COVID-19

• UPDATED - Are children at risk of getting COVID-19?

  Everyone, including children, is at risk of getting COVID-19. The Omicron variants of COVID-19 are more transmissible than the ancestral strain and earlier variants and are causing higher number of cases in children compared with the original strain and prior variants, but are not causing more severe disease.^1-3 Household or close family contact from unvaccinated adults poses the greatest risk of spread to children.^4,5 Children tend to get mild disease and the majority do not require hospitalisation, but rarely, around 1 in 3,500 children infected with SARS-CoV-2 may develop a post-COVID inflammatory syndrome, called PIMS-TS (also known as MIS-C).

  Vaccination is available for children aged 6 months and older and has been shown to protect against hospitalisation and severe disease, with new evidence suggesting it may also protect against PIMS-TS.⁶ Vaccination of adults will protect themselves against severe disease and is important in those who live and work among young children.

• How serious is COVID-19 in children?

  COVID-19 is usually milder in children than in adults. Around 37–68% of children and adolescents get mild infection and around 16–28% have no symptoms at all.^7,8 The most common symptoms in children are runny nose, fever, cough and headache.^7,8 However, some children require hospitalisation and a smaller number intensive care.

  Studies show that children and adolescents with underlying medical conditions have a greater risk of developing severe disease and complications from SARS-CoV-2 infection.^9-11 Children very rarely die from COVID-19. Studies in the United Kingdom suggested that 2 per every 1 million children infected with the virus died of COVID-19, and deaths only occurred in children with chronic, complex, often life-limiting conditions. This is lower than childhood deaths from influenza (3–6 per million children).^11-13

• Which children are at risk of serious illness from COVID-19?

  Some of the conditions that increase the risk of being hospitalised with COVID-19 in children, compared with healthy children, include (but are not limited to): children with congenital heart disease, chronic pulmonary disease, neurological diseases, prematurity or obesity.^8,14

• Can children spread COVID-19 to other children or adults?

  Yes, children can spread COVID-19 to other children and adults.¹⁵ Most children who get infected with the virus have no symptoms or have only mild symptoms.^4,8 However, it is possible they can still pass the virus on to others in their home and the community. The risk of transmission is higher among unvaccinated household contacts.

• What are the symptoms of COVID-19 in children?

  It is estimated that 16–28% of children who get COVID-19 may not have any symptoms at all.⁸ Of those who do get symptoms, the illness is usually very similar to other respiratory viral illnesses, with the most common symptoms being fever and cough. Children can also have non-specific symptoms like runny nose and tiredness. Some children may have gastrointestinal symptoms like nausea, diarrhoea or vomiting.

• UPDATED - How are people cared for when they get COVID-19?

  Most people, including children and adolescents, diagnosed with COVID-19, will experience only mild symptoms or no symptoms at all. This can generally be managed at home and with ‘over the counter’ medications, such as paracetamol and ibuprofen.  Children should also be encouraged to continue to drink small volumes of fluid regularly. More information on what to do if you or your child test positive for COVID-19 can be found here.

  If children feel unwell and have difficulty breathing or keeping fluids in, they may need to be reviewed in hospital and sometimes require feeding support, some oxygen or medical treatment. Healthy children rarely need intensive care treatment – this is more likely to be needed for older children with underlying medical conditions, including obesity, who have a greater risk of developing more severe disease.

• What is ‘long COVID’? Do children get ‘long COVID’?

  In children, the condition of ‘long COVID’, also known as the ‘Post COVID condition’, is not well defined. It usually refers to the persistence of COVID-19 symptoms such as fatigue and breathlessness, for over 3 months.¹⁷ There is no conclusive evidence that ‘long COVID’ exists in children, as similar symptoms have been revealed in children who are exposed to frequent lockdowns and the general unease created by the global pandemic._^18,19 It also appears to occur less commonly in children than in adults. Some of the symptoms such as body aches, difficulty concentrating, changes to mood have been reported in children and teenagers without prior infection and may be a consequence of living in the pandemic and in lockdown. Longitudinal studies tracking the duration of symptoms in children with COVID-19 frequently find almost complete symptom resolution within a few days.^20,21

• What are the risks–benefits (pros and cons) of COVID-19 vaccination in children?

