Since its first appearance, the severity of COVID-19 seemed to scale with age: older adults had higher mortality rates and risks, as opposed to the young. That's what makes a new report from the Centers for Disease Control and Prevention (CDC) so alarming, as it notes a surprising spike in COVID-19 hospitalizations for infants under six months old during the omicron variant wave, which spanned from June 2021 to August 2022.
Fortunately, the reason for this increase is not because COVID-19 is adapting to infect the young better; but rather, because children under six months old are too young to be vaccinated. The report highlights the need to take precautions that might prevent COVID-19 from spreading to one's family, particularly when a family has one or more infants.
Despite the popular misconception that COVID-19 is harmless to children, the CDC report reminds the public that the disease "can and does cause severe and fatal outcomes in children." The study was based on data collected in 13 states during the period when the omicron BA.2/BA.5 strain was dominant (December 19, 2021–August 31, 2022), infants under six months old struggled because they were not vaccinated. Within that period of time, the number of weekly hospitalizations per every 100,000 infants fluctuated from 2.2 per week to 26 per week, with a weekly average of 13.7. Moreover, there was an elevenfold increase in infant hospitalizations at the wave's peak, as the 2.2 per week figure occurred in the week ending April 9, 2022 and the 26 per week figure occurred in the week ending July 23, 2022.
The average weekly hospitalization rate, 13.7, is almost the same as the average hospitalization rate during this period for adults aged 65–74 years: 13.8. This means that, because young infants are not vaccinated and do not have previous infectious to build up their immune systems, they need particularly strict precautions to be kept safe from COVID-19 infections.
The authors also noted a difference between infections from the omicron phase and infections from the delta phrase.
"This does not necessarily mean that infections with the Omicron variant of SARS-CoV-2 are more severe than infections with the Delta variant of SARS-CoV-2; rather it might reflect the greater transmissibility of the SARS-CoV-2 Omicron variant relative to the Delta variant," Dr. Sarah Hamid, corresponding author of the CDC report, told Salon by email. "Unlike older age groups, young infants are not protected from disease through vaccination or prior infection and so are more susceptible to severe outcomes such as hospitalization."
The study itself explains there are a number of reasons why there were so many hospitalizations among infants, particularly during the omicron wave.
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"Multiple factors likely contributed to high COVID-19–associated hospitalization rates among young infants during the omicron variant–predominant period," the authors explain, listing among them the fact that the omicron variant was unusually infective and had high community transmission rates. In addition, there is a "relatively low threshold for hospitalizing infants for signs and symptoms consistent with COVID-19 (e.g., fever) relative to that in older children." Finally, the reality is that infants cannot be vaccinated until they are at least six months old.
"Because infants are more likely to be immunologically naïve, and vaccines are not approved for infants aged [less than] 6 months, maternal COVID-19 vaccination during pregnancy might help to protect young infants," the authors add. Studies have found that pregnant mothers who take two doses of a "primary monovalent mRNA COVID-19 vaccination series" may benefit, as doing so "has been estimated to be 52% effective against COVID-19 hospitalization among infants aged [less than] 6 months."
"The public should be aware that inadequate vaccination amongst adults and vaccine eligible children can put our youngest babies at risk for severe illness and hospitalization."
Dr. Georges Benjamin, executive director of the American Public Health Association, told Salon by email that "while it was well know that infants could get COVID-19, the risk of disease severe enough for hospitalization has often been understated. This study documents that the disease is not benign in infants and demands a strategy to protect them under the age of 6 months where vaccination is not available."
Benjamin, who was not involved in the study, added that "the public should be aware that inadequate vaccination amongst adults and vaccine eligible children can put our youngest babies at risk for severe illness and hospitalization."
The risks of COVID-19 are still being stressed by other public health officials, including the nation's top infectious disease expert Dr. Anthony Fauci.
"I don't care if you're a far-right Republican or a far-left Democrat, everybody deserves to have the safety of good public health and that's not happening," Fauci told NBC's "Meet the Press" on Sunday.
Children appear to be equally or possibly more likely than adults to have long-term symptoms after contracting COVID-19 and clearing it — a condition informally known as long COVID. A recent study found that 10 percent of children with COVID-19 become "long haulers," so named because patients initially only suffer mild infections before developing serious long-term symptoms. Another recent study found that children with COVID-19 are more likely to develop to suffer from seizures and epilepsy than those who developed influenza infections. In June, a study in the journal JAMA Network Open that children whose mothers developed COVID-19 infections while they were pregnant with them were more likely to have neurodevelopmental issues.
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