Most COVID-19–associated hospitalizations occur in older adults, but severe disease that requires hospitalization occurs in all age groups, including adolescents aged 12 to 17 years, according to a Morbidity and Mortality Weekly Report released by the Centers for Disease Control and Prevention (CDC).
Using the Coronavirus Disease 2019-Associated Hospitalization Surveillance Network (COVID-NET), COVID-19 adolescent hospitalization rates from COVID-NET peaked at 2.1 per 100,000 in early January 2021, declined to 0.6 in mid-March, and rose to 1.3 in April. Among hospitalized adolescents, nearly one-third required intensive care unit admission, and 5% required invasive mechanical ventilation; no associated deaths occurred.
Recent increased hospitalization rates in spring 2021 and potential for severe disease reinforce the importance of continued COVID-19 prevention measures, including vaccination and correct and consistent mask wearing among persons not fully vaccinated or when required.
On May 10, 2021, the U.S. Food and Drug Administration expanded the Emergency Use Authorization for Pfizer-BioNTech COVID-19 vaccine to include persons aged 12 to 15 years, and CDC’s Advisory Committee on Immunization Practices recommended it for this age group on May 12, 2021. Before that time, COVID-19 vaccines had been available only to persons aged ≥16 years. Understanding and describing the epidemiology of COVID-19–associated hospitalizations in adolescents and comparing it with adolescent hospitalizations associated with other vaccine-preventable respiratory viruses, such as influenza, offers evidence of the benefits of expanding the recommended age range for vaccination and provides a baseline and context from which to assess vaccination impact.
CDC examined COVID-19–associated hospitalizations among adolescents aged 12 to 17 years, including demographic and clinical characteristics of adolescents admitted during Jan. 1 to March 31, 2021, and hospitalization rates (hospitalizations per 100,000 persons) among adolescents during March 1, 2020 to April 24, 2021. Among 204 adolescents who were likely hospitalized primarily for COVID-19 during Jan. 1 to March 31, 2021, 31.4% were admitted to an intensive care unit (ICU), and 4.9% required invasive mechanical ventilation; there were no associated deaths. During March 1, 2020 to April 24, 2021, weekly adolescent hospitalization rates peaked at 2.1 per 100,000 in early January 2021, declined to 0.6 in mid-March, and then rose to 1.3 in April.
Cumulative COVID-19–associated hospitalization rates during Oct. 1, 2020 to April 24, 2021, were 2.5–3.0 times higher than were influenza-associated hospitalization rates from three recent influenza seasons (2017–18, 2018–19, and 2019–20) obtained from the Influenza Hospitalization Surveillance Network (FluSurv-NET).
COVID-NET is a population-based surveillance system of laboratory-confirmed COVID-19–associated hospitalizations in 99 counties across 14 states, covering approximately 10% of the U.S. population. Included in surveillance are COVID-19–associated hospitalizations among residents in a predefined surveillance catchment area who had a positive real-time reverse transcription–polymerase chain reaction or rapid antigen detection test result for SARS-CoV-2 (the virus that causes COVID-19) during hospitalization or ≤14 days before admission.
COVID-NET data indicate that COVID-19–associated hospitalization rates were lower in adolescents aged 12 to 17 years compared with those in adults but exceeded those among children aged five to 11 years during March 1, 2020 to April 24, 2021. Moreover, COVID-19–associated hospitalization rates among adolescents increased during March to April 2021, and nearly one third of 204 recently hospitalized adolescents required ICU admission. Rates of COVID-19–associated hospitalization among adolescents also exceeded historical rates of seasonal influenza-associated hospitalization during comparable periods. Recent increased hospitalization rates and the potential for severe disease reinforce the importance of continued COVID-19 prevention measures among adolescents, including vaccination and correct and consistent wearing of masks.