OverviewCOVID19 incidence and burdenEmergency department visitsHospita - PDF document

OverviewCOVID19 incidence and burdenEmergency department visitsHospitalization rates and severityCOVIDassociated mortalityMultisystem Inflammatory Syndrome in Children (MISPostCOVID conditionsOther impacts of the pandemic on children and families Currently eligible for COVIDvaccination11 years 17 years 6 months4 years COVID19 incidence and burden Trends in number of COVID19 cases in the United States among persons of all ages January 23

, 2020 June 14, 2022Cases: 85,681,615Source: COVID Data Tracker, https://covid.cdc.gov/coviddatatracker/#trends_dailytrendscases. Accessed June 16, 2022 Trends in number of COVID19 cases in the United States among persons of all ages January 23, 2020 June 14, 2022Cases: 85,681,615Source: COVID Data Tracker, https://covid.cdc.gov/coviddatatracker/#trends_dailytrendscases. Accessed June 16, 2022 Omicron surge started in December 2

021 Trends in number of COVID19 cases in the United States among persons of all ages January 23, 2020 June 14, 2022Cases: 85,681,615Source: COVID Data Tracker, https://covid.cdc.gov/coviddatatracker/#trends_dailytrendscases. Accessed June 16, 2022 Omicron surge started in December 2021 day average: 103,935 200400600800100012001400160018002000 Incident cases per 100,000 population Case earliest date by end of week 1 year 4 years 11 y

ears 17 yearsCOVID19 weekly cases per 100,000 population among children ages 017 years by age group United States March 1, 2020 June 12, 2022Reporting may be incomplete for the most recent two weeks of data, denoted by the grey box. Source: COVID Data Tracker, https://covid.cdc.gov/coviddatatracker/#demographicsovertime. Accessed June 16, 2022 200400600800100012001400160018002000 Incident cases per 100,000 population Case earliest dat

e by end of week 1 year 4 years 11 years 17 yearsCOVID19 weekly cases per 100,000 population among children ages 017 years by age group United States March 1, 2020 June 12, 2022Reporting may be incomplete for the most recent two weeks of data, denoted by the grey box. Source: COVID Data Tracker, https://covid.cdc.gov/coviddatatracker/#demographicsovertime. Accessed June 16, 2022 Total number of COVID19 cases1 year578,1684 years1,945,3

8911 years5,106,67317 years5,691,196 Seroprevalence of infection - induced SARS - CoV - 2 antibodies among children ages 6 months17 years National Commercial Lab Seroprevalence Study September 2021April 2022Shading indicates confidence intervals for each trend line.Data updated for March/April 2022, based on Clarke K, Kim Y, Jones J et al. Pediatric InfectionInduced SARSCoV2 Seroprevalence Estimation Using Commercial Laboratory Speci

mens: How Representative Is It of the General U.S. Pediatric Population? (April 26, 2022). SSRNhttps://ssrn.com/abstract=4092074 http://dx.doi.org/10.2139/ssrn.4092074 COVIDassociated emergency department (ED) visits Dashed line, on December 19, 2021, represents the first date w�hen 50% of nationally sequenced SARSCoV2 specimens were Omicronvariant. Data contains emergency department visits from NSSP ED data feeds consistently r

eporting data from 20202022. The data contains visits with an ICDSNOMED code for COVID19. Weekly percent of emergency department visits diagnosed with COVID19 among children ages 1years , National Syndromic Surveillance Program May 3, 2020May 14, 2022Omicron period COVIDassociated hospitalizationsBurden and severity of disease COVIDassociated hospitalizations among children and adolescents 6 months17 years, COVIDNETMarch 2020 March

2022Source: COVIDNET, https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html . Accessed May 21, 2022. 3/21/206/21/209/21/2012/21/203/21/216/21/219/21/2112/21/213/21/22 Hospitalization rate per 100,000 population Week End Date 6 months-4 years 5-11 years 12-17 years Cumulative COVIDassociated hospitalizations among children and adolescents 6 months17 yearsCOVIDNETMarch 2020 March 2022 1001201403/21/206/21/209/21/2012/21/203/21/216/21/219/21

