Top 5 Takeaways

1. Omicron Surge: COVID-19–associated hospitalization rates among children and adolescents increased rapidly in late December 2021 with the emergence of the Omicron variant, particularly among children aged 0–4 years.
2. Vaccination Impact: Hospitalization rates remained significantly lower among fully vaccinated adolescents aged 12–17 years compared to unvaccinated adolescents during both Delta and Omicron periods.
3. Severity Indicators: Although hospitalization rates were higher during the Omicron period, the proportions of ICU admissions and use of invasive mechanical ventilation were lower compared to the Delta period.
4. Disparities in Vaccination: A higher proportion of unvaccinated adolescents were hospitalized and admitted to the ICU compared to their vaccinated counterparts, highlighting the importance of vaccination.
5. Public Health Recommendations: Vaccination of eligible children and adolescents, along with other preventive measures, is critical to reducing severe COVID-19 outcomes.

Original Article Author and Citation

Corresponding Author

Kristin J. Marks, KJMarks@cdc.gov

Suggested Citation

Marks KJ, Whitaker M, Anglin O, et al. Hospitalizations of Children and Adolescents with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, July 2021–January 2022. MMWR Morb Mortal Wkly Rep 2022;71:271–278. DOI: http://dx.doi.org/10.15585/mmwr.mm7107e4

Summary

This report examines COVID-19–associated hospitalizations among U.S. children and adolescents during the Delta and Omicron variant predominance periods. The analysis reveals a significant increase in hospitalization rates during the Omicron period, particularly among children aged 0–4 years. Vaccination was shown to be effective in reducing severe outcomes among adolescents.

Methods

Data were collected from the COVID-NET, which conducts population-based surveillance for laboratory-confirmed COVID-19–associated hospitalizations across 99 counties in 14 states. Hospitalization rates were calculated based on positive SARS-CoV-2 test results. The study period covered July 3, 2021, to January 22, 2022, with detailed clinical data available from July 1 to December 31, 2021. Rates were stratified by age and vaccination status, and statistical analyses were performed to compare outcomes between the Delta and Omicron periods.

Discussion

The findings indicate that the Omicron variant led to a higher rate of pediatric hospitalizations compared to the Delta variant. Despite the increased transmissibility of Omicron, the severity of outcomes, such as ICU admissions and use of invasive mechanical ventilation, was lower. The study underscores the importance of vaccination, which significantly reduced hospitalization rates among adolescents. Disparities in vaccination coverage and the need for enhanced outreach strategies were also highlighted.

Conclusion

The rapid increase in COVID-19–associated hospitalizations among children and adolescents during the Omicron period, especially among unvaccinated individuals, emphasizes the critical role of vaccination and other preventive measures. Public health efforts should focus on increasing vaccination coverage to mitigate severe COVID-19 outcomes in this population.

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