  There are benefits and risks associated with all medical products and procedures. Throughout these FAQ, we provide information about the benefits and potential safety concerns associated with vaccinating children against COVID-19. Below is a general summary of some of the key points:²²

  Individual benefits (pros)

  • Protection from COVID-19 disease
  • Protection from severe disease and death
  • Potential protection from PIMS-TS or MIS-C
  • Potential protection from uncertainty associated with new variants

   

  Individual risks (cons)

  • A small risk of adverse events, including the rare risk of myocarditis or pericarditis
  • Unknown level of protection against PIMS-TS/MIS-C for children aged 5–11 years, although early data suggest vaccines may be protective
  • Unknown level of protection against ‘long COVID’ in children

   

  A COVID-19 vaccine decision aid is also available to help parents and carers make an informed decision about COVID-19 vaccination for their children. Access this decision aid here.
   

• UPDATED - Why do children need to get a COVID-19 vaccine if they usually develop only mild illness?

  It is recommended that all children 5 years of age and older, and some children with certain medical conditions aged 6 months to under 5 years, get a COVID-19 vaccine in Australia for several reasons. These include:23-25

  • To protect against severe COVID-19. COVID-19 is usually milder in children than in adults but can still very rarely cause severe illness, particularly in children with chronic medical conditions. Some children will require hospitalisation or intensive care.26,27
  • To reduce the spread of virus between themselves and to adults. Household transmission between children and from children to adults is common.27 Vaccinated people are less likely to pass on the virus than unvaccinated people.28,29 Vaccinating children can potentially reduce the spread of virus between themselves and to vulnerable adults.
  • To prevent other complications such as ‘long COVID’ or PIMS-TS/MIS-C. Even after recovery from COVID-19, there is a chance of long-term complications. ‘Long COVID’ is a condition where people with COVID-19 experience persistent symptoms, such as fatigue, shortness of breath, cognitive dysfunction (‘brain fog’) and others, that continue for at least 2 months. There is limited evidence on the severity and duration of long COVID in children, yet it may be less severe and of shorter duration in children than in adults.18,20 PIMS-TS (also known as MIS-C) is a rare inflammatory condition that has been seen in children following COVID-19 infection. It normally occurs 2–6 weeks after infection and can be mild to life-threatening.
• Why are vaccination policies for children different in different countries?

  Children aged ≥6 months are eligible for COVID-19 vaccines in many countries globally. However, some countries may be prioritising vaccination for children who are more likely to suffer from moderate to severe illness, rather than all children.

  COVID-19 is less likely to cause serious illness in children compared with adults. The vaccines were originally developed for and tested on adults. As there was limited supply of vaccines initially, many countries prioritised vaccination for those most at risk of severe disease. This included older adults. As the vaccination supply increased, younger people became eligible for vaccination.

  In Australia, we are in a fortunate position to have been able to vaccinate over 95% of the adult population. Australia has therefore commenced a vaccination program for children to protect them from severe disease and, potentially, to help stop the spread of the virus.

• What is the minimum age for children to get a COVID-19 vaccine?

  The minimum age for children to get a COVID-19 vaccine is 6 months in Australia.^25,30  All children aged 5 years and older can receive a COVID-19 vaccine and some children aged 6 months to under 5 years with certain medical conditions can receive a COVID-19 vaccine.

• UPDATED - How many doses of COVID-19 vaccine do children and adolescents need? Do they need a booster dose?

  COVID-19 vaccine is recommended for all people aged 5 years and older and some children aged 6 months to 4 years who are at increased risk of severe COVID-19. Boosters at an interval of 6 months from infection or a previous dose can be considered for those aged 5-17 years who are at increased risk of severe COVID-19.

  The recommended number of doses and vaccine brand are based on age and other conditions. Access the ATAGI clinical guidance or the poster ATAGI recommended COVID-19 doses and vaccines for details (see page 2 for immunocompromised). Your immunisation provider can discuss these options with you and a list vaccines available by ages is available here. Some COVID-19 vaccines approved for use in Australia are not currently registered for used in people under 18 years of age.