/2112/21/213/21/22 Cumulative hospitalization rate per 100,000 population Week Ending Date 6 months-4 years 5-11 years 12-17 yearsSource: COVIDNET, https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html . May 21, 2022. Rates of monthly COVID - 19 - associated hospitalizations by vaccination status among children and adolescents 17 years, COVIDNETJune 2021 March 2022Source: CDC COVID Data Tracker: COVIDNET Hospitalizations by Vaccinatio

n Status. Accessed May 12, 2022. 0.05.010.015.020.025.030.035.0Jun-21Jul-21Aug-21Sep-21Oct-21Nov-21Dec-21Jan-22Feb-22Mar-22 Hospitalization Rate per 100,000 Adolescents ages 1217 years who are unvaccinated Adolescents ages 1217 years vaccinated with at least primary series Children ages 511 years who are unvaccinated Children ages 511 years vaccinated with primary series Proportion of children ages 6 months4 yearswith COVID19 associate

d hospitalization who were primarily admitted for COVID19, COVIDNETMarch 2020 March 2022All children in COVIDNET had a positive SARSCoV2 test within 14 days of or during hospital admission. “Primarily admitted forCOVID19” was defined based on the “Reason for admission” field from the case report form. If the chief complaint or history of present illness in themedical chart documents fever/respiratory illness, COVID19

like illness, or a suspicion for COVID19, a case is categorized as having COVID19 as the primary reason for admission. Examples of other nonCOVID19related reasons for admission seen in this age group include admissions for trauma or inpatient surgeries. Source: COVIDNET data, Accessed May 21, 2022. 87.3%86.1%12.8%13.9%Pre-Omicron (March 1, 2020-December 18, 2021)Omicron (December 19, 2021-March 31, 2022) Primarily admitted for COVID-19

Other reason for admission Percent of children ages 6 months – 4 years with COVID19 associated hospitalization with underlying health conditions Source: 1. New Vaccine Surveillance Network. Preliminary data as of May 25, 2022, reflecting data from March 2020April 20222. COVIDNET data. Accessed May 21, 2022, reflecting data from March 2020March 2022 COVIDNET, March 2020 March 2022 New Vaccine Surveillance Network, March 2020 April

2022 At least 1 underlying medical conditions No underlying medical conditions Severity of COVIDassociated hospitalizations among children and adolescents 6 months17 years, COVIDNET, December 19, 2021 March 31, 2022 (Omicron period)BiPAP: bilevel positive pressure, CPAP: continuous positive pressureSource: COVIDNET data. Accessed May 21, 2022. 23.6%16.2%6.4%6.4%0.0%19.6%6.8%5.8%5.2%0.0%18.6%4.9%3.3%4.5%0.9%10%15%20%25%30%Intensive car

e unit (ICU)admissionHigh flow nasal cannulaBiPaP or CPAP useMechanical ventilationIn-hospital death 6 months4 years (N=535) 11 years (N=260) 17 years (N=256) COVIDassociated hospitalizationsComparisons to other pediatric infectious diseases Cumulative influenzaand COVIDassociated hospitalization rates per 100,000 children ages 6 months‒4 years , FluSurvNET and COVIDNET, Source: Delahoy MJ, Ujamaa D, Taylor CA, et al. Comparison of

influenza and COVIDassociated hospitalizations among children 18 years old in the United StatesFluSurvNET (OctoberApril 2021) and COVIDNET (October 2020September 2021). Clin Infect Dis. 2022 May 20:ciac388. doi: 10.1093/cid/ciac388. COVID19 Oct 21Apr 22COVID19 Oct 20Sep 21 Cumulative influenzaand COVIDassociated hospitalization rates per 100,000 children ages 6 months‒4 years , FluSurvNET and COVIDNET, Source: Delahoy MJ, Ujamaa D

