As of 05/2021
Prevention of COVID-19 in Children
- Wash those hands!
- “Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer. Look for one that is 60% or higher alcohol-based.”
- Practice physical distancing (AKA: “social distancing”)
- “This means staying home as much as possible and avoiding groups. If you do need to run an essential errand like going to the grocery store or pharmacy for your family, the CDC recommends wearing a cloth face covering.”
- More information: Cloth Face Coverings for Children
- Children under 2 years of age should not wear masks because:
- 1) They are more likely to touch their faces with masks on
- 2) They have smaller airways and may have more difficulty breathing through additional material
- 3) Infants may not be able to remove a mask themselves if it becomes dislodged and/or blocks their airway.
- “This means staying home as much as possible and avoiding groups. If you do need to run an essential errand like going to the grocery store or pharmacy for your family, the CDC recommends wearing a cloth face covering.”
- Teach kids to cough and sneeze into a tissue, their arm, or their elbow, and not to cough or sneeze into their hands.
- Throw away tissues after each use
- Make sure to have your child wash their hands after blowing their nose, coughing, or sneezing into a tissue, and to wash your hands if you’ve helped them.
- “Clean and disinfect your home as usual using regular household cleaning sprays or wipes.”
- Wash potentially contaminated toys
- “Wash stuffed animals or other plush toys, following manufacturer’s instructions in the warmest water possible and dry them completely.”
- This is especially important if children may be sharing these toys and/or have been recently sick.
- “Wash stuffed animals or other plush toys, following manufacturer’s instructions in the warmest water possible and dry them completely.”
- “Avoid touching your face; teach your children to do the same.”
- “Follow local and state guidance on travel and stay at home restrictions.”
*If you are concerned about your child having symptoms or having been exposed, please call your child’s pediatrician for guidance or call 911 in an emergency.*
Symptoms
DISCLAIMER
This section is meant to offer an overview of general symptoms of COVID-19 infection and warning signs for severe illness in children. It is not a comprehensive list. If you are concerned that your child may have COVID-19 or be otherwise sick, please call your pediatrician for guidance OR 911 in an emergency.
- Children with COVID-19 are less likely to show symptoms than adults
- When they do have symptoms, they are usually mild compared to those seen in adults
- Early data suggests that children may have more upper respiratory (nose and throat/allergy-like), rather than lower respiratory (mostly lung), symptoms than adults
- The most common symptoms of COVID-19 seen in children are:
- Fever
- Respiratory symptoms (such as cough or shortness of breath)
- Sore throat/congestion
- Gastrointestinal symptoms (such as stomach pain, diarrhea, vomiting, and/or loss of appetite)
- *Decreased appetite may lead to your child drinking less. It’s especially important in children to watch for signs of dehydration (fewer wet diapers than normal, dry mouth/lips/skin, sunken soft spot (fontanel) in infants, etc.).
- Muscle aches
- Less common symptoms of COVID-19 in children are:
- Chest pain/aches
- Loss of smell or taste
- Headaches
Sources: DeBiasi, R. et al. Severe COVID-19 in Children and Young Adults in the Washington, DC Metropolitan Region. Journal of Pediatrics, May 2020. & COVID-19 in Children: Initial Characterization of Pediatric Disease
- Warning signs of severe illness potentially related to COVID-19 in children include:
- Trouble breathing (fast breathing, difficult breathing, abnormal breathing, nasal flaring and/or head bobbing while breathing in infants)
- Bluish face and/or lips
- Lethargy (decreased responsiveness, difficulty waking up or staying awake, extreme weakness)
- New confusion
- Severe abdominal pain
- Chest pain or pressure that does not go away
*If your child has any of these warning signs or other concerning symptoms, SEEK EMERGENCY CARE RIGHT AWAY.*
Source: For Parents: MIS-C
- Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19
- Recently, a very small percentage of children have shown signs of a potentially very serious multi-system inflammatory syndrome that is believed to be related to recent or current COVID-19 infection.
- Additional symptoms of rash, conjunctivitis (red, irritates eyes with or without drainage), “strawberry tongue”, neck pain, lymph node swelling, and heart problems were seen in these patients in addition to other COVID-19 symptoms.
