If infected with COVID-19, children and young people are more likely than adults to experience mild or asymptomatic infection. Severe illness, hospitalisation and mortality are rare. Over the time of the pandemic, however, concerns have grown about the longer-term effects of infection, known as ‘Long COVID’. The REACT-2 studies of people in the community in England found that around a fifth of those surveyed reported having had a COVID-19 symptom previously, with over a third of these reporting at least one symptom lasting 12 weeks or more. The prevalence of persistent symptoms, or long COVID, increased with age, with a 3.5 percentage point increase in likelihood in each decade of life. The prevalence of long COVID was higher among women, people who are overweight or obese, who smoke, live in deprived areas, or had been admitted to hospital. These studies did not look at long-COVID in children.
The Joint Committee on Vaccination and Immunisation (JCVI) statement on COVID-19 vaccination of children and young people aged 12-17 years says:
Concerns have been raised regarding post-acute COVID-19 syndrome (long COVID) in children. Emerging large-scale epidemiological studies indicate that this risk is very low in children, especially in comparison with adults, and similar to the sequelae of other respiratory viral infections in children.
Children and young people can experience symptoms associated with long COVID including fatigue, followed by dyspnoea and difficulties concentrating. However, the evidence base is incomplete and rapidly developing. The sub-group will continue to review this evidence and will update advice if required in light of new findings.
An increasing number of countries are beginning to adjust their vaccination strategies as Delta cases rise, including vaccinating 12-17 year olds. However, the JCVI currently recommends against routine universal vaccination of children and young people under the age of 18 in the UK. As evidence shows that COVID-19 rarely causes severe disease in children without underlying health conditions, at this time the JCVI’s view is that the health benefits of offering universal COVID-19 vaccination to children do not outweigh the potential risks. Clinicians have requested that the JCVI keep this judgement under close review and the sub-group is aware that the guidance on reducing risks in schools will be updated in line with any change to the JCVI advice.