, Taylor CA, et al. Comparison of influenza and COVIDassociated hospitalizations among children 18 years old in the United StatesFluSurvNET (OctoberApril 2021) and COVIDNET (October 2020September 2021). Clin Infect Dis. 2022 May 20:ciac388. doi: 10.1093/cid/ciac388. COVID19 Oct 21Apr 22COVID19 Oct 20Sep 21 Among children ages 6 months4 yearsOct 2020Sep 2021 COVID19 hospitalization rates were lower than influenza hospitalization rat

es during 201718 through 201920 (prepandemic) influenza seasonsOct 2021Apr 2022 COVID19 hospitalization rates were as high or higher than influenza hospitalization rates during 201718 through 22 influenza seasons Other Pediatric Vaccine Preventable Diseases: Hospitalizations per Year Prior to Recommended Vaccines 1 https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5603a1.htm Davis MM, Patel MS, Gebremariam A. Decline in varicellarelated hospi

talizations and expenditures for children and adults after introduction of varicella vaccine in the United States.Pediatrics. 2004;114(3):786792. doi:10.1542/peds.2004Centers for Disease Control and Prevention (CDC). Direct and indirect effects of routine vaccination of children with 7valent pneumococcal conjugate vaccine on incidence of invasive pneumococcal diseaseUnited States, 19982003. MMWR Morb Mortal Wkly Rep. 2005 Sep 16;54(36):

8937. PMID: 16163262.COVIDNET data, Accessed May 21, 2022.Vaccinetype invasive pneumococcal disease annual rate for children 5 years in 19981999 was 80 per 100,000, of which about 50% were hospitalized. Hepatitis AVaricella(Chickenpox)Vaccinetype Invasive Pneumococcal DiseaseCOVIDAge 14 years4 years4 years6 months4 yearsTime periodYear 1: April 2020March Year 2: April 2021March Hospitalization Burden(Annual rate per 100,000 population)

Year 1: 29.8Year 2: 89.3 COVIDassociated mortality 1001502002500-5months6-11monthsCOVID19 deathsAge in yearsCOVID19 deaths in children and adolescents by age based on death certificate data, National Center for Health Statistics, January 1, 2020May 11, 2022Source: https://data.cdc.gov/NCHS/ProvisionalCOVID19DeathsCountsbyAgeYears/3apk4u4f/data. Accessed May 14, 2022. Children 6 months 4 years ��202COVID19 deaths�

�1.7% of all deaths in this age group COVID19 is a leading cause of death among children ages 019 yearsMarch 1, 2020April 30, 2022Based on death certificate data from the National Center for Health Statistics. COVID19 based on cumulative total incidence of COVID19 deaths from March 1, 2020April 30, 2022.Source: Flaxman S, Whittaker C, Semenova E et al. Covid19 is a leading cause of death in children and young people ages 019 ye

ars in the United States. medRxiv 2022.05.23.22275458; doi: https://doi.org/10.1101/2022.05.23.22275458 Age groupRank of COVID19 among causes of death 1 year4 years 9 years1014 years1519 years Pediatric vaccine preventable diseases: Deaths per year in the United States prior to recommended vaccines Hepatitis AMeningococcal (ACWY)VaricellaRubellaRotavirusCOVIDAge 20 years18 yearsyearsAll ages5 years6 months 4 yearsTime period19952004Jan

2020May 2022Average deaths per yearVogt TM , Wise ME, Bell BP, Finelli L. Declining hepatitis A mortality in the United States during the era of hepatitis A vaccination. J Infect Dis2008; 197:1282National Notifiable Diseases Surveillance System with additional serogroup and outcome data from Enhanced Meningococcal Disease Surveillance for 2015Meyer PA, Seward JF, Jumaan AO, Wharton M. Varicella mortality: trends before vaccine licensur

e in the United States, 1970J Infect Dis. 2000;182(2):383390. doi:10.1086/315714Roush SW , Murphy TV; Historical comparisons of morbidity and mortality for vaccinepreventable diseases in the United States. JAMA 2007; 298:2155Glass RI, Kilgore PE, Holman RC, et al. The epidemiology of rotavirus diarrhea in the United States: surveillance and estimates of disease burden. J Infect Dis. 1996 Sep;174 Suppl 1:S511. https://data.cdc.gov/NCHS/P

rovisionalCOVID19DeathsCountsbyAgeYears/3apk4u4f/dataAccessed May 14, 2022 Multisystem Inflammatory Syndrome in Children (MIS Multisystem Inflammatory Syndrome in Children (MISSevere illness in persons ages 020 yearscharacterized by fever, multisystem organ involvement, laboratory evidence of inflammation, and SARSCoV2 infection with no alternative plausible diagnosisOccurring 26 weeks after acute SARSCoV2 infection70% of patients are

admitted to intensive care2, 3, 42% die 2, 3, 41. https://www.cdc.gov/mis/misc/hcp/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmis%2Fhcp%2Findex.html. Accessed June 7, 2022. 2. Feldstein LR, et al. Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome inildren (MISC) Compared With Severe Acute COVIDJAMA. 2021;325(11):10741087. doi:10.1001/jama.2021.20913. Belay ED, et al. Trends in

