What to Know About COVID-19, Variants, and Children

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There’s growing concern about whether the B.1.1.7 variant first detected in the United Kingdom could be causing more infections in children.Lab studies suggest that the B.1.1.7 variant has a mutation that make…

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  • There’s growing concern about whether the B.1.1.7 variant first detected in the United Kingdom could be causing more infections in children.
  • Lab studies suggest that the B.1.1.7 variant has a mutation that makes it easier for the virus to latch onto our cells and cause an infection — which could be why more kids seem to be getting the disease. 
  • Quickly vaccinating adults who are around and live with kids is crucial. 

Children have been largely spared during the pandemic, mainly because the coronavirus has a harder time binding to receptors in their cells compared to those of adults. 

Now there’s growing concern about whether the B.1.1.7 variant first detected in the United Kingdom could be causing more infections in children.

Lab studies suggest the B.1.1.7 variant has a mutation that makes it easier for the virus to latch onto our cells and cause an infection — which could be why more kids seem to be getting the disease. 

But the lab studies don’t tell the full story, experts say, and it’s important to look at other factors at play.

The B.1.1.7 variant doesn't appear to cause more severe illness in kids, and even in the United Kingdom, the vast majority of young people who contract the variant experience mild symptoms

It’s unclear how readily young people spread COVID-19 to others, but experts agree that adults who spend time or live with kids who run a risk of exposure should be prioritized for vaccination.

Do kids contract B.1.1.7 more easily?

Children’s sinuses are underdeveloped, and they have fewer ACE-2 receptors (the site where the coronavirus binds to our cells) than adults.

Experts widely believe this is why kids have been protected from severe COVID-19.  

According to Dr. Jay Levy, a virologist and professor of medicine at the University of California, San Francisco, lab studies suggest that the B.1.1.7 variant can attach with more strength to the ACE-2 receptors than the earlier renditions of the virus. 

“If this is a virus that attaches with much more robust nature, then it can have less attachment sites and still infect,” Levy said.  

This theory could explain the uptick in cases amongst younger people, but other factors are likely at play.

More people have been visiting nonessential businesses and traveling between states in recent weeks.

COVID-19 may now be more widespread in communities that have lower vaccination rates and low population immunity.

Even if more children test positive than they did in previous waves, it could simply be because certain areas have a higher prevalence of SARS-CoV-2, as research from the United Kingdom suggests. 

Kids don’t seem to be getting sicker

If children do have a higher chance of getting contracting the B.1.1.7 variant, Levy says it’s important to ask whether they're now experiencing severe illness or symptoms of a common cold.

Recent data shows that B.1.1.7 hasn't changed the pediatric hospitalization rate and that severe COVID-19 remains rare in kids.

The pediatric hospitalizations rate was 1.9 per 100,000 of hospitalizations on January 1, 2021 and 1.4 per 100,000 of hospitalizations on April 1, 2021, per data sourced from the HHS Protect Public Data Hub.

“There is no evidence in those under 18 that you’re seeing increased severity of disease,” said Dr. Monica Gandhi, an infectious diseases specialist and professor of medicine at the University of California, San Francisco.

A variant that's easier to contract would naturally lead to more cases and ultimately more deaths — but the clinical course in illness caused by B.1.1.7 doesn't appear to be different. 

“I don’t see it being more virulent,” said Levy, noting that it’s unknown how many kids who get COVID-19 get really sick.

Are kids passing it more?

If kids experience a milder infection like the common cold, it’s unclear if and how they might transmit the virus to others, says Levy.

Could a kid’s mild infection spread and cause a severe illness in an at-risk adult? 

“It’s possible, but we don’t know that,” Levy said. It’s also entirely possible that children’s immune systems may be robust enough to control the virus and prevent a lot of mutations from spreading.

One thing is clear: Quick vaccination of adults who are around children is crucial. 

“Those people whom [kids] go home to should be vaccinated,” Gandhi said. 

States have prioritized vaccination for those who are most vulnerable to COVID-19, according to Gandhi. 

“We have to protect the vulnerable, especially if children are out more and they live with the vulnerable,” explained Gandhi. 

We're well on our way. The CDC shows that 77 percent of seniors 65 and older have been vaccinated, and states have been directed to expand eligibility to all adults by April 19.

K-12 educators in every state are eligible to get the shot, and over 80 percent of teachers and staff have received a vaccine dose. 

Both Israel and the United Kingdom were hit hard by the B.1.1.7 variant, but when they ramped up vaccinations, COVID-19 cases plummeted. 

The United States isn't there yet, with only 25 percent of the adult population fully vaccinated.

“We will be there by fall when the schools open,” Gandhi said. 

The bottom line

Children have been largely spared during the pandemic, mainly because the coronavirus has a harder time binding to receptors in their cells compared to those of adults.

Concern is growing that kids can contract the B.1.1.7 variant more easily, but there’s no evidence to suggest the variant causes more severe symptoms in kids. Quickly vaccinating adults who are around and live with kids is crucial.