Covid hospitalizations rising among kids under 5, AAP says

Jessica D'Argenio Waller, MS, CNS, LDN
·4 min read
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It’s likely not news to hear that Covid cases have been increasing—especially as we head into fall virus season. For weeks, we’ve been hearing that severe cases of Covid seemed to primarily impact people over 65 or those with underlying conditions, but the latest data tells a different story. Over the past three months, the number of kids with a confirmed case of Covid at hospital admission has been rising steadily, according to a new analysis by The American Academy of Pediatrics (AAP), who note that children under 5 are at highest risk.

Since Covid data collection began in 2020, the month of June 2023 had the lowest level of pediatric Covid hospitalizations seen yet. As of mid-June, hospital admissions of kids under 18 with Covid numbered 237. The week of Sept. 9, that number had jumped nearly five-fold to 1,175, AAP states. For reference, the week ending Dec. 24, 2022, around the height of Omicron’s BA.5 subvariant, pediatric Covid hospitalizations reached 1,785.

“While children ages 0-4 are one-quarter of the overall U.S. child population, they comprise roughly half of recent COVID-19 hospital admissions,” writes AAP. Why are case numbers increasing among our youngest population? It’s likely that they haven’t yet received vaccination against the virus.

As of May 2023, when the public health emergency was lifted, just 13% of kids aged 6 months to 4 years had received at least one dose of a Covid vaccine.

“This increase in hospitalizations, especially for the youngest children, is very concerning,” said AAP President Sandy L. Chung, M.D., FAAP, in a statement. “We know this is the age group with the lowest vaccination rates. Right now, we have updated COVID vaccines that can help children’s immune systems learn to detect and resist the virus, including the strain that is circulating now. The virus is still here, and I’d urge parents to talk with their pediatricians about how they can protect their family.”

Considering a Covid vaccine for kids under 5?

Covid, like the flu, is a vaccine-preventable illness, pediatrician Mona Amin, DO, tells Motherly in a previous interview. The vaccines are not 100% effective at preventing infection (no vaccine is), but they can help reduce the chance of your child getting a symptomatic infection, and they can drastically reduce a child’s risk of hospitalization or death—the vaccines are very good at this.

“It’s important to understand that this age group is at a lower risk for complications [from Covid infection] as we compare it to adults and even children over 5,” Dr. Amin notes. “That being said, when you look at the benefits of reducing hospitalization risk [from vaccination], it’s absolutely there.”

What if your child recently had Covid? Even though prior Covid infection does offer some natural immunity to prevent future infections, it may only last around 3 months. “Per CDC recommendations, getting vaccinated adds protection,” says Suellen Hopfer, PhD, CGC, an assistant professor in the department of health, society and behavior, and the department of pediatrics at University of California, Irvine, to Motherly.

It’s also important to consider that a potential tripledemic of flu, Covid and RSV could quickly frill up pediatric hospitals. “The combined effects of seasonal respiratory viruses, including flu and respiratory syncytial virus (RSV), could strain hospital resources if left unchecked,” a Pfizer spokesperson tells Motherly. Avoiding a tripledemic only becomes realistic if we consider using the new vaccines that are available, including not only the updated Covid booster but also the RSV shot for infants and an updated flu shot.

Here’s what to know about who’s eligible for the updated monovalent Covid booster

You should be able to find a new Covid vaccine available now at pharmacies, health departments, doctors’ offices and clinics near you.

  • Everyone 5 years of age and older should get a single dose of an updated mRNA Covid vaccine at least two months after the last dose of any Covid vaccine.

  • Kids 6 months through 4 years of age who previously were vaccinated against Covid are eligible to receive one or two doses of an updated mRNA Covid vaccine. Timing and number of doses to administer depends on the previous vaccine received.

  • Kids 6 months through 4 years of age who are getting their Covid vaccine for the first time should get either two doses of a Moderna vaccine or three doses of a Pfizer vaccine, with at least one dose being an updated shot.