What is already know about this topic? Severe illness from COVID-19 can and does occur in children and adolescents.

What is added by this report? COVID-19 cases, emergency department visits, and hospital admissions increased from June to August 2021 among persons aged 0-17 years. Emergency department visits and hospital admissions in a 2-week period in August 2021 were higher in states with lower population vaccination coverage and lower in states with higher vaccination coverage.

What are the implications for public health? Community vaccination, in coordination with tTesting strategies and other Prevention measures, is critical to protecting pediatric populations from SARS-CoV-2 infection and severe COVID-19.

Although COVID-19 generally results in milder disease in children and adolescents than in adults, severe illness from COVID-19 can occur in children and adolescents and might require hospitalization and intensive care unit (ICU) support (1–3). It is not known whether the B.1.617.2 (Delta) Variants,* which has been the predominant Variants of SARS-CoV-2 (the Virus that causes COVID-19) in the United States since late June 2021,† causes different clinical outcomes in children and adolescents compared with Variantss that circulated earlier. To assess Trends among children and adolescents, CDC analyzed new COVID-19 cases, emergency department (ED) visits with a COVID-19 Diagnosis code, and hospital admissions of patients with confirmed COVID-19 among persons aged 0–17 years during August 1, 2020–August 27, 2021. Since July 2021, after Delta had become the predominant circulating Variants, the rate of new COVID-19 cases and COVID-19–related ED visits increased for persons aged 0–4, 5–11, and 12–17 years, and hospital admissions of patients with confirmed COVID-19 increased for persons aged 0–17 years. Among persons aged 0–17 years during the most recent 2-week period (August 14–27, 2021), COVID-19–related ED visits and hospital admissions in the states with the lowest vaccination coverage were 3.4 and 3.7 times that in the states with the highest vaccination coverage, respectively. At selected hospitals, the proportion of COVID-19 patients aged 0–17 years who were admitted to an ICU ranged from 10% to 25% during August 2020–June 2021 and was 20% and 18% during July and August 2021, respectively. Broad, community-wide vaccination of all eligible persons is a critical component of mitigation strategies to protect pediatric populations from SARS-CoV-2 infection and severe COVID-19 illness.

CDC analyzed COVID-19 cases, ED visits with a COVID-19 Diagnosis code, and hospital admissions of patients with laboratory-confirmed COVID-19 among persons aged 0–17 years during August 1, 2020–August 27, 2021. Daily COVID-19 case data were obtained from CDC’s case-based Surveillance system.§ Daily ED visits were obtained from the National Syndromic Surveillance Program (U.S.)¶ and were stratified into three age groups: 0–4, 5–11, and 12–17 years. Daily hospital admission data were obtained from the U.S. Department of Health and Human Services (HHS) Unified Hospital Data Surveillance System.** The number of daily cases, ED visits, and hospital admissions were averaged over a 7-day period to obtain a 7-day average. The state-specific percentage of the population aged ≥12 years who had completed the COVID-19 vaccination series as of July 31, 2021, was used to group states into vaccination coverage quartiles.†† Results were also examined by HHS Region. U.S. Census Bureau midyear 2019 population estimates§§ were used to calculate vaccination coverage and cases and hospital admissions per 100,000 persons. COVID-19–associated ED visits were assessed as a percentage of all ED visits. To assess differences in COVID-19 outcomes by vaccination coverage quartile, ratios for ED visits and rate ratios for hospital admissions during the 2-week period August 14–27, 2021, along with corresponding 95% confidence intervals (CIs), were calculated. R (Version 4.1.0; R Foundation) was used for calculations.

Suggested citation for this article: Siegel DA, Reses HE, Cool AJ, et al. Trends in COVID-19 Cases, Emergency Department Visits, and Hospital Admissions Among Children and Adolescents Aged 0–17 Years — United States, August 2020–August 2021. MMWR Morb Mortal Wkly Rep. ePub: 3 September 2021.

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