  As of 24 January 2023, in Australia, 74.0% of those aged 12–15 years had received two doses of the Pfizer vaccine or Moderna vaccine and 39.3% of children aged 5–11 years had received two doses of the paediatric Pfizer vaccine. For more information on COVID-19 vaccine coverage in Australia, refer to the Australian Government Department of Health website.

  The COVID-19 Vaccine Clinic Finder is also available to find out when and where you can receive a COVID-19 vaccine. The Vaccine Clinic Finder provides information on which vaccines are recommended for you on the basis of your age.

  More information can be found here:

  • ATAGI 2023 booster advice
  • ATAGI recommendations on use of the Pfizer bivalent (Original/Omicron BA.4/5) COVID-19 vaccine
  • ATAGI recommendations on the use of a third primary dose of COVID-19 vaccine in individuals who are severely immunocompromised
  • ATAGI recommendations on COVID-19 vaccine use in children aged 6 months to <5 years
  • ATAGI statement on the use of the Moderna bivalent Original/Omicron vaccine.
  • ATAGI statement on the use of the Pfizer bivalent Original/Omicron vaccine
  • ATAGI recommendations on use of the Pfizer COVID-19 vaccine for children aged 6 months to 4 years

   

• How do mRNA COVID-19 vaccines work?

  An mRNA vaccine contains the genetic code for an important part of the COVID-19 virus called the ‘spike protein’. After getting the injection, the body reads the genetic code and makes copies of the spike protein. The immune system then detects these spike proteins and learns how to recognise and fight against COVID-19. The genetic code does not combine with the DNA in our cells; it is quickly broken down and cleared away by the body.

• What is Novavax and how does it work?

  Novavax, also called Nuvaxovid or NVX-CoV2373, is a COVID-19 vaccine developed by Novavax. It is an adjuvant protein subunit vaccine. It uses a version of the spike protein on SARS-CoV-2 (the virus that causes COVID-19) and adjuvants within the vaccine that mimic the way the real virus would activate your immune system to boost your immune system and provide protection.

  The adjuvants are based on a natural product known as saponin, an extract from tree bark. The spike proteins resemble the structure of SARS-CoV-2; however, once injected they cannot replicate and cause COVID-19. The vaccine does not contain any live component of the virus.

  People aged 12 years and older can receive 2 doses of Novavax, 8 weeks apart for the primary course. It is not approved for use as a booster dose.

• UPDATED - Are COVID-19 vaccines effective in children and adolescents?

  Clinical trials of the Pfizer vaccine (Comirnaty) and Moderna vaccine (Spikevax) in children and adolescents have shown these vaccines provide excellent protection against COVID-19.

  A review of studies in children and adolescents aged 2 to 18 years found that 2 doses of the Pfizer or Moderna vaccine was 63% effective at preventing hospitalisation, 76% effective at preventing symptomatic infection and 83% effective at preventing hospitalisation due to COVID-19.

• Should children avoid any activities after COVID-19 vaccination?

  Children can continue to perform all regular daily activities after COVID-19 vaccination. If they feel well after their vaccine, they can continue their usual exercise. Those who feel unwell after vaccination (e.g. with a fever or tiredness) are recommended to rest, and to seek medical attention for any symptoms they or their parents/carers are worried about.

• Can children get COVID-19 from COVID-19 vaccines?

  No, children cannot get COVID-19 from a COVID-19 vaccine. To get COVID-19, a live virus that can multiply in your body has to infect you. No COVID-19 vaccine supplied currently in the world contains live coronavirus. All the vaccines currently available for children in Australia and elsewhere contain the code for the body to make only the spike protein (not the actual virus) that the person’s immune system then responds to, to provide protection against severe COVID-19 in the future.

• UPDATED - My child has had COVID-19. Should they still be vaccinated?

  Yes, children can be vaccinated (with the usual two-dose schedule or booster) from 6 months after testing positive for COVID-19. A COVID infection means you produce antibodies that can help protect against COVID-19, this is called natural immunity.

• UPDATED - Can children with underlying health conditions get a COVID-19 vaccine?

  Yes, children with underlying health conditions are recommended to receive a COVID-19 vaccine, particularly if they have a health condition that increases their risk of severe illness. Talk to your family doctor to find out whether a particular health condition increases the risk of severe COVID-19.

