Children's Risk Of Serious Illness From COVID-19 Is As Low As It Is For The Flu

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For children, the risk of serious consequences from COVID-19 is the same magnitude as the risk they face from the flu. But for parents, experts say, it's a matter of perspective. / Getty Images

The Centers for Disease Control and Prevention made a strong statement about the effectiveness of vaccines when it decided that fully vaccinated people don't need to wear masks in most circumstances. But it left some parents concerned about how the change might affect children too young to be vaccinated.

Dr. Paul Offit, who heads the vaccine education center at Children's Hospital of Philadelphia, says that the new mask guidance is mostly good news.

"But I think that has made this world a little less safe for young children," he says.

Even a vaccinated parent can occasionally get infected with the coronavirus. There's also a small risk that the virus can pass to an unvaccinated child.

But the risk that a child gets seriously ill is extremely small — comparable to the risk that children face of having serious illness as a result of the flu.

To date, out of more than 74 million children in the United States, there have been about 300 COVID-19 deaths and a few thousand serious illnesses. By comparison, the CDC registered 188 flu-related deaths in children during the 2019-2020 flu season. (This past year, there was essentially no flu season at all.)

Hospitalization numbers look worse for COVID-19. But those numbers are inflated as a result of the CDC's reporting rules. The CDC requires every child admitted to a hospital to be tested for the coronavirus.

Dr. Roshni Mathew, a pediatric infectious disease specialist at the Stanford University School of Medicine, says experience at her hospital found that 45% of the time, a child who tested positive for the coronavirus was not actually sick with COVID-19. The findings have been published online in the journal Hospital Pediatrics.

In those cases, hospitalization was due to "a completely unrelated diagnosis, like appendicitis or femur fracture or something else," she says.

For children in particular, the risk of serious consequences from COVID-19 is the same magnitude as the risk they face from the flu, she says. But many parents seem more worried about the new and less familiar disease. That anxiety is heightened by the new guidelines on mask-wearing. But experts urge parents to try not to worry too much.

"If you stop going into stores because you're terrified you'll run into an unmasked person, that's probably overreacting," says Gretchen Chapman, a psychology professor who studies health conundrums like this at Carnegie Mellon University.

It's understandable why parents would feel that way, she says. Though these risks are very low, they're not zero. And people struggle to conceptualize the difference between small risks — for example, something that's 1 in 1,000 versus 1 in 1 million.

"It doesn't seem that different to the person," Chapman says.

But it's also a matter of perspective. A tiny risk has a small impact on the population as a whole, but parents understandably aren't thinking in terms of the population as a whole.

"When you're a parent and you're thinking of your one or two kids, it's really all or nothing," Chapman says. "Of course, the probability is really, really low of that very bad event, but it's not zero."

The risk is continuing to decrease, as COVID-19 rates fall and the chance of encountering an unmasked person with an infection diminishes.

Soon, the whole question will be turned on its head. The challenge will be not to reassure parents about very low risks but to convince them to get their children vaccinated, to drive that low risk down even more. Right now, children 12 and older are eligible for the Pfizer-BioNTech vaccine, but the vaccines are being tested in younger children.

Once children are eligible, COVID-19 "becomes a vaccine-preventable infection," Mathew says, "so you'd take every opportunity to prevent every single pediatric death."

Only about two-thirds of children end up being vaccinated for the flu. And vaccination is important not just for their own sake, but because children are a major reason that the flu spreads rapidly through communities.

Health officials are likely to confront a similar challenge to convince parents to vaccinate their children against COVID-19.

You can contact NPR science correspondent Richard Harris at rharris@npr.org.

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