- *Again, if your child is showing any of these signs or you are otherwise concerned that your child may be sick, please contact your pediatrician for guidance or call 911 in an emergency.*
- Recently, a very small percentage of children have shown signs of a potentially very serious multi-system inflammatory syndrome that is believed to be related to recent or current COVID-19 infection.
Sources: COVID-19 and Multi-System Inflammatory Syndrome in Children & For Parents: MIS-C & Belhadjer, Z. et al. Acute Heart Failure in Multisystem Inflammatory Syndrome in Children (MIS-C) in the Context of Global SARS-CoV-2 Pandemic. American Heart Association, May 2020.
- CDC Criteria for Suspected MIS-C: A person less than 21 years old with:
- 1) A recorded fever >38.0 C (100.4 F) or subjective fever for 24 hours or more,
- 2) laboratory evidence of inflammation, and
- 3) evidence of clinically severe illness requiring hospitalization, with 2 or more organ systems involved
- AND no alternative plausible diagnoses
- AND positive for current or recent SARS-CoV-2 (the virus that causes COVID-19 illness) infection as shown by testing or known COVID-19 exposure within the 4 weeks before symptoms started.
Source: CDC: HAN00432
Testing
- A list of testing sites for children across the DMV area can be found here: Rapid Testing for Coronavirus
- The link to site-specific information for pediatric COVID-19 testing in the District of Columbia can be found here: District of Columbia Care Facilities for Testing of COVID-19
*If you are concerned about your child having symptoms or having been exposed, please call your child’s pediatrician for guidance or call 911 in an emergency.*
Caring for Children with Suspected or Confirmed COVID-19 at Home
After consulting with your pediatrician/care provider, you may be instructed to isolate at home if you or your child(ren) have mild symptoms. The following are some additional recommended steps for families who are instructed to isolate a sick individual at home:
- “Separate family members with COVID-19 from others as much as possible.”
- “The person with the virus should stay in a specific room and away from other people in your home. Ideally, they should use a separate bathroom, if available. Limit visitors in the house.”
- “Avoid contact with pets.” (As much as possible, especially family members who are sick)
- “This includes petting, snuggling, being kissed or licked, and sharing food.”
- “Call ahead before visiting the doctor.”
- “This will help them take steps to keep other people from getting infected or exposed.”
- “Avoid sharing personal household items.”
- “Don’t share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in the home. After using these items, they should be washed thoroughly with soap and water.”
- “Extra cleaning for all “high-touch” surfaces.”
- “These include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool [poop], or body fluids on them. Use a household cleaning spray or wipes and follow the instructions on the label.”
- “Monitor symptoms.”
- “Call your doctor or health department right away if the illness gets worse.”
*The severity of symptoms in children can change quickly, so when in doubt, call your pediatrician, even if previously instructed to support your child at home, or call 911 in an emergency.*
How to Talk to Children about COVID-19
There’s a lot of news coverage about the outbreak of COVID-19 and it can be overwhelming for parents and frightening to kids. The American Academy of Pediatrics encourages parents and others who work closely with children to filter information and talk about it in a way that their child can understand. These tips can help:
- “Simple reassurance.
- Remind children that researchers and doctors are learning as much as they can, as quickly as they can, about the virus and are taking steps to keep everyone safe.
- Give them control.
- It’s also a great time to remind your children of what they can do to help – washing their hands often, coughing into a tissue or their sleeves, and getting enough sleep.
- Watch for signs of anxiety.
- Children may not have the words to express their worry, but you may see signs of it. They may get cranky, be more clingy, have trouble sleeping, or seem distracted. Keep the reassurance going and try to stick to your normal routines.
- Monitor their media.
- Keep young children away from frightening images they may see on TV, social media, computers, etc.
- For older children, talk together about what they are hearing on the news and correct any misinformation or rumors you may hear.
- Be a good role model.
- COVID-19 doesn’t discriminate and neither should we. While COVID-19 started in Wuhan, China, it doesn’t mean that having Asian ancestry – or any other ancestry – makes someone more susceptible to the virus or more contagious.
- Stigma and discrimination hurt everyone by creating fear or anger towards others. When you show empathy and support to those who are ill, your children will too.”
