Covid-19 boosters could keep thousands of children out of hospital, but uptake remains low

Covid-19 boosters could keep thousands of children out of hospital, but uptake remains low


Higher Covid-19 vaccination rates among American children could avert thousands of pediatric hospitalizations and millions of missed school days, according to analysis released Tuesday by the Commonwealth Fund and the Yale School of Public Health.

If school-age children were vaccinated with the updated Covid-19 booster at the same rate they were vaccinated against influenza last season – between 50% and 60% coverage – at least 38,000 pediatric hospitalizations could be avoided, including about 9,000 stays in intensive care units, through March. And if Covid-19 booster coverage reaches 80% among school-aged children by the end of the year, more than 50,000 hospitalizations could be averted.

Preventing Covid-19 hospitalizations could help ease pressure on pediatric hospitals, which have been particularly full in recent weeks as respiratory virus season – including influenza, RSV and Covid-19 – sweeps through the country earlier than usual. Fewer than 1 in 4 pediatric hospital beds are available nationwide, including less than 10% of beds in seven states, according to data from the US Department of Health and Human Services.

“The overwhelmed healthcare system means some families may not be able to get the care their child needs for a medical emergency,” Dr. Moira Szilagyi, president of the American Academy of Pediatrics, wrote in a statement. CNN Opinion article, calling the situation a “crisis.”

Covid-19 transmission is significantly lower now than at the start of the year; less than 5% of the US population lives in a county considered to have a high community level of Covid-19, according to the US Centers for Disease Control and Prevention. But more than 2,400 children were admitted to hospital with Covid-19 last week — nearly three times as many as the previous week, CDC data shows.

The new analysis also found that higher vaccination rates could help keep children in school, a benefit that other research has found could have important effects on mental health and academic achievement.

Assuming a five-day isolation period for children with mild illness and 10 days for those who are hospitalized or seriously ill, aligning the Covid-19 booster intake with flu shots for children could avoid more than 22 million days of absenteeism from school.

But the scenarios presented in the new analysis are quite unrealistic. So far, less than 5% of school-age children are getting their updated booster shot, according to CDC data.

A record number of updated Covid-19 boosters were administered in the first week of November, and US officials say they plan to push this week for people to be boosted against Covid-19 to offer maximum protection around Thanksgiving, but overall uptake remains low. To reach 50% coverage by the end of the year, the rate of vaccination would need to be at least 10 times faster than it was in November.

And Covid-19 vaccination rates among children have long lagged behind those of adults. Only 32% of children aged 5 to 11 and 61% of those aged 12 to 17 participated in their first round of vaccination against Covid-19, compared to 78% of adults.

“Accelerated vaccination campaigns that achieve high coverage at all ages have the potential to prevent a possible imminent outbreak of Covid-19, protecting children both directly and indirectly and providing them with additional stability in terms of school attendance and other social commitments,” the study authors wrote. “The cost of inaction could be high: millions of additional days of school absenteeism and thousands of preventable hospitalizations for children.”

For this analysis, the researchers did not take into account the possibility of an immune-evasive new coronavirus variant, but did take into account both naturally acquired and vaccine-induced immunity that would wane over time.

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