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CDC urges vaccination, layers of protection in schools as more children infected with COVID-19

August 27, 2021

Editor’s note: For the latest news on COVID-19, visit http://bit.ly/AAPNewsCOVID19.

As COVID-19 cases among children continue to escalate, health officials are pleading for everyone who is eligible to be vaccinated and for schools to implement layers of protection.

“It’s human nature to protect our children above all else, and the best way to protect them is to … surround children who are not vaccine-eligible with people who are vaccinated to effectively shield them from COVID,” Centers for Disease Control and Prevention (CDC) Director Rochelle P. Walensky, M.D., M.P.H. said Friday.

About 45% of teens ages 16-17 years and 35% of adolescents ages 12-15 years are fully vaccinated, along with 63% of adults, according to CDC data and an AAP analysis.

A new study found wide variation in adolescent vaccination rates by state. About 20% of adolescents in Mississippi had received their first dose by the end of July compared to 70% in Vermont.  

Surging pediatric COVID-19 cases

As health officials work to raise vaccination rates and await vaccines for younger children, more than 180,000 new pediatric COVID-19 cases were reported during the week ending Aug. 19, nearly 50% higher than the week before, a report from the AAP and Children’s Hospital Association (CHA) shows. There has been a four-fold increase from the week ending July 22 when about 38,000 new cases were reported. Children made up about 22% of all new cases last week. About 1% of children with COVID-19 have been hospitalized since the start of the pandemic and at least 402 have died.

“While symptomatic and severe cases in children remain less common than in other age groups, we have seen increases in pediatric cases and hospitalizations over the last few weeks, which is likely the result of increases in community transmission generally and more specifically the delta variant’s increased transmissibility,” Dr. Walensky said.

The surge comes at the same time as an unseasonable spike in respiratory syncytial virus cases.

“Many children’s hospital intensive care units are at or near capacity, with kids waiting in emergency departments because there aren’t enough beds to admit them or enough hospital staff to safely care for them,” CHA CEO Mark Wietecha, M.B.A., M.Sc. wrote in an opinion piece published Thursday in USA Today.

Layers of protection in schools

Two new studies released in the Morbidity and Mortality Report on Friday show that layers of protection recommended by the AAP and CDC can be effective in preventing the spread of COVID-19 in schools and the consequences of rejecting these strategies.

One study looked at COVID-19 cases in Los Angeles schools providing in-person education to students in transitional kindergarten through 12th grade while implementing prevention measures. Data from September 2020 to March 2021 show case rates among these students were 3.4 times lower at their peak in December 2020 than the rates for all children and adolescents in the county.

A second study looked at an outbreak linked to an unvaccinated elementary school teacher who read to her students without wearing a mask while she was infected and symptomatic. Health officials said her actions resulted in 26 infections, including half of her class and some of their family members.

“Evidence has repeatedly demonstrated that multilayer prevention strategies like vaccination for all children and adults who are eligible; masks for all students, teachers, staff and visitors; ventilation; cohorting; physical distancing and screening testing work to prevent the spread of COVID in schools,” Dr. Walensky said. “Schools should implement as many of these prevention layers as possible simultaneously. This serves to protect our children even if there are inevitable breaches in any single protection layer.”

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