Family Life During COVID-19
The following are a collection of resources from Healthy Children together with the American Academy of Pediatrics to support your family life and family coping during COVID-19:
- Working and Learning from Home During the COVID-19 Outbreak
- Age-Based Tips to Help Juggle Parenting & Working at Home During COVID-19
- Parenting in a Pandemic: Tips to Keep the Calm at Home
- Getting Children Outside While Social Distancing
- Co-Parenting Through COVID-19: Putting Your Children First
- How to Help Children Build Resilience in Uncertain Times
More Child Health Resources for Parents and Guardians
General Resources
- Is it OK to See My Pediatrician During COVID-19?
- Is it Safe to Send My Child to Child Care During COVID-19?
- Why Keeping Your Distance Helps Keep Others Safe
- Preventing Tobacco Exposure During Stay-at-Home Orders
- Caring for Children in Foster Care During COVID-19
- Can Household Disinfectants be Used to Treat COVID-19
- Hand Sanitizers: Keep Children Safe from Poisoning Risk
- Return to School During COVID-19
For parents and guardians with (or soon expecting) an infant:
- Would It Be Safer to Plan a Home Birth Rather than Deliver My Baby at the Hospital?
- Tips for Coping with a New Baby During COVID-19
- Breastfeeding During COVID-19 Pandemic
- Simple Ways to Entertain & Boost Your Baby’s Development at Home
- Are There Shortages of Infant Formula Due to COVID-19?
- How Should We Feed Our Baby if We’re Running Low on Money?
- May 21, 2020: American Academy of Pediatrics Updated Guidance on Newborns Born to Mothers with Suspected or Confirmed COVID-19
For parents and guardians with teenagers:
- Teens & COVID-19: Challenges and Opportunities During the Outbreak
- Mental Health During COVID-19: Signs Your Teen May Need More Support
For parents and guardians of children with special needs:
Children and the COVID-19 Vaccines
Overview
As of 5/12/21, the Pfizer vaccine is approved for use in individuals 12 years old and up!
The Moderna vaccine is approved for those ≥18 years old. These approvals may expand to include younger age groups as more safety and efficacy data becomes available. See below for information on current clinical trials in younger age groups.
Johnson & Johnson’s Janssen COVID-19 single dose vaccine is only approved for ages ≥18 years old. After a brief “pause” on J&J vaccine administration due to reports of concerning adverse events, these reports have been investigated and these reports deemed rare adverse events that are so rare that they do not outweigh the benefit of protection from severe illness with COVID-19 following administration of this vaccine.
Clinical trials updates for children:
Pfizer: On 4/19/21, Pfizer announced that it started its new trial to including children ages 6 months and older. It is currently approved for use in those ≥12 years old.
Moderna: After promising results in their clinical trial for ages 12-18 years, Moderna has voiced hope that their vaccine may be granted emergency use authorization within the upcoming weeks, with the goal of having children in these age groups vaccinated prior to the start of school this fall. They also announced on 3/16/21 that they had started their Phase 2/3 clinical trial for children ages 6 months- 12 years.
More information will be added when available.
Pediatric vaccination sites in the DMV area:
- Walk-up locations are updated daily and listed here: Walk-up Vaccination Sites (*Check the listing to make sure the site listed is offering Pfizer for your child’s age.)
- Safeways, CVS pharmacies, and Walgreens providing the Pfizer vaccine are now cleared to administer it to children 12 years and older. Call ahead to ask which vaccine is being offered at the location nearest you.
- Children’s National Hospital is offering the Pfizer vaccine to children and young adults ages 12-22 years old living in D.C. and Prince George’s County. The appointment request form can be found here: COVID-19 Vaccine Registration Form. The Children’s National Vaccine FAQs sheet can be found under resources below.
Other resources and answers to frequently asked questions:
- Coronavirus Vaccine FAQs- Children’s National Hospital
- COVID-19 Vaccine: Frequently Asked Questions– The American Academy of Pediatrics
- Ask a Pediatrician: Now That There’s a COVID-19 Vaccine, When Will Life Go Back to “Normal” for My Family?- Connecticut Children’s
- Pfizer vs. Moderna COVID-19 Vaccines: How Do They Compare?- AARP
