Children rarely transmit COVID-19

Editor's Note

A commentary published in Pediatrics, the official journal of the American Academy of Pediatrics, concludes that children rarely transmit COVID-19 to each other or to adults, and that schools can and should reopen in the fall, if safety guidelines are followed and community transmission is low.

The commentary, by pediatric infectious disease specialists on the faculty of the University of Vermont’s Larner College of Medicine and the associate editor of Pediatrics, is based on a new study published in Pediatrics and four other recent studies.

The new Pediatrics study examined the households of 39 Swiss children infected with COVID-19. Contract tracing showed that only three of the children were suspected to be the index case, with symptom onset preceding illness in adult household contacts.

A study from China found that of 68 children with COVID-19, nearly 96% were infected by household contacts of previously infected adults. Another Chinese study of 10 children found only one possible child-to-child transmission.

In a French study, a boy with COVID-19 exposed more than 80 classmates at three schools to the disease, and none contracted it. Transmission of influenza was common at the schools.

In a study from New South Wales, Australia, nine students and nine staff members across 15 schools exposed 735 students and 128 staff members to COVID-19. Only two infections resulted, one transmitted by an adult to a child in primary school and one high school student who was exposed to two infected classmates.

The key takeaway from the studies is that children are not driving the pandemic, and reopening of schools in a safe manner this fall is important for the healthy development of children, the authors say.