  Children 6 months of age and older who are severely immunocompromised are recommended to receive a third primary dose of COVID-19 vaccine, from 2 months after they have had their second dose, as part of their primary schedule.

  Those aged 5-17 years who are at increased risk of severe COVID-19 can consider a booster dose from 6 months since either their last dose of vaccine or SARS-CoV-2 infection. Speak to your immunisation provider to discuss a risk benefit assessment. 

• Can children get a COVID-19 vaccine if they are on other medications?

  In most cases, medication should not be stopped before or after having a vaccine, including a COVID-19 vaccine. There are a few situations in which people might be advised to either delay vaccination or delay a particular medication:

  • Some people taking blood thinners (anticoagulants) may be advised to delay vaccination if there is a high risk of bleeding or bruising at the site where the vaccine is injected. Most people on a stable dose of blood thinner can receive the vaccine without any checking of medication levels or change to their medication.
  • People taking immune-weakening treatments (immunosuppressants), including chemotherapy, have a higher risk of developing severe COVID-19 and importantly can have a COVID-19 vaccine. but should discuss the best timing of vaccination with their treating doctor For people taking certain immunosuppressive treatments, there may be a time point in their treatment cycle where they are anticipated to have a better immune response to the vaccine. In some cases, it may be possible to withhold a dose of the immunosuppressant to maximise the immune response to the vaccine.

  Children and adults taking other medications should continue their regular treatment before and after vaccination.

• UPDATED - Is COVID-19 vaccination mandatory for adolescents in Australia?

  COVID-19 vaccination is not mandatory for children or adolescents in Australia (refer to the question “Is the COVID-19 vaccine mandatory” in NCIRS COVID-19 vaccines: Frequently asked questions.

  However, all children aged 5 years and older and some children aged 6 months to <5 years are recommended to receive a COVID-19 vaccine to protect themselves from serious disease and to potentially prevent spread of the virus to other children and adults.

• My child recently had COVID-19 or a COVID-19 vaccination. Do they need to wait before getting other vaccines?

  Children can get non-COVID vaccines, including influenza vaccine, without any minimum interval if they have recently had a COVID-19 vaccine or have tested positive to COVID-19. If they have a fever or are feeling very unwell, talk to your doctor about the best time to get vaccinated. However if they are feeling well and have no symptoms or only minor symptoms, they can get other (non-COVID) vaccines at any time. It’s important to be up to date with other vaccines, including influenza vaccine, to minimise risk of other infections.

• UPDATED - Are COVID-19 vaccines safe in children and adolescents?

  Clinical trials and real-world studies^32,41-43 have shown that COVID-19 vaccines approved for children (6 months–11 years) and adolescents (≥12 years) are safe. Children are likely to experience mild side effects, such as fever, fatigue/sleepiness and pain at the injection site after vaccination, but these usually resolve within 48 hours. Infants and children are prone to febrile convulsions most frequently due to viral infection but these can also occur after vaccination.

  Side effects are expected and reflect a developing immune response to vaccination. Studies have found that rates of side effects after a COVID-19 vaccine in children and adolescents were similar to those experienced by adults and in some instances were milder and occurred less frequently than in adults.^33-36

  A risk of myocarditis and pericarditis has been seen in people who have received COVID-19 vaccines. Myocarditis after a COVID-19 vaccine has been reported most often after dose two of an mRNA vaccine in males under 40, but it can occur at any age, in any gender and after any dose. Data from the USA showed no evidence of an increased risk for myocarditis following mRNA COVID vaccination in children ages 6 months to 5 years. There is currently not enough evidence to indicate that there is an increased risk of myocarditis or pericarditis in children aged 5 to 11 years following COVID-19 vaccination, however cases may occur. 

  In Australia, the Therapeutic Goods Administration (TGA), part of the Australian Government Department of Health, is responsible for approving medicines and vaccines for use in Australia. The TGA has a rigorous process for assessing vaccine safety, quality and efficacy before approving vaccines for use in the population.

