COVID-19 and your child’s health

Many parents and carers may be worried about COVID-19, particularly if your child has a long-term health condition. International data continues to show that children are affected less severely than adults by COVID-19. Even children with serious underlying conditions will usually experience only mild symptoms and most will be able to recover at home.

If your child has COVID-19, the following options will help you identify suitable medical care:

call the National Coronavirus Helpline on 1800 020 080 for information and advice on COVID-19 test results, symptoms, health risks, self-care and managing COVID-19
complete the COVID care self-checker. This is a clinical self-assessment tool designed to help understand what healthcare may be needed based on symptoms and other risk factors.

If your child has a serious medical condition and you are concerned about COVID-19 treatment or vaccinations, please speak to your child’s specialist.

Vaccination provides your child with the best protection against COVID-19. The COVID-19 vaccine is safe, effective and free.

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Health advice

COVID-19 and children

The medical world continues to learn more about COVID-19 every day, but we do know that children represent a very small proportion of confirmed COVID-19 cases worldwide.

Current data also shows children tend to have less severe cases of COVID-19 than adults. In most cases the SARS-CoV-2 virus causes mild or moderate symptoms, which can include fever and cough, but also milder cases of pneumonia. Some children may require hospitalisation but severe complications in children are uncommon.

To help reduce the spread of COVID-19 and protect those in our community who are more at risk, it is very important for everyone to follow the recommended infection prevention guidelines (see below).

For more, read our blog COVID-19 and Kids: What you need to know

For more information about COVID-19 and what it might mean for children with chronic and complex medical conditions, please see below.

General information

What can I do to protect myself and my family from getting COVID-19?

Good hand and respiratory hygiene remains the most important measure for preventing infection. These include:

Washing hands with soap and water regularly and properly.
Covering your nose and mouth with a tissue or flexed elbow when coughing or sneezing.
Avoiding contact with anyone who has flu-like symptoms.
If possible, avoiding close contact with family members with flu-like illnesses.
Avoid touching your face.
Get vaccinated when you are eligible.

Should my child and family have the flu vaccination?

The Australian Government recommends and funds the seasonal influenza (flu) vaccine for ‘medical at risk’ groups from six months of age. Your child’s condition may make them eligible for free seasonal influenza vaccine.

Please note, the seasonal ‘flu’ vaccine does not prevent COVID-19 but is the most important measure we have to prevent influenza and its complications. At this time, preventing this common and serious respiratory infection is extremely important.

You can get the seasonal influenza vaccine at:

Local immunisation providers (e.g. council clinics and community child health clinics)
General Practitioners
Queensland Children’s Hospital
- Inpatients – discuss with your treating doctor
- Outpatients – Queensland Specialist Immunisation Service (Level 2, Mon-Fri 8am to 4pm (no appointment required).

Flu vaccination is also recommended for all family members.

Babies and infants

The latest published data suggests infants are at an increased risk of developing severe cases of COVID-19 compared to young children, but with a similar risk to adolescents. Approximately 10% of babies with confirmed COVID-19 to date have required admission to hospital to receive oxygen, in a similar way to other winter viruses. These are important and serious infections, but these babies almost all recover without needing support from intensive care. This is very different to the experience in the elderly, particularly those with existing health problems.

Children with complex and chronic conditions

Cancer

Cancer and cancer treatment can weaken the immune system. This means that a child with cancer is often at higher risk for infection and illness. Most children with cancer experience mild illness and do well if they get COVID-19 but more severe illness can occur, so close observation is needed.

Our current advice is to follow the recommended infection prevention guidelines (outlined above) to protect your child’s health.

Are children with cancer at higher risk of serious illness with COVID-19?
Unlike the adult population, the majority of COVID-19 infections in children with cancer are asymptomatic or with mild symptoms. The commonest symptoms are fever and cough. The risk of developing severe coronavirus disease and need for oxygen therapy is far less likely than in adults, but higher than in healthy children.

My child is currently receiving treatment for cancer – are they at an increased risk of getting COVID-19?
Current evidence shows that children with cancer have a higher risk of contracting COVID-19, and that they are more affected during the intensive phase of treatment. It is important to follow the recommended infection prevention guidelines (outlined above) to protect your child’s health. Having vaccinated carers/close contacts is an essential part to protecting your child from COVID-19.

Important: If your child develops a temperature of 38°C or over, or has trouble breathing, please seek an urgent medical review.

Speak to your child’s oncologist about the best plan for your child.

My child has completed their cancer treatment. Are they at increased risk?
Most children with cancer who have completed their planned treatment should have a relatively normal immune system within two to three months of completing therapy and are unlikely to be at increased risk of severe infection. No further special precautions are advised for these children at this stage.

Is it safe for my child to return to school?
In 2020, the Australian and New Zealand Children’s Haematology/Oncology Group (ANZCHOG) announced that it was safe for the vast majority of paediatric oncology and BMT patients to attend to school during the pandemic. Read more.

Check with your child’s oncologist if you have any questions or concerns about your child returning to school.

Cardiac conditions

There is currently no information specific to people with congenital heart disease (CHD) but the overall risk of COVID-19 for children and young adults with CHD is believed to be low.

Children are at significantly less risk of developing severe lung infection from COVID-19 than adults and it is believed this low risk should apply to most children with CHD.

However, children with complex lesions with associated heart failure or low oxygen levels may be at an increased risk.  Some cardiac children may also have an associated impaired immune function or be on medicines which affect immune function, which could place them at an increased risk. Speak to your child’s specialist about the best plan for your child over the coming months.

