Children And COVID-19 In 2025
Why I'm not overly concerned about my daughter and COVID-19
In the five years since the COVID-19 pandemic erupted, there have been many questions. An almost endless cavalcade of important queries that we’ve needed answers to - how do we prevent the spread of infection? What measures have the biggest impact and lowest cost? What are the long-term effects of the virus, and who needs the most protection?
But none of the discussions has been more contentious than the arguments about children. There’s almost nothing you can say about COVID-19 and kids that won’t be immediately attacked by someone. It’s understandable - emotions run high when we’re talking about our most vulnerable - but it does usually result in some very virulent discussions.
Case in point - I recently said online that I’m not overly concerned about COVID-19 when it comes to my daughter. She’s 18 months old, and as an expert who has been involved with research into the coronavirus since 2020 I personally do not feel that there is a strong need for her to be protected from the disease.
Of course, this doesn’t mean that I want her to get sick. As with any disease, it is always better not to get COVID-19. There is no disease that we have discovered where an infection is good for your health. By definition, any infection that results in symptoms - and many that don’t - is net negative. Ideally we should be taking reasonable actions to reduce the likelihood of kids getting any diseases at all However, I’m personally no more concerned by COVID-19 than anything else that she’s likely to pick up at daycare.
Because of this opinion, someone implied that I was a murderer. So I thought I should explain why I, as an expert and the parent of a young child, am not particularly concerned about COVID-19 for her.
Acute Infections
We’ve known since the beginning that acute COVID-19 risk was strongly related to age. In every study conducted on the topic, older people are at higher risk from the virus in the short term. The older you are, the more likely you will be to experience bad outcomes if you experience a coronavirus infection.
Indeed, one of my most impactful pieces of work during the pandemic was showing in 2020 that the risk of death from COVID-19 increases exponentially by year of age. Using international data, we showed that the infection fatality rate from COVID-19 follows an exponential function whereby every 8 years or so your risk of death doubles from the virus. Vaccination and other immunity has reduced this risk enormously since 2020, but at the time we showed that the risk rose from about 1 in 10,000 at age 20 to nearly 1 in 100 at age 60 and 1 in 10 by age 82.
This has been replicated time and again. Other data shows similar risk ratios by age for severe COVID-19 outcomes like hospitalization and ICU admission. As a general rule, the risk of severe acute disease is higher the older you are. For younger children - especially those between 1-10 years of age - the acute risk of COVID-19 has always been quite similar to that of seasonal influenza. This is even more true in 2025, when it’s likely that every child over the age of 2 has had COVID-19 at least once and is therefore at a lower risk of serious disease if they get it again. For example, the rate of ICU admission for COVID-19 in the UK for children is substantially lower than the rate for influenza.
Post-Acute/Long COVID
The next point is Long COVID. Most people are much less worried that their child will have to go to ICU than the possibility that they will develop Long COVID. It’s a reasonable fear, given how poor the communication has been when it comes to long-term outcomes from COVID-19.
As I’ve previously written, the biggest predictor of serious long-term problems from COVID-19 is acute severity. People who have more severe infections are much more likely to experience long-term symptoms later on. Only a very small fraction of those who describe their initial symptoms as “mild” go on to have Long COVID, and in many cases their long-term symptoms are also quite mild.
One of the most robust studies on this topic is the REACT data from the UK. This study was a nationally-representative, high-quality survey in England. The authors found that around 3% of the people who reported mild acute COVID-19 went on to report long-term symptoms, which was actually fewer than those who were never infected at all. While it’s unlikely that COVID-19 is preventing long-term symptoms - even though the authors did control for confounders in their analysis, their model was not nearly strong enough to draw such a strong conclusion - it is reassuring evidence that if people feel that their infections are mild they very rarely go on to have long-term problems from COVID-19.
In addition, we know that children who don’t go to hospital are unlikely to have serious long-term issues. A national Israeli study with nearly 2 million participants showed that children infected with COVID-19 who were not hospitalized had small increases in some symptoms 1-6 months after diagnosis, but that these risk almost entirely disappeared by 6-12 months after their infection. Similar results from the UK Office For National Statistics show that few children experience Long COVID after infection, with only a very small fraction reporting activity-limiting symptoms.