  Australia’s national active vaccine safety surveillance system AusVaxSafety also monitors vaccine safety in real-time and provides detailed information on age-specific rates of adverse events, as well as adverse events in Aboriginal and Torres Strait Islander people and those with risk conditions.

  In addition, tens of millions of adolescents have been vaccinated in countries that are closely monitoring and reporting on safety, including the USA, Europe, Canada, Israel, Singapore and Japan. Similarly, over 10 million children aged 5–11 years and around 1.5 million children aged <5 years have received at least one dose of the COVID-19 vaccine in the US, which is more than the total population for these age groups in Australia.⁴⁵ For the period 18 June 2022 to 20 July 2022, just over 544,000 children under 5 years of age have received at least one dose of Moderna (25mcg) in the USA.⁴⁶

• Can COVID-19 vaccines cause permanent damage/long-term side effects in children?

  As with any medical product, including vaccines, there is a small risk of rare side effects. However there are much greater risks associated with the disease itself and the benefits of vaccination outweigh these risks. Only the Pfizer and Moderna vaccines are licensed for use in children to protect them against COVID-19. Both these vaccines have been associated with the small risk of the rare side effect of myocarditis or pericarditis. However, there is a risk of myocarditis or pericarditis from COVID-19 as well as a more severe condition called PIMS-TS/MIS-C. In a US study, 87% of those who experienced myocarditis after vaccination had their symptoms resolved by hospital discharge (average length of stay is around 1–2 days).⁴⁷ In early data from the US, follow up of 12–15 year olds who experienced myocarditis following vaccination 92% had their symptoms resolved.⁴⁸ Longer term follow-up of people who have had myocarditis or pericarditis following a COVID-19 vaccine or COVID-19 disease is ongoing.

  See also "What is myocarditis and pericarditis, and can Pfizer or Moderna vaccine cause it?" and ATAGI advice on myocarditis.

  COVID-19 vaccination primes the immune system to protect against infection and disease from SARS-CoV-2.  When a rare serious/permanent adverse event has occurred for other vaccines, it has occurred soon after vaccination (generally within 6 weeks), so it is unlikely to see adverse events from vaccination years after a vaccine has been given. That is, the risk of ‘long-term’ side effects is very low.
   

• Have there been any deaths following COVID-19 vaccination in children?

  In Australia, there have been no reports of death linked to COVID-19 vaccination in children.

  Clinical trials and real-world studies^32,41-43 have shown that COVID-19 vaccines approved for children (6 months to 11 years) and adolescents (≥12 years) are safe. Both Pfizer and Moderna COVID-19 vaccines have now been administered to many millions of children aged ≥5 years and adolescents around the world.

  In Australia, vaccine safety is monitored by the Therapeutic Goods Administration (TGA) where people can directly report side effects following vaccination. More information about the TGA processes of reviewing a death after a COVID-19 vaccination can be found here. There are other forms of vaccine safety monitoring, such as AusVaxSafety, in which clinics send SMS messages to people receiving vaccines (or their parents or carers) to ask if they had any reactions after receiving a vaccine. Independent experts analyse the responses to make sure that any safety issues are detected quickly. View the vaccine safety data in children here.

  When vaccines are rolled out to this many people worldwide in a short period of time, it is inevitable that this will coincide with life events. Some people will experience a new illness or die within a few days or weeks after the vaccine, but usually, these events are due to chance, rather than being caused by the vaccine. The TGA encourages and reviews these reports, but just because a death has been reported, it does not mean that the vaccine played a role in the death. There have been large amounts of false information about the COVID-19 vaccines and deaths circulating online and on social media. All deaths linked to a COVID-19 vaccine will be reported on the TGA website.
   

• UPDATED - What is myocarditis and pericarditis, and can a COVID-19 vaccine cause it?

  Myocarditis is inflammation of the heart muscle. Pericarditis is inflammation of the outer lining of the heart. Myopericarditis is where these two conditions occur together.

  Myocarditis and/or pericarditis can occur very rarely in younger people, including adolescents and children 5 years of age and older, who have had a COVID-19 vaccine. It is more common after dose 2 and in adolescent males. 