Should I take any special precautions to protect my child?
It is important to follow the recommended infection prevention guidelines (outlined above) to protect your child’s health. It is also recommended your child has the seasonal flu vaccine.

Chronic respiratory illness

Currently there is no specific information available about whether children with chronic respiratory illnesses (such as asthma) are at increased risk of COVID-19. However, most children with chronic respiratory illness do not have life-threatening disease when they contract other respiratory viruses such as influenza (the ‘flu’), and it is likely that this is also the case with COVID-19.

Should I take any special precautions to protect my child?
Until more information about COVID-19 and children with chronic respiratory illness is available, it is important to follow the recommended infection prevention guidelines (outlined above) to protect your child’s health. It is also recommended your child has the seasonal flu vaccine.

As with all viral seasons, it is important to obtain medical review if your child develops a persistent moist cough for more than three days.

If your child is on regular treatment make sure your child has enough medications for the next two to three months.

Seek medical advice if your child is unwell and avoid contact with sick people.

Cystic fibrosis

Currently there is no specific information available about whether children with cystic fibrosis are at increased risk of COVID-19. However, most children with chronic respiratory illness do not have life-threatening disease when they contract other respiratory viruses such as influenza (the ‘flu’), and it is likely that this is also the case with COVID-19.

Should I take any special precautions to protect my child?
Until more information about COVID-19 and children with cystic fibrosis is available, it is important to follow the recommended infection prevention guidelines (outlined above) to protect your child’s health. It is also recommended your child has the seasonal flu vaccine.

As with every viral season, it is very important to have a supply of antibiotics available in case your child has a chest flare up or develops a moist cough. Make sure your child has enough medications for the next two to three months.

Seek medical advice if your child is unwell and avoid contact with sick people.

For more information
Cystic Fibrosis Service
Queensland Children’s Hospital
t 07 3068 2303
e QCH_CF@health.qld.gov.au

Diabetes and endocrine

There is currently no evidence that children with diabetes (type 1, type 2 and MODY) are at increased risk of COVID-19.

However, recent data suggests that children with suboptimal diabetes control (high HbA1c) are potentially at more risk for developing a serious infection.

Talk to your child’s medical or nursing team about their currently level of risk.

Should I take any special precautions to protect my child?
It is important to follow the recommended infection prevention guidelines (outlined above) to protect your child’s health. It is also recommended your child has the seasonal flu vaccine.

For more information
Department of Endocrinology and Diabetes
Queensland Children’s Hospital
t 3068 5264

Immunosuppressed or immunocompromised

Children whose immune systems have been compromised due to medical treatment (such as organ transplants, current use of immunosuppressive medications etc) are more at risk from the common cold, the flu and other infections, and are therefore potentially more at risk of developing a serious infection from COVID-19. This includes patients with autoimmune diseases, inflammatory bowel disease (Crohn’s disease and Ulcerative colitis), those who are post liver transplantation, and those who have had a splenectomy.

It is important to discuss your child’s current level of immunosuppression with their specialist, and follow the recommended infection prevention guidelines (outlined above) to protect your child.

You should maintain your child’s current therapies and pathology monitoring as directed by your specialist team. Self-regulating dosing to reduce levels or use of emergency steroid management without specialist supervision will put your child at unnecessary greater risk of disease flare, increased risks of infection, increased risk of complications, organ rejection, and possibly death.

If you are unsure about the wellbeing of your child and you are concerned, visit your GP or attend your local emergency department for a review. Be sure to explain their background medical history.

If your child develops a temperature of 38°C or over, please seek a medical review. Remember to follow your team’s usual management plans and protocols and your child’s emergency management and or emergency steroid management plan if they have one.

Children with a disability

Based on current available information, there is no evidence that children with a physical disability are at increased risk of COVID-19. Most children with physical impairments do not have life-threatening disease when they have other respiratory viruses such as influenza (or ‘the flu’), and it is likely that this will also be the case with COVID-19. However, until further research and information is available, parents and carers are advised to follow the recommended infection prevention guidelines (see above) to protect your child’s health.

If your child has an underlying health condition, that makes them more susceptible to respiratory and other serious health complications, speak with their specialist, or your child’s GP about any risks associated with the COVID-19 pandemic.

For more information and advice about children with disability and COVID-19, visit

Also, there is information available on the Department of Education website (both general and specific to children with disability).

Rheumatological conditions

There is currently limited information available about the impact it might have on children with rheumatological conditions such as juvenile idiopathic arthritis (JIA) or Lupus who are taking immunosuppressive medicines. However, we do know that children overall experience milder cases of the disease than older people. Severe complications in children are also uncommon.

For up-to-date information about the COVID-19 vaccine in patients with rheumatic disease, including for patients on immunosuppressive medications, visit the Arthritis Queensland and Australian Rheumatological Association websites.

Should I take any special precautions to protect my child?
It is important to follow the recommended infection prevention guidelines (outlined above) to protect your child’s health. It is also recommended your child has the seasonal flu vaccine.

Should my child continue to take their immunosuppressive medication?
Yes, your child should continue to take their current medications so their disease doesn’t flare. This includes commonly used low-dose immunosuppressive medications such as methotrexate, biologics, mycophenolate, azathioprine, leflunomide and steroids.

If your child becomes unwell especially with a fever, the medication should be withheld as you would normally do. If your child is taking steroids these must NOT be stopped during an illness and your steroid action plan should be followed.

For more information
Rheumatology Service
Queensland Children’s Hospital
t 07 3068 2389
e CHQ_RheumAdmin@health.qld.gov.au

The information is based on the current evidence-based information about COVID-19 and was correct at time of distribution.