This makes perfect sense when you remember that acute issues drive Long COVID. Children have much more mild acute disease, and therefore they have a dramatically lower risk of long-term outcomes as well. While Long COVID is certainly a population hazard, and devastating for the few kids who do experience it, it’s no more worrying to me as a parent than long influenza or long RSV.
What About Disabled Kids?
The final point that always comes up is disabled children. Your child may be fine, but what about children who are more vulnerable? What about the 1 in 10 or so under-18s who have a disability?
The first thing to note here is that disability is not a very useful term when it comes to discussing risk of infectious disease. It’s far too broad. Every disability has a decidedly different impact on the immune system, and there’s no one answer when it comes to the increase in risk from COVID-19.
This is clear from some of the UK data on mortality risk from the Open SAFELY study. Chronic respiratory disease increased the risk of death by a lot, but asthma had no noticeable impact. Having an organ transplant had a major impact on risk, but having no spleen did not.
Even where disability does have an impact, it is often relatively low when compared with the risk of being a bit older. The UK ONS - with some of the most robust data on COVID-19 in the world - concluded that having a hearing or vision impairment, or both, increased the risk of death from COVID-19 by around 40% after controlling for confounders such as socioeconomic status. That is similar to the risk increase conferred by about 3 years of age. To put it another way, a 29 year old who was both deaf and blind likely had a lower risk of dying from COVID-19 in 2020 than a 33 year old with neither impairment.
In other words, the points above generally apply equally to abled and disabled children. There are certainly some kids for whom any infection is disastrous, but that’s not quite the same as COVID-19 being uniquely dangerous.
What About Repeat Infections?
The final point that is regularly made is the question of repeat infections. What happens if children get COVID-19 over and over again?
I’ve previously written on the topic. In general, repeat infections are much lower risk than initial ones. In 2020, COVID-19 was quite problematic for older kids (especially aged 14+), but at this point there are vanishingly few people over the age of 2 who have not had the disease at least once. Existing immunity reduces the risk of all the negative outcomes we’ve discussed, including Long COVID.
My daughter will probably catch many coronaviruses over her lifetime. On average, she will probably get at least one a year. Most of them will not be COVID-19, but some of them certainly will. Personally, I am no more worried about the repeat infections from, say, HCoV-229E or even other viruses like influenza or RSV, than SARS-CoV-2.
The biggest risk of COVID-19 was always that it was a novel virus. We had no immunity built up to the disease, and before vaccines no way of gaining that immunity without a dangerous infection. But at this point, with most people having had both a vaccine and at least two infections, the risk of each individual case of COVID-19 is much, much lower than in 2020. This seems to be true for acute disease, Long COVID, and every other complication that the virus causes.
As I said right at the start, I’d rather my daughter never gets sick. This year she had a round of gastroenteritis that impacted thousands of children across the state which was likely caused by norovirus. The experience was extremely unpleasant for all of us. She’s never tested positive to COVID-19, but in all likelihood she’s had at least once subclinical infection already. I fully support basic measures to reduce the risk of spreading various diseases - in the case of norovirus, education on handwashing and improved hygiene measures in daycares are particularly important.
However, I’m not especially concerned about COVID-19 above everything else that she could catch. It may be useful to implement some additional protections to reduce the burden of respiratory diseases more broadly - perhaps require future constructions of daycare facilities to have better air filtration systems - but otherwise I’m not personally worried about the disease for my daughter beyond the usual parental wish to shield her from all harm.
While COVID-19 will always be a public health problem, as an epidemiologist and a father I think that the risk to individual children is very similar to the gamut of other infections they have always faced. My advice for other parents is not to worry too much more about COVID-19, as difficult as that may be.
I'm reassured for my grandchildren. Does not being more concerned about COVID-19 than about the flu mean that your child has been vaccinated for both?
have seen the negative response to this post/position. Perhaps if this was framed a bit differently...mention of vaccinations for kids? Maybe acknowledging concerns in a stronger way?