Top 5 Takeaways

1. Increased Hospitalization Rates: COVID-19–associated hospitalization rates among children and adolescents rose significantly from late June to mid-August 2021, coinciding with the spread of the Delta variant.
2. Age-Specific Incidence: The cumulative incidence of COVID-19–associated hospitalizations was highest among children aged 0–4 years and adolescents aged 12–17 years.
3. Vaccination Effectiveness: Hospitalization rates among unvaccinated adolescents were approximately 10 times higher than those among fully vaccinated adolescents.
4. Severity of Disease: Indicators of severe disease, such as ICU admissions and the need for mechanical ventilation, remained consistent before and during the Delta variant predominance.
5. Preventive Measures: Implementation of preventive measures, including vaccination, universal masking in schools, and recommended masking in other indoor public spaces, is critical to reduce severe outcomes in children.

Original Article Author and Citation

Corresponding Author

Miranda J. Delahoy, MDelahoy@cdc.gov

Suggested Citation

Delahoy MJ, Ujamaa D, Whitaker M, et al. Hospitalizations Associated with COVID-19 Among Children and Adolescents — COVID-NET, 14 States, March 1, 2020–August 14, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1255–1260. DOI: http://dx.doi.org/10.15585/mmwr.mm7036e2

Summary

This article analyzes COVID-19–associated hospitalizations among children and adolescents in 14 U.S. states from March 1, 2020, to August 14, 2021. The study found a significant increase in hospitalization rates among children and adolescents during the period of Delta variant predominance. The data also highlighted the effectiveness of vaccination in reducing hospitalization rates among adolescents.

Methods

COVID-NET conducted population-based surveillance for laboratory-confirmed COVID-19–associated hospitalizations in 99 counties across 14 states. Hospitalization rates were calculated using National Center for Health Statistics’ population estimates. The study compared hospitalization rates and severity indicators before and during the Delta variant predominance. Statistical analyses included Wilcoxon rank sum tests and chi-square or Fisher’s exact tests.

Discussion

The study observed a rapid increase in COVID-19–associated hospitalization rates among children and adolescents, particularly among those aged 0–4 years. The data indicated that vaccination was highly effective in preventing hospitalizations among adolescents. Despite the increase in hospitalization rates, the severity of disease indicators remained consistent with earlier periods of the pandemic. The findings underscore the importance of implementing preventive measures, including vaccination and universal masking, to reduce severe COVID-19 outcomes.

Conclusion

The main takeaways from the study are the significant rise in COVID-19–associated hospitalizations among children and adolescents during the Delta variant predominance and the effectiveness of vaccination in reducing these hospitalizations. Preventive measures, such as vaccination and masking, are crucial to mitigate severe outcomes in this population.

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