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Study examines COVID-19 racial disparities among children, young adults

March 10, 2021

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A new study found significant racial disparities in COVID-19 cases among children and young adults early in the pandemic. The disparities have declined over the last quarter of 2020 as cases among White youths have risen, but gaps remain for some racial and ethnic groups.

People under 25 who are Native Hawaiian/Pacific Islander (NH/PI), American Indian/Alaska Native (AI/AN) and Hispanic have experienced the most persistent disparities, according to research the Centers for Disease Control and Prevention (CDC) published today in the Morbidity and Mortality Weekly Report.

Researchers analyzed data on 689,672 COVID-19 cases among children and young adults in 15 states and Washington, D.C., throughout 2020. Rates were calculated by dividing the case total for a racial/ethnic group by the population of that group, then multiplying it by 100,000. The cases per 100,000 persons were

  • 6,263 NH/PI,
  • 4,754 AI/AN,
  • 4,245 Hispanic,
  • 2,787 White,
  • 2,083 Black,
  • 1,725 Asian and
  • 1,113 people of multiple races.

The largest disparities were seen in January through April 2020 when the case rates per 100,000 persons were 163 among those who are AI/AN and 137 among those who are Hispanic compared to 35 among those who are White.

Disparities decreased throughout the year largely due to cases among White children and young adults rising, not a decline in cases among racial minorities, according to the report. Researchers attributed disparities to long-standing systemic and social inequities.

“Racial and ethnic minority groups are disproportionately represented in essential work settings, making it difficult for youths and parents to stay at home; a higher likelihood of living in a multigenerational household also increases the risk for household exposures to SARS-CoV-2,” they wrote.

They also found case rates increased with age. Those who were ages 0-4 had a rate of 1,087 per 100,000 persons compared to 5,415 per 100,000 for those ages 20-24. Females had higher case rates per 100,000 persons than males (3,114 vs. 2,693).

Authors noted case counts and racial disparities likely are underrepresented due to children with mild cases not being tested and a lack of access to testing among some racial groups.

“Ensuring equitable and timely access to preventive measures, including testing, safe work and education settings and vaccination when eligible is important to address racial/ethnic disparities,” they wrote.

Earlier this week, Marcella Nunez-Smith, M.D., M.H.S., who chairs the Biden administration’s COVID-19 Health Equity Task Force, laid out some of the federal efforts to decrease inequities in vaccination. Those include establishing federal sites and engaging pharmacy partners in targeted areas, having sites with extended hours, deploying mobile units and building relationships in communities. The government also is partnering with federal health centers that serve large communities of people who have low income, are racial/ethnic minorities and have limited English proficiency.

“Achieving equity is not an aspirational goal,” Dr. Nunez-Smith said. “This is mission critical. Absent equity, we will not be able to stop this pandemic from continuing to claim lives, strain our health care system and weaken our economy.”

COVID-19 vaccines have not been authorized for anyone under 16 years of age. Anthony Fauci, M.D., chief medical adviser to President Joe Biden, said Wednesday Pfizer and Moderna have fully enrolled clinical trials down to age 12 years, and he expects to see vaccination of high school students in the fall.

The AAP has continued to push for children to be vaccinated as more than 3.2 million have been infected and at least 253 have died, according to data from the AAP and the Children’s Hospital Association. The pandemic also has taken a toll on children’s mental and emotional health, social well-being and their educational experience.

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