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Illustration: Sarah Grillo/Axios

More kids are landing in the hospital due to COVID and it's not yet clear if it's because the Delta variant is causing more serious illness in kids.

Why it matters: Hospitals are raising concerns about the increasing impact of COVID on kids at the same time schools around the country are preparing to head back for in-person instruction — many without the protection of vaccination or mask mandates.

Driving the news: The latest numbers from the American Academy of Pediatrics show there were nearly 94,000 cases of COVID among kids in the last week, or about 15% of weekly total cases. Kids made up between 1.5% and 3.5% of total hospitalizations, they said.

  • But while serious illness in kids is still comparatively rare compared to adults, pediatric hospitalizations in some areas of the country have reached worrying levels.
  • There is an "epidemic" of very young COVID patients at Children's Hospital New Orleans, physician-in-chief Mark Kline told Robin Roberts on Good Morning America. Half the kids in the hospital are under two years old, he said.

Infectious disease doctors agree the high level of transmission of the Delta virus, particularly in regions of the country with low vaccination rates, is in large part to blame for the uptick.

  • "The states that have the lowest vaccine rates are the states that we have outbreaks and the states where we have people overwhelming the hospital system. There's a clear and direct correlation. It's not a confusing picture," Dr. Roberta DeBiasi, chief of infectious diseases at Children’s National Hospital in D.C. told Axios.

Reality check: But they worry the level of pediatric hospitalizations may also be due to the Delta variant being more virulent in kids than previous variants.

  • "I do think we're seeing more severe disease and I think part of that is because the kids we're seeing don't have underlying medical conditions," Kenneth Alexander, infectious diseases division chief for Nemours Children's in Orlando told Axios.
  • The hospital has eight or nine children hospitalized with COVID, including two in the ICU. Last summer, the hospital might've had one or two.
  • “Everybody is a little bit nervous about the possibility that the Delta variant could, in fact, be, in some way, more dangerous in kids,” Richard Malley, a pediatric infectious disease specialist at Boston Children’s Hospital, told the New York Times.
  • But there's still some debate on the matter. DeBiasi said the data hasn't shown an uptick in rates of serious illness among kids in D.C. "It's really remarkable. The entire time, it's been the exact same percentage who've been hospitalized and the exact same percentage who've been critically ill. We've not seen a change even though the type or variant of virus has changed," DeBiasi said.

Zoom out: Kids of different ages are often impacted differently by COVID, and specifically the Delta variant.

  • Teens and children younger than 1 have seemed more likely to be hospitalized, the doctors said.
  • Kids who are obese, as well as kids who are Hispanic or Black seem to be at higher risk, but "we’ve had some very sick kids that don’t have risk factors," Alexander said.
  • Meanwhile, the rare condition associated with COVID-19 called Multisystem Inflammatory Syndrome in Children (MIS-C) peak median age of kids most commonly impacted are around age nine, DeBiasi said. The majority of those cases typically appeared within four to six weeks after each of the big waves of COVID, DeBiasi said.

Experts expect new surges to hit among kids and adults within the next two weeks of the return to school, particularly in states like Florida where mask mandates have been banned.

  • "As we flirt with the idea of not wearing masks, we're not only putting children in danger, we're putting their parents and grandparents in serious danger," Alexander said.

Bottom line: Experts say the concerning rise makes the case for both masks and vaccinations for kids in the Delta era.

  • "We have so much information now on millions and millions of people that have been vaccinated showing the efficacy of preventing severe disease," DeBiasi said. "Even though the virus has changed and the variants changed, that has been a consistent finding."

Go deeper

Updated Oct 21, 2021 - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Vaccines: Pfizer booster has 95.6% efficacy, large study shows — FDA authorizes mix-and-match for booster shots — J&J expects $2.5 billion of vaccine sales this year.
  2. Health: Cases and deaths keep falling — White House unveils plan to "quickly" vaccinate kids ages 5-11 — The global coronavirus vaccine gap — Gates Foundation to send $120 million of antiviral pills to lower-income countries.
  3. Politics: Reports: Brazil leader to be accused of crimes against humanity over COVID — Puerto Rico leads U.S. vaccination rates — Hawaii invites fully vaccinated travelers to return from Nov. 1.
  4. Education: Education secretary reveals limits to Biden’s mask push on states — LA extends deadline for school employee vaccinations — Parent sues Wisconsin school district after child tests positive.
  5. Variant tracker: Where different strains are spreading.
Oct 21, 2021 - Health

CDC director approves boosters for Moderna and J&J and mix-and-match

Boxes containing vials of the Janssen COVID-19 vaccine. Photo: Jon Cherry/Getty Images

The Centers for Disease Control and Prevention director Rochelle Walensky expanded the eligibility for COVID-19 booster shots on Thursday night, hours after the CDC's independent advisory panel recommended booster doses of the Moderna and Johnson & Johnson vaccines and allowed people to mix-and-match doses.

The big picture: The CDC's expansion aligns with the Food and Drug Administration authorization Wednesday night which said people could switch to whichever vaccine they wanted for their booster shot.

Oct 21, 2021 - Health

India crosses 1 billion COVID vaccinations milestone

A health worker inoculates a COVID-19 vaccine dose to a man wearing a face mask of Prime Minister Narendra Modi in Beawar, India, in September. Photo: Sumit Saraswat/Pacific Press/LightRocket via Getty Images

India's Prime Minister Narendra Modi announced Thursday that the country's health workers have now administered more than 1 billion COVID-19 vaccines doses.

Of note: While this is a significant milestone for the country of 1.4 billion, which has been devastated by the coronavirus, only about 30% of the eligible population has been fully vaccinated against the virus, per AP. Roughly 75% have received at least one dose.