By Marie Rosenthal, MS

The latest COVID-19 surge caused by the omicron variant is throwing curveballs, according to Rochelle Walensky, MD, MPH, the director of the CDC.

Data released today from COVID-NET (COVID-19-Associated Hospital Surveillance Network), a population based surveillance system that collects data about laboratory-confirmed COVID-19–associated hospitalizations among children and adults, found that hospitalizations are increasing for all ages, including children. Although rates among children continue to be much lower than adults, “pediatric hospitalizations are at the highest rate compared to any prior point in the pandemic,” Dr. Walensky said. “Sadly, we are seeing the rates of hospitalizations increasing for children 0 to 4—children who are not yet currently eligible for COVID-19 vaccinations,” she said.

For the week ending Jan. 1, the rates per 100,000 for children who are 0 to 4 years of age were 4.3 per 100,000, and 1.1 per 100,000 for those aged 5 to 17 years. To give context, for those older than 65, the rate is 14.7 per 100,000, so still lower than adults, but higher than seen previously.

It is not unusual to see pediatric hospitalizations rise due to respiratory diseases at this time of year, but she said the rates are higher than normal for the winter months. 

However, she admitted that they do not yet know whether the increased hospitalization rates reflect a greater burden of disease in the community or lower vaccination rates for youths younger than 18 years of age. 

“Currently just over 50% of children 12 to 11 are fully vaccinated, and only 16% of those 5 to 11 are fully vaccinated,” she said.

“The rate of COVID-19–associated hospitalizations in unvaccinated adolescents age 12 to 11 years was about 11 times higher than fully vaccinated adolescents of the same age range for those children who are eligible,” she said. “I strongly encourage their parents to get them vaccinated. And if they are 12 or older, get boosted. A review of over 26 million vaccine doses in this age group was publicly reviewed at our advisory committee this week and demonstrated the overwhelming safety of COVID-19 vaccinations. Please, for our youngest children, those who are not yet eligible for vaccinations, it’s critically important that we surround them with people who are vaccinated to provide them protection.”

This is the highest number of pediatric hospitalizations that has been seen since the start of the pandemic, but whether that signals that omicron is more serious in children or they are just more vulnerable because there is more transmission is unknown, she added. 

“It has been nearly two years since CDC activated its emergency response for COVID-19. Throughout that time, this virus has changed and is constantly throwing us curveballs,” she said. “The past few weeks have been a challenge for all of us. Omicron has rapidly become the predominant variant, and cases have substantially increased rates higher than we have seen at any point throughout this pandemic.” 

At a press briefing on Jan. 7, she said “tremendous progress” has been made at keeping children safe so that they could attend in-class learning, and omicron should not stop that.

“I know that many teachers and parents have concerns about the omicron variant. Coming back after the holiday for break many schools return to virtual learning because of a surge in COVID-19 cases in their communities, largely due to the omicron variant,” she said, adding that the test-to-stay protocols and updated recommendations for isolation and quarantine“provide the tools necessary to get these schools reopened for in-person learning and to keep them open for the rest of the school year.”

Although a layered protection strategy that involves vaccination, masking, ventilation and testing is the key to protecting children, vaccination is the cornerstone of that strategy, she reiterated.

The FDA and CDC recently made several changes to pediatric COVID-19 vaccination, she reminded, which includes a third dose for eligible immunocompromised children and booster doses for children between 12 and 18 years of age. In addition, they recommended that boosters be given five months after the primary series.

“Vaccination is the best tool we have to protect our children from COVID-19,” she said.