Pediatric hospitalizations: Some important news today

Today we got two huge questions answered that we (epidemiologists, clinicians, and parents) have been anxiously waiting for…

  1. What are hospitalization rates across different pediatric age groups? Until now, pediatric hospitalizations have only been reported as <18 years, which is not helpful.

  2. Is Delta more severe for kids compared to previous variants? We know that Delta is more severe for adults. But is it for kids? Could that be explaining the high number of pediatric hospitalizations across the US?

The CDC just published a paper (50 minutes ago, you’re welcome) using data from the Coronavirus Disease 2019–Associated Hospitalization Surveillance Network (COVID-NET). This is a database of COVID-19–associated hospitalizations in 99 counties across 14 states. Scientists looked at pediatric hospitalizations from March 1, 2020–August 14, 2021. What did they find?

  • The cumulative number of COVID19 hospitalization was 49.7 per 100,000 kids

    • Rates were highest among children aged 0–4 years (69.2 per 100,000) and adolescents aged 12–17 years (63.7 per 100,000)

    • Rates were lowest among children aged 5–11 years (24.0 per 100,000)

  • Among pediatric COVID19 hospitalizations, 26.5% were admitted to an ICU, 6.1% required ventilation, and 0.7% of the children died

The rate of hospitalizations has dramatically increased in the past month

  • Pediatric hospitalization rates are 5 times higher in August compared to June

    • The biggest increase was among 0–4 year olds, with a COVID-19 hospitalization rate 10 times higher in August compared to June

  • The hospitalization rate among unvaccinated adolescents (aged 12–17 years) was 10 times higher than that among fully vaccinated adolescents

The figure shows increasing COVID-19 hospitalizations in children and adolescents since the Delta variant.
COVID-19–associated weekly hospitalizations per 100,000 children and adolescents,* by age group — COVID-NET, 14 states,† March 1, 2020–August 14, 2021 (3-week smoothed running averages)§

But, this isn’t necessarily because Delta is more severe

To assess severity of Delta compared to previous variants, hospitalizations were split up into two time periods: before Delta (March 1, 2020–June 19, 2021) and after Delta (June 20–July 31, 2021).

  • The rate in which kids died, were admitted to the ICU, needed oxygen, or ventilation was not statistically different during Delta compared to before Delta:

    • Before Delta: 26.5% were admitted to an ICU, 6.1% required ventilation, and 0.7% died

    • After Delta: 23.2% were admitted to an ICU, 9.8% required ventilation, and 1.8% died

So, Delta is not likely more severe for kids. Increasing pediatric hospitalization rates are due to high transmission in the community.

Our vaccine wall for kids is largely working in states that have one

The CDC also published a second paper this afternoon, but it’s less surprising. This study looked at hospital records across states to see whether state-level vaccination rates impacted pediatric hospitalizations. In other words, does the vaccine immunity wall help kids? Drum roll…

  • Emergency department visits and hospital admissions are higher in states with lower population vaccination coverage

  • Emergency department visits and hospital admissions are lower in states with higher vaccination coverage

Bottom Line: Pediatric hospitalizations have dramatically increased in the past month. Yes, the media is accurately portraying the situation on the ground. And, hospitalizations have increased the most for 0-4 year olds. Importantly, this isn’t because Delta is likely more severe, it’s because we are transmitting Delta in the community and our kids aren’t protected. Your decision not to get a vaccine or implement public health measures in schools or the community is directly impacting the health of kids.

Please do your part this Labor Day weekend.

Love, YLE