Geographic and Temporal Distribution of US Children With Multisystem Inflammatory Syndrome Durithe COVID19 Pandemic [published online ahead of print, 2021 Apr 6].JAMA Pediatr. 2021;e210630. doi:10.1001/jamapediatrics.2021.06304. Miller AD, Zambrano LD, Yousaf AR, Abrams JY, Meng L, Wu MJ, Melgar M, Oster ME, Godfred Cato SE, Belay ED, Campbell AP; MC Surveillance Authorship Group. Multisystem Inflammatory Syndrome in ChildrenUnited Sta

tes, February 2020July 2021. Clin Infect Dis. 2021 Dec 5:ciab1007. doi: 10.1093/cid/ciab1007. Epub ahead of print. Erratum in: Clin Infect Dis. 2022 Apr 27;: PMID: 34864955; PMCID: PMC8689703. Daily MIS - C and COVID - 19 cases reported to CDC day moving average), onsetFebruary 19, 2020May 21, 2022 MISC cases are among individuals ages 21 years. COVID19 cases reflect all cases reported to CDC (among individuals of all ages). The grayed

out area on the right side of the figure represents the most recent 6 weeks of data, for which reporting of MISC cases is still incomplete. Date of onset was missing for 1 of the 8,525 cases. https://covid.cdc.gov/coviddatatracker/#misnationalsurveillance. Accessed June 7, 2022.Total MISC cases:8,52569 deaths Weekly MIS - C case counts among persons ages 0 – 20 years by age group (N=8,525)February 1, 2020 May 31, 2022 Weekly MIS

- C case counts among persons ages 0 – 20 years by age group (N=8,525)February 1, 2020 May 31, 2022Among children 6 months 4 years:9 deaths MISC patients by race & ethnicity for children and adolescents ages 6 months17 yearsby age groupFebruary 1, 2020 May 31, 2022Age is missing for 1 case.Source: CDC data. Accessed June 7, 2022 31%33%32%26%30%30%27%23%26%9%8%7%6%6%5%0%5%10%15%20%25%30%35%6 months4 years11 years17 years White

, Non-Hispanic Black, Non-Hispanic Hispanic/Latino Other Unknown/Refused PostCOVID Conditions in Children PostCOVID conditions in childrenA range of new, returning or ongoing, health problems occurring 4 or more weeks after acute SARSCoV2 infectionOccur in adultsand children 18 yearsChildren ages 05 years with SARSCoV2 infection are more likely than controls (without known SARSCoV2 infection) to experience the following symptoms lasting

more than 4 weeks after acute infectionFatigue Loss of taste Loss of smell https://www.cdc.gov/coronavirus/2019ncov/hcp/clinicalcare/postcovidscience.htmlBullOttersonL, Baca S, Saydah S, et al. PostCOVID Conditions Among Adult COVID19 Survivors Aged 1864 and ≥65 Years United States, MarcNovember 2021. MMWR MorbMortal WklyRep 2022;71:713717. DOI: http://dx.doi.org/10.15585/mmwr.mm7121e1 Rao S, Lee GM, Razzaghi H, et al. Clinical featu

res and burden of postacute sequelae of SARSCoV2 infection in children and adolescents: an exploratory EHRbased cohort study from the RECOVER program. medRxiv2022.05.24.22275544; https://doi.org/10.1101/2022.05.24.22275544 BorchL, Holm M, Knudsen M, et al. Long COVID symptoms and duration in SARSCoV2 positive children a nationwide cohort study. European Journal of Pediatrics. 2022 2022/04/01;181(4):1597607. PostCOVID conditions in chil

drenEvidence regarding the prevalence and spectrum of postCOVID conditions among children, especially young children, is limited byInability of younger children to verbalize symptomsFew studies including childrenLack of control groupsSymptoms frequently occur in children without known SARSCoVinfection 1. Zimmermann P, PittetLF, Curtis N. The Challenge of Studying Long COVID: An Updated Review. The Pediatric infectious disease journal. 2

