COVID-19 and pediatrics: Your questions answered

The pandemic has left us all with a lot of questions. Here, the Ovia Health clinical team answers your questions about COVID-19, postpartum, and breastfeeding.

Should I take my child to well-visit appointments or get vaccines? 

Call ahead to find out how your child’s pediatric practice is handling each type of appointment. Many appointments can be handled virtually by phone or video, with most in-person appointments being prioritized for those needing time-sensitive vaccinations or evaluation. Some practices are holding well-visits in a different office or at different times than sick visits, so calling ahead is especially important[1].

Most practices have resumed routine in-person pediatrics appointments. Sick visits may be handled differently to limit a potentially COVID positive child from entering an office. Having Covid tests at home is recommended. Keeping up with your child’s vaccination schedule to prevent other diseases is one of the most important things you can do to protect their health during the pandemic.

Because it can be hard to keep infants and toddlers from touching surfaces in public places, if you do need to bring them to an appointment, you might consider wearing them in a carrier or keeping them in their car seat or stroller at the provider’s office. And use hand sanitizer when you don’t have access to a sink for proper handwashing. 

Does my child need to wear a mask?

As local rates of COVID decrease, many mask mandates have ended. The CDC advises that all children over 2 years old should wear coverings over their mouth and nose during certain activities or when disease risk is elevated in your community. The American Academy of Pediatrics and the CDC have both released statements encouraging schools to require masking at all times for children and adults in school buildings when community Covid levels are elevated (even those who are fully vaccinated) because masking decreases rates of illness. Children with certain high-risk health conditions should wear special N-95 masks, and any family who chooses to mask should be supported regardless of community risk level. Talk to your child’s health provider if you have concerns about your child’s particular masking needs. Check your local regulations for masking requirements.

How can I prevent my child from getting COVID-19?

All children over the age of 6 months are eligible, and recommended to get the COVID-19 vaccine. Vaccinating all members of your family is the best way to prevent your child from getting sick.

The CDC website has trustworthy, up-to-date information about how you can help decrease your child’s exposure to COVID-19, as well as decrease the chance that they will pass the virus on to other people if they do have it. This website also includes guidance on when and how children should wear masks. The American Academy of Pediatrics (AAP) has also put together COVID-19 information for parents, available here. It’s always a great idea to review with your children the ways we protect ourselves from infection including social distancing, proper hand washing, and mask wearing.

Kids in the classroom

Now that your child has returned to the classroom, you might be thinking about how to keep them safe. The best way to think about your options will depend on the COVID risk in your area, whether your family has been vaccinated, and your specific child’s needs. Here are some questions you can ask your school administrators, school nurse, or your child’s teacher: 

  • Will masking be required for everyone regardless of vaccination status?
  • How will social distancing be practiced and encouraged — in classrooms, in hallways and common areas during times of transition, during lunch or recess, at the start and end of the school day, and on public transportation?
  • How many students, educators, and staff will be in a classroom space together or interact with each other over the course of the day?
  • Will the classrooms, bathrooms, and common spaces be disinfected regularly?
  • How is adequate ventilation being assured in classrooms and public spaces?
  • Will the school screen students, educators, and staff for illness?
  • What is the plan if a member of the school community gets sick?
  • Will the school provide emotional, behavioral, and mental health support throughout the year?
  • What are the school’s current guidelines for isolation and quarantine of students who have been infected with COVID-19 or exposed to someone who tested positive for COVID-19?
  • What are the school’s current guidelines for COVID-19 testing for staff and students and will COVID-19 testing be performed at the school?

When safety measures are implemented consistently, particularly masking, studies have shown very low transmission rates in schools.

If my child has symptoms that might be COVID-19, what should I do?

First, don’t panic. Although infants and children can get the virus, they typically have more mild cases than older people do[2]. Call your child’s provider to find out what they would like you to do. They will have a process in place for getting your child the evaluation and care they need, which might include a phone or video appointment depending on the circumstances. In the meantime, do not send your child to school or daycare where they will be around other children. And be sure to follow the CDC’s guidance for reducing exposure for the rest of the family. Paxlovid is approved for at home use in children over 12 at risk for serious disease.

