From the Guidelines
Children can indeed get COVID-19 multiple times, including up to five times or more, because immunity from previous infections or vaccinations wanes over time and new variants can evade existing immunity. This is supported by the fact that the virus continues to evolve, producing new variants that can partially escape immunity from previous infections, which explains why reinfections occur despite prior exposure to the virus 1. If your child has had multiple COVID infections, continue following standard prevention measures like encouraging hand washing, ensuring they stay home when sick, and keeping vaccinations up to date according to age-appropriate recommendations. For symptom management, use age-appropriate over-the-counter medications like acetaminophen or ibuprofen for fever and discomfort, ensure adequate rest and hydration, and monitor for any severe symptoms that would require medical attention.
Some key points to consider when managing COVID-19 in children include:
- The importance of monitoring for severe symptoms, such as difficulty breathing, chest pain, or severe headache, which would require medical attention 1
- The need to keep vaccinations up to date, as this can help reduce the risk of severe illness and complications 1
- The use of age-appropriate over-the-counter medications, such as acetaminophen or ibuprofen, to manage symptoms like fever and discomfort 1
- The importance of ensuring adequate rest and hydration to help the body recover from the infection 1
It's also important to note that multiple infections don't necessarily cause cumulative damage in most healthy children, but each infection carries its own risk of complications. The guidance provided in the American College of Rheumatology clinical guidance for multisystem inflammatory syndrome in children associated with SARS-CoV-2 and hyperinflammation in pediatric COVID-19: version 1, supports the use of immunomodulatory therapy in patients with COVID-19 and hyperinflammation, and highlights the need for further research in the pediatric population 1.
From the Research
COVID-19 Infection in Children
- Children can contract COVID-19, and the relative proportion of pediatric cases has increased significantly following the emergence of the Omicron variant 2
- While children typically present with milder symptoms than adults, severe disease can still occur, particularly in children with comorbidities 2, 3, 4
Risk of Repeated Infections
- There is no direct evidence in the provided studies to suggest that children can contract COVID-19 five times
- However, the studies do suggest that children can be reinfected with COVID-19, especially with the emergence of new variants 2, 4
Factors Associated with Severe COVID-19 in Children
- Certain factors, such as chronic lung disease, neurologic disorders, cardiovascular disease, prematurity, and airway abnormality, are associated with severe COVID-19 in children under 2 years old 3
- In children aged 2-17 years, factors such as feeding tube dependence, diabetes mellitus, and obesity are associated with severe COVID-19 3
- Male sex, Black/African American race, and obesity are also associated with higher severity disease in children 4
Vaccination and Prevention
- Vaccination is highly recommended for children to prevent severe illness and reduce the risk of post-infectious complications such as MIS-C and long COVID 2, 5
- The risks and benefits of vaccination in children should be carefully considered, especially in the context of low risk of severe illness from COVID-19 5