As the highly contagious delta variant of the coronavirus surges across the United States, unvaccinated populations remain the most vulnerable. Among them are young children below age 12, who are not yet eligible for vaccination, prompting medical experts to warn of a potential wave of cases in the fall to coincide with the coming school year.
As of July 8, more than 4 million children had been diagnosed with Covid-19, representing 14.2 percent of all cases, according to the American Academy of Pediatrics. More than 31,000 new cases were reported in the week of June 24 to July 8, the association reported.
At least 335 children, ages 17 and younger, have died from Covid-19, according to the latest data from the Centers for Disease Control and Prevention, although serious complications in kids remain extremely rare. But increasing cases among children, including severe ones, are expected as the delta variant spreads and with no Covid vaccine authorized for children under the age of 12.
“Last year, for example, you would have to give a child a really high infectious dose to make them sick, but with the virus that's more contagious, even what would be an insignificant exposure could get them sick,” said Dr. Carlos Oliveira, a pediatric infectious diseases doctor and assistant professor of pediatrics at the Yale School of Medicine.
As of July 8, more than 16,600 children had been hospitalized with the coronavirus, about 2.2 percent of total hospitalizations, according to a report from the American Academy of Pediatrics using available data from 23 states and New York City.
In Mississippi, health officials said this week seven children were in an intensive care unit with Covid, with two on ventilators.
Such severe cases demonstrate the ongoing danger of the virus, experts said.
“I think we should expect that if more kids are getting infected, we would see more of those severe cases come to light,” said Amanda Simanek, an epidemiology professor at the University of Wisconsin-Milwaukee.
Still, there is no evidence that children are more susceptible to the delta variant of the virus than others who are unvaccinated or that it causes more severe illness.
Dr. Sean O'Leary, vice chair of the committee on infectious diseases for the American Academy of Pediatrics, said “it is more contagious in kids just like it's more contagious in other unvaccinated individuals, but it's not more contagious in kids than other unvaccinated individuals.”
Oliveira said one concern is what will happen come fall when in-person school resumes.
A Food and Drug Administration official said Thursday that emergency use authorization for children under 12 could come in early to midwinter.
“If we don't have a vaccine for school-aged children, I think that that's when we'll probably see the really high numbers that we were seeing before,” Oliveira said.
He stressed the “urgency” to develop a vaccine that worked and was safe for children under 12.
“We do need to be able to protect them, because it's just a matter of time before the virus mutates and it becomes an even bigger problem in the ones who aren't immunized,” he said.
O'Leary said he was also concerned about a potential “big fall surge with this delta variant” among school children, especially if higher vaccination rates are not achieved in the coming months in the country.
The CDC has said fully vaccinated students do not need to wear masks in classrooms this fall, but that only applies to children 12 and up, leaving a large proportion of school-age children unprotected.
The agency continues to recommend "layers of protection," including masks, proper hand-washing and approaches such as weekly Covid-19 testing for unvaccinated students.
Simanek, who has children who are 12, 10 and 5 years old, said her family has been taking its own precautions throughout the duration of the pandemic as her youngest two children still cannot receive the vaccine.
If her family socializes with others from a household with members who are both vaccinated and unvaccinated, it does so outdoors. She avoids taking her children to indoor events and when she has, she makes sure they wear masks. They still watch movies at home or go to the drive-in instead of a regular movie theater. Mask wearing, good hygiene and social distancing are still rules that can protect children, as well as vulnerable adults who may not be vaccinated yet, she said.
“It's not just kids who are at risk, it's anyone who is unvaccinated,” she said. “There are plenty of pockets in the U.S. where the rate of adult vaccination is not high.”