other childhood conditions including toxic shock syndrome and Kawasaki disease, it appears to be a separate illness, related to infection with SARS-CoV-2, the virus that causes COVID-19. We still have a lot to learn about MIS-C and what brings it on in a small number of children recovering from COVID-19.

Can children experience long-haul COVID-19?

Just in adults, a significant portion of children take several weeks or even months to make the return to full-health, rather than the week or less that most children take to feel better following COVID-19. It is likely that some of these individuals have a form of long-haul COVID, similar to that described in proportion of adults after COVID-19, but again, it appears to be relatively unusual, with most children showing full recovery within four to six weeks of their initial infection.

I’m anxious about my young child getting the COVID-19 vaccine? Is it safe?

Just as with COVID-19 vaccines for older individuals, vaccines for children aged five to 11 have been studied very carefully, with many of the usual steps in the careful evaluation of vaccines overlapping and running at the same time rather than following-on one from another, so that all the usual steps demonstrating the effectiveness and safety of the vaccines have been completed in a shorter timeframe. There have been no shortcuts taken in investigating these vaccines for younger children. As discussed above, children are at risk from severe disease from COVID-19 and the protection provided by COVID-19 vaccines is also important in keeping children from some of the worst effects of the COVID-19 pandemic, including social isolation and the loss of educational and learning opportunities.

Can my kids get their regular vaccinations if they get the COVID-19 vaccine?

Yes, kids’ immune systems are dealing with multiple germs and viruses every day of their lives and can respond to COVID-19 and other vaccines given on the same day or within the same week. There is no need to space vaccines out, and it makes sense to consider getting other needed-vaccines together with the COVID-19 vaccine if these are offered and available at the same visit.

Should my kids get a flu shot?

Yes, with social distancing and masking last winter we saw very little flu activity—but the same may not be true for the coming flu season with schools and businesses open, and we are worried that the lack of community-exposure to influenza last year might leave us all more vulnerable this winter. This is a good time to get your child a flu shot, potentially at the same visit as the COVID shot if your pediatric office is offering these together.

Getting kids vaccinated

At this time, Swedish has limited pediatric vaccine availability and encourages you to check the Swedish COVID-19 hub for more information soon.
You can also schedule appointments at www.seattle.gov/vaccine to get a free COVID-19 vaccine through our partnership with the City of Seattle and Amazon.
You can find vaccination appointments at the Washington State Department of Health’s Vaccine locator or by visiting your local pharmacy or checking with your child’s local school district.

Find a doctor

Whether you require an in-person visit or want to consult with a doctor virtually, you have options. Swedish ExpressCare Virtual connects you face-to-face with a practitioner who can review your symptoms, provide instruction and follow-up as needed. If you need to find a physician, caregiver or advanced care practitioner, you can use our provider directory.