Highly transmissible viruses have tremendous capacity for targeting vulnerable populations, especially clusters of unvaccinated individuals. Over the last decade, this scenario has resulted in serious and even lethal outbreaks of measles and, more recently, coronavirus disease 2019 (COVID-19).

The latter half of 2021 has been notable for a devastating “fourth wave” epidemic of COVID-19, especially in US southern states where COVID-19 vaccination uptake among young people, including teenagers, is profoundly low. Across many parts of the South, fewer than 30% of teenagers are vaccinated, allowing the highly transmissible severe acute respiratory syndrome coronavirus 2 Delta variant to accelerate and spread rapidly. During this surge, states such as Louisiana, Mississippi, and Florida have sustained the highest incidence of COVID-19 globally. The result has been catastrophic rates of hospitalizations, including pediatric ICU admissions and deaths.

This devastating impact of COVID-19 on pediatric populations reflects a “one-two punch” of a Delta virus variant...

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