022;41(5):4 Other impacts of the COVIDpandemic on children and families Percent of parents who say: In the past year, they or another adult in their household left a job or changed work schedules to take care of their childrenJuly 15, 2021August 2, 2021 Source: KFF COVID19 Vaccine Monitor: The Impact Of The Coronavirus Pandemic On The Wellbeing Of Parents And Children | KFF. Accessed May 24, 2022. 40 years and older18-39 yearsParent o

f adolescent ages 12-17 yearsParent of child ages 5-11 yearsParent of child under age 5 yearsTotal parents $90K or more$40K-$89.9K$40KWhiteHispanicBlackParent ageRace/EthnicityHousehold income Percent of parents who say: In the past year, they or another adult in their household left a job or changed work schedules to take care of their childrenJuly 15, 2021August 2, 2021 Source: KFF COVID19 Vaccine Monitor: The Impact Of The Coronavi

rus Pandemic On The Wellbeing Of Parents And Children | KFF. Accessed May 24, 2022. 40 years and older18-39 yearsParent of adolescent ages 12-17 yearsParent of child ages 5-11 yearsParent of child under age 5 yearsTotal parents $90K or more$40K-$89.9K$40KWhiteHispanicBlackParent ageRace/EthnicityHousehold income Worsening of mental or emotional healthWidening of existing education gapsDecreased physical activity and increased body mass

index (BMI)Decreased healthcare utilizationDecreased routine immunizationsIncrease in Adverse Childhood Experiences (ACEs)Other indirect impacts of COVID19 pandemic on children Conclusion Summary: COVID19 epidemiology in children and adolescents ages 6 months 4 yearsAs of June 12, 2022, COVID19 has caused �570,000 cases among infants age ear and
y1;.1 ;1.9 millioncases among children ages 14 years Omicron surge in the U

nited States led to the highest numbers of COVIDcases, emergency department visits, and hospitalization rates seen during the pandemic Summary: COVID19 epidemiology in children and adolescents ages 6 months 4 yearsChildren ages 6 months4 years are at risk of severe illness from COVIDMore than half of hospitalized children ages 6 months4 years had no underlying conditionsDuring Omicron predominance, COVID19 associated hospitalizations a

mong children ages 6 months4 years have similar or increased severity compared to older children and adolescentsBurden of COVID19 hospitalization is similar to or exceeds that of other pediatric vaccine preventable diseasesCOVID19 pandemic continues to have significant impact on families and increases disparities AcknowledgementsACIP COVID19 Workgroup Team: Sara Oliver, Evelyn Twentyman, Monica Godfrey, Danielle Moulia, Megan Wallace, L

auren Roper, Kate Woodworth Epidemiology Task Force and Division of Viral DiseasesVaccine Effectiveness Team: Ruth LinkGelles, Tamara PilishviliCOVIDNET: Fiona Havers, Chris Taylor, Rebecca Woodruff, Kristin Marks, Kadam Patel, Michael Whitaker, Huong Pham, Jenny Milucky, Onika Anglin, Dallas ShiNatural History Team: Jefferson Jones, Kristie Clarke, Sharon SaydahMISC unit: Angie Campbell, Laura Zambrano, Allison MillerNVSN: Heidi Moline

, Meredith McMorrow, Ariana Perez, Benjamin Clopper, Aaron CurnsCore Clinical Unit: David SiegelData, Analytics and Visualization Task Force: Casey Lyons, Susan Wacaster, Kingsley Iyawe, Vaccine Data SectionNSSP: Aaron KitePowell, Kelly Carey, Kathleen Hartnett, Karl SoetebierFluSurvNET: Shikha Garg, Dawud Ujamaa, Miranda DelahoyDivision of Vital Statistics, National Center for Health StatisticsMany more… For more information, con

tact CDCCDCINFO (2324636)TTY: 16348 www.cdc.govThe findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. cdc.gov/coronavirus COVID19 epidemiology in children ages 6 months4 yearsKatherine E. FlemingDutra, MDNational Center for Immunization and Respiratory DiseasesCenters for Disease Control and PreventionJune 17, 2022