COVID-19 pandemic & children: Omicron unlikely to increase threat in children

Hasty vaccination of healthy young people will have little benefit 

By Chandrakant Lahariya
Published: Friday 24 December 2021

Illustration: Ritika BohraThe emergence of omicron, the new variant of the novel coronavirus (SARS-COV-2) that causes COVID-19, has raised several questions.

One of the more pertinent questions now is whether the new variant will increase the vulnerability of children to moderate to severe disease.

The answer is that there is no scientific evidence that omicron will affect children differently than the previous variants.

Data suggests that among all age groups, children are at the least risk of moderate to severe disease, hospitalisation and death. A few epidemiological analyses have concluded that children have a lower risk of hospitalisation due to SARS-CoV-2 than other diseases such as seasonal flu or dengue.

Most children who develop moderate to severe disease and require hospitalisation often have pre-existing health conditions.

COVID-19 infections have been associated with multi-system inflammatory syndrome in children or MIS-C; however, very few cases of mis-c have been reported in India.

Also, as the number of symptomatic cases have remained low, the reported cases of post-COVID-19 symptoms in children have also been far and few.

Then, a series of seroprevalence surveys have estimated that three or even four out of every five children in India have already been infected with SARS-CoV-2, without many serious outcomes.

The susceptible pool of children in India now is less than one-fifth than before the start of the second wave. Previous variants of concern — alpha, beta, gamma and delta — also did not increase their vulnerability.

Therefore, there is no reason to assume that Omicron will pose additional risks to children.

Some parents in India have been waiting for their children to be vaccinated, linking to the school opening. However, one needs to remember that COVID-19 vaccines have a limited role in preventing infection.

Their main role is in reducing the severity of the disease, hospitalisation and deaths, the risk of which is low in children. Though a few countries have started vaccinating older children, they also had schools open for in-person classes, even before the vaccination started.

Scientific evidence is clear that school reopening does not increase the risk of COVID-19 infection in children, and the benefits of school opening are greater. Moreover, there may be little benefit in offering covid-19 vaccines to all healthy children.

There is more value in vaccinating children at high-risk due to pre-existing illnesses or comorbidities. For others, it will be prudent to wait for more evidence.

As omicron cases increase, policymakers in India, before putting restrictions, need to remember that UNICEF and UNESCO guidance suggests that schools should be the last to close.

Lahariya is a physician-epidemiologist associated with the Foundation for People-centric Health Systems, New Delhi.

Views expressed are the author's own and don't necessarily reflect those of Down To Earth.

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