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Peak COVID-19-related hospitalization rates among children and adolescents during the omicron surge were higher than peak rates when delta was predominant. In addition, the largest increase in hospitalization rates was among children ages 0-4, who are not eligible to be vaccinated, according to a study published today in the Centers for Disease Control and Prevention’s (CDC’s) Morbidity and Mortality Weekly Report.
Researchers analyzed data from the Coronavirus Disease 19-Associated Hospitalization Surveillance Network (COVID-NET), which conducts population-based surveillance in 99 counties in 14 states. The authors described COVID-19-associated hospitalizations among children ages 0-11 years and adolescents ages 12-17 years when delta was predominant (July 1 through Dec. 18, 2021) and when omicron was predominant (Dec. 19, 2021, through Jan. 22, 2022).
Complete clinical data were available for 1,834 and 266 hospitalized children and adolescents in the delta and omicron predominant periods, respectively.
According to the study, rates of weekly COVID-19-associated hospitalizations per 100,000 children and adolescents peaked during the weeks ending Sept. 11, 2021, for delta, and Jan. 8, 2022, for omicron. The omicron variant peak of 7.1 cases per 100,000 children was four times that of the delta variant peak of 1.8 cases per 100,000.
Hospitalization rates among children ages 0-4 years were about five times higher during the peak week of the omicron period than during the delta period (15.6 vs. 2.9 per 100,000).
Peak intensive care unit admission rates for children and adolescents were 1.4 times higher during omicron predominance (the two-week period ending Dec. 31, 2021) than during delta’s predominance (the two-week period ending Sept. 11, 2021).
During December 2021, the hospitalization rate among unvaccinated adolescents was six times higher than among fully vaccinated adolescents (23.5 vs. 3.8 per 100,000).
Vaccination eligibility was expanded to include children ages 5-11 years on Nov. 2, 2021. However, because they could not be fully vaccinated until Dec. 7, 2021, the study did not consider vaccination status in this age group.
Study limitations included the likelihood of missing COVID-19-related hospitalizations because of testing practices and test availability, and the limited amount of clinical data available when omicron was predominant. Additionally, since the COVID-NET data included only about 10% of the U.S. population, the findings might not be generalizable to the entire country.
“Vaccination of eligible persons, in addition to other prevention strategies such as masking, are critical to reducing the incidence of severe COVID-19 among children and adolescents,” the authors concluded. “All persons who are eligible for vaccination should receive and stay up to date with COVID-19 vaccines to reduce the risk for severe disease for themselves and others with whom they come into contact, including children who are currently too young to be vaccinated.”
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