Top 5 Takeaways

1. Increased COVID-19 Cases: Since July 2021, with the Delta variant predominating, COVID-19 cases among children and adolescents aged 0–17 years have increased significantly.
2. Higher ED Visits and Hospital Admissions: COVID-19-related emergency department visits and hospital admissions have risen, particularly in states with lower vaccination coverage.
3. ICU Admissions: The proportion of pediatric COVID-19 patients admitted to ICUs ranged from 10% to 25% during August 2020–June 2021, stabilizing around 20% during July and August 2021.
4. Vaccination Impact: States with higher vaccination coverage among those aged ≥12 years had significantly lower rates of COVID-19-related ED visits and hospital admissions for children and adolescents.
5. Community Vaccination Importance: Broad, community-wide vaccination is crucial to protect pediatric populations from severe COVID-19 illness.

Original Article Author and Citation

Corresponding Author

David A. Siegel, dsiegel@cdc.gov

Suggested Citation

Siegel DA, Reses HE, Cool AJ, et al. Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0–17 Years — United States, August 2020–August 2021. MMWR Morb Mortal Wkly Rep 2021;70:1249–1254. DOI: http://dx.doi.org/10.15585/mmwr.mm7036e1

Summary

This article examines the trends in COVID-19 cases, emergency department (ED) visits, and hospital admissions among children and adolescents aged 0–17 years in the United States from August 2020 to August 2021. The analysis reveals significant increases in these metrics since July 2021, coinciding with the predominance of the Delta variant. The study highlights the critical role of community-wide vaccination in mitigating severe COVID-19 outcomes in pediatric populations.

Methods

CDC analyzed daily COVID-19 case data from its case-based surveillance system, ED visit data from the National Syndromic Surveillance Program, and hospital admission data from the U.S. Department of Health and Human Services Unified Hospital Data Surveillance System. Data were stratified into three age groups (0–4, 5–11, and 12–17 years) and averaged over a 7-day period. States were grouped into vaccination coverage quartiles based on the percentage of the population aged ≥12 years who had completed the COVID-19 vaccination series as of July 31, 2021. The BD Insights Research Database provided indicators of severe disease among pediatric patients hospitalized with laboratory-confirmed COVID-19.

Discussion

The study found that COVID-19 cases, ED visits, and hospital admissions among children and adolescents increased during June–August 2021, particularly in states with lower vaccination coverage. The findings underscore the importance of community vaccination, testing strategies, and other prevention measures to protect children from SARS-CoV-2 infection and severe COVID-19. The study also notes that while the Delta variant is highly transmissible, it is unclear if it causes more severe illness compared to earlier variants.

Conclusion

Community-wide vaccination is essential to protect pediatric populations from severe COVID-19 illness. Continued monitoring of trends in ED visits and hospital admissions, along with the implementation of multiple prevention measures in schools and communities, is critical as schools resume in-person activities. Vaccination of eligible persons, especially those in close contact with children under 12 years who are not yet eligible for vaccination, is anticipated to provide significant protection.

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