The FDA has approved remdesivir as a treatment for children older than 28 days and heavier than 7 pounds who are at risk for severe disease or who are hospitalized.

What is Multisystem Inflammatory Syndrome in Children (MIS-C). What do I need to know?

In early May 2020, doctors in the United Kingdom and the U.S. started reporting a few cases of children who were experiencing inflammation in multiple organs that appeared similar to a rare condition called Kawasaki disease[3]. Kawasaki disease causes swelling and inflammation in the blood vessels of the skin, eyes, and heart, causing symptoms like persistent fever, body rash, swelling in the lymph nodes (neck), swelling of the hands and feet, red eyes, and peeling skin[4]. 

Again, generally speaking, children are less likely than adults to become sick with COVID-19. Very few children with COVID-19 develop this syndrome, and almost all of those who do recover well. However, MIS-C can be severe and should be treated quickly to avoid long-term damage to organs. Treatment tends to focus on reducing the inflammation. 

This disease appears to be related to COVID-19, though the link is unclear, and researchers are tracking it closely. Although there has been a lot of news coverage on it, this disease appears to be very, very rare.

If my child has a medical emergency, should I do anything differently because of COVID-19?

In a life-threatening emergency, you should always seek immediate care. That can include calling 911 or going to your local emergency room or urgent care center. If it is safe to delay treatment, call your child’s provider to find out what they would like you to do. They will have a process in place for getting your child the evaluation and care they need, which might include phone or video visits depending on the circumstances. 

Should my child receive the COVID-19 vaccine?

The vaccine manufactured by Pfizer-BioNTech is authorized for people age 6 months and older. The Moderna vaccine is approved for children 6 months to 5 years old. The American Academy of Pediatrics recommends that all children ages 6 months or older get the COVID-19 vaccine. If your child is 6 months or older, it’s a good idea to speak with their healthcare provider and decide together if getting the vaccine is the best next step. For more information about the vaccines head here.

Bivalent booster shots are available for those 6 months  and older who have completed their primary vaccination series.

The COVID-19 vaccines do not contain “live” virus. This means you or your child cannot get COVID-19 from the vaccine. Side effects for the COVID-19 vaccines include pain at the site of injection, fever, fatigue, and chills. These typically go away after a couple of days. These side effects are normal and expected. They are indicators of your immune system doing its job to learn to protect you from the virus. That said, there have been reports of very rare, unexpected, reactions to the vaccines. A severe allergic reaction called anaphylaxis can happen in very rare cases. The CDC recommends if you have a moderate or severe allergic reaction after your first dose of an mRNA vaccine that you do NOT receive the second dose. You should speak with your healthcare provider about next steps. The Johnson & Johnson vaccine has been linked with rare cases of dangerous blood clots, particularly in women under 50 who have a condition called thrombocytopenia or low platelets [5]. MRNa or the Novavax vaccine are preferable for most people, but the incidences of these adverse events is so low, getting vaccinated remains safer than potentially getting infected with COVID-19. [6].

There has been a recent increase in the number of reports of myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the tissue surrounding the heart) in male adolescents and young adults who have received the RNA COVID vaccines. This happens most commonly in the few days after receiving the second dose. Symptoms are chest pain, shortness of breath, or fast or pounding heartbeat. The CDC and FDA have acknowledged this is a rare adverse event and are continuing to monitor cases for long-term effects. Thankfully, to date, most cases of this inflammation have responded quickly to rest and medication. The CDC continues to recommend that all individuals age 5 and older get the vaccine as the risk of developing complications from COVID-19 infection — including hospitalization and life-long health conditions — is still much higher than the risk of this adverse event from vaccination.

Your child’s pediatrician or other healthcare professional is a great resource for more information about the COVID-19 vaccine.

Reviewed by the Ovia Health Clinical Team
Updated January 30, 2023

Your COVID-19 guide

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