  Different rates of myocarditis have been reported from many countries as they have different ways of capturing information. The rates after dose 2 for males aged 12-17 years range from 71 to 136 per million doses for Pfizer and 237 per million doses for Moderna. For females aged 12-17 years, the rates after dose 2 range from 2-28 per million doses for Pfizer and 0-28 per million for Moderna.⁴⁹ For children aged 6 months to 11 years, there is currently no clear attributable risk of myocarditis and/or pericarditis from the COVID-19 vaccines.

  Rates of myocarditis following a booster (third) dose have been observed to be lesser than after dose 2 but greater than after dose 1. Data from the USA and Israel suggest the rates in adults following a 4th dose are not above the expected background rates.⁴⁹ There are currently no data on rates following a 5th dose or subsequent dose.

  Early data from the USA and UK suggest there is a risk of myocarditis and pericarditis following the bivalent vaccines. The symptoms typically appear within 1–5 days of vaccination and are usually mild. Most children and adults with myocarditis or pericarditis related to COVID-19 vaccination recover quickly after a short period of monitoring (usually in hospital) and no or simple treatment, such anti-inflammatory medication; however, occasionally children need to refrain from returning to sports for weeks to months.

  The symptoms of myocarditis or pericarditis can include:

  • chest pain, pressure or discomfort
  • palpitations (irregular heartbeat, skipped beats or ‘fluttering’)
  • syncope (fainting)
  • shortness of breath
  • pain with breathing.

   

  It is important to note that this can present with atypical features, such as the absence of chest pain, or the presence of abdominal pain or other non-specific symptoms. If a child or adult experiences any of these symptoms in the weeks following vaccination, they should seek prompt medical attention. Further information can be found in the ATAGI guidance on myocarditis and pericarditis after mRNA COVID-19 vaccines. A tool has been developed by the Paediatric Research in Emergency Departments International Collaborative (PREDICT) to assess children and adolescents with chest pain following mRNA vaccination and evaluation of chest pain guideline in the emergency department.

  It is important to note that there could be other causes for these symptoms. Data indicate that in young adults around 3-8 cases of myocarditis and pericarditis that are not related to COVID-19 vaccination occur on average each week in Australia. The rate of myocarditis and pericarditis is higher in people with COVID-19 disease, than after a COVID-19 vaccine.⁵⁰

• Do the COVID-19 vaccines cause PIMS-TS/MIS-C?

  PIMS-TS/MIS-C is a rare and serious inflammatory complication that has been found to occur after COVID-19 infection in children. There have been some reports of cases of PIMS-TS/MIS-C occurring in the weeks after COVID-19 vaccination, but these don’t prove a causal link. Not all adverse events that occur following vaccination are necessarily caused by the vaccine.

  A study from the US⁵¹ investigated cases of PIMS-TS/MIS-C following vaccination and found that there were 21 potential reports as of 31 August 2021. However, of those cases, 71% had a previous infection with SARS-CoV-2. The study suggested that the rate of PIMS-TS/MIS-C in those who did not have prior SARS-CoV-2 infection was 0.3 cases per million vaccinated individuals). 

  In Australia, as of 8 September 2022,⁵² there have been no cases of PIMS-TS/MIS-C linked to COVID-19 vaccination.
   

• Can COVID-19 vaccines lead to infertility?

  No, there is no evidence that any of COVID-19 vaccines being used in the Australian COVID-19 vaccination program can lead to infertility. Importantly, COVID-19 vaccines protect young people from getting severely ill and developing serious complications which could affect their ability to become parents.

  Before human trials, the Pfizer, Moderna, AstraZeneca and Novavax vaccines were assessed for their effect on fertility in animal studies. These studies found pregnancy rates in animals that received the vaccine were same as for those that did not receive the vaccine.

  Studies from Israel and the US of mRNA vaccines in women undergoing in vitro fertilisation (IVF) comparing who had and had not been vaccinated or had COVID-19 in the past showed that Pfizer and Moderna vaccines did not affect fertility treatment.⁵³ In studies conducted on healthy men, there were no significant impacts on sperm parameters after COVID-19 vaccination.^54,55

• Can children get COVID-19 in school?

  Yes, children can get COVID-19 in schools. However, research shows they are more likely to catch COVID-19 in their own home environment or in gatherings outside of school. An ongoing study of the transmission of COVID-19 in educational settings in Australia shows that although the risk of child-to-child spread is low (0.3%), infected school staff members (adults) can pass on the virus to children (1.5%).⁵⁶

• How can we keep children safe in schools?

  There are many relatively simple measures that can be taken to minimise COVID-19 spread in schools. These include regular hand hygiene, keeping adults and parents off school grounds and avoiding large crowds. 

  As always, it is important that children who are unwell with even mild symptoms stay home from school and get tested for COVID-19. Vaccinating adults and children aged 6 months and older will protect people from severe disease and potentially decrease spread among the general population.

• Is it safe for my child to go to school even though they haven’t yet received a COVID-19 vaccine?

  Yes, your child can go to school if they have not yet received a COVID-19 vaccine; however, vaccination is recommended. COVID-19 is usually milder in children than in adults and since the vaccination rates in adults in Australia is high, over 90%, children are well protected from COVID-19. The spread of COVID-19 is also a lot less common in the school setting compared with the household setting.^27,55

  COVID-19 can still very rarely cause severe illness in children, particularly those with chronic medical conditions. Therefore, all children aged ≥5 years, and some children aged 6 months to under 5 years are recommended to receive two doses of a COVID-19 vaccine. To find a vaccination provider and book an appointment, visit the COVID-19 Vaccine Clinic Finder. The clinic finder is also available in 15 languages.
   

• List of references
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  2. Wang L, Berger NA, Kaelber DC, et al. Comparison of outcomes from COVID infection in pediatric and adult patients before and after the emergence of Omicron. medRxiv 2022.
  3. Havers FP, Whitaker M, Self JL, et al. Hospitalization of Adolescents Aged 12-17 Years with Laboratory-Confirmed COVID-19 - COVID-NET, 14 States, March 1, 2020-April 24, 2021. MMWR Morbidity and mortality Weekly Report 2021;70:851-7.
  4. National Centre for Immunisation Research and Surveillance (NCIRS). COVID-19 Delta variant in schools and early childhood education and care services in NSW, Australia: 16 June to 31 July 2021. 2021. Available from: https://www.ncirs.org.au/sites/default/files/2021-09/NCIRS%20NSW%20Schools%20COVID_Summary_8%20September%2021_Final.pdf (Accessed 29 September 2021).
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  8. Williams P, Koirala A, Saravanos G, et al. COVID-19 in children in NSW, Australia, during the 2021 Delta outbreak: Severity and Disease spectrum. medRxiv 2021:2021.12.27.21268348.
  9. Kompaniyets L, Agathis NT, Nelson JM, et al. Underlying medical conditions associated with severe COVID-19 illness among children. JAMA Network Open 2021;4:e2111182.
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  11. American Academy of Pediatrics. Children and COVID-19: State-Level Data Report. 2021. Available from: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/ (Accessed 29 September 2021).
  12. Smith C, Odd D, Harwood R, et al. Deaths in Children and Young People in England Following SARS-CoV-2 Infection during the First Pandemic Year: A National Study Using Linked Mandatory Child Death Reporting Data. 2021. Available from: https://www.researchsquare.com/article/rs-689684/v1 (Accessed 29 September 2021).
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  14. Shi Q, Wang Z, Liu J, et al. Risk factors for poor prognosis in children and adolescents with COVID-19: a systematic review and meta-analysis. EClinicalMedicine 2021;41:101155.
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  17. Borch L, Holm M, Knudsen M, Ellermann-Eriksen S, Hagstroem S. Long COVID symptoms and duration in SARS-CoV-2 positive children - a nationwide cohort study. Eur J Pediatr 2022;181:1597-607.
  18. Zimmermann P, Pittet LF, Curtis N. How common is long COVID in children and adolescents? Pediatric Infectious Disease Journal 2021;40:e482-e7.
  19. Stephenson T, Shafran R, De Stavola B, et al. Long COVID and the mental and physical health of children and young people: national matched cohort study protocol (the CLoCk study). BMJ Open 2021;11:e052838.
  20. Molteni E, Sudre CH, Canas LS, et al. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. The Lancet Child & Adolescent Health 2021.
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