How to weigh risk when traveling with children this holiday

A pediatrician explains the omicron variant's risk for kids — especially young ones who are ineligible for vaccines

By Nicole Karlis

Senior Writer

Published December 22, 2021 3:02PM (EST)

A child with a mask with a Christmas hat decorates the Christmas tree in his house (Simona Granati - Corbis/Getty Images)
A child with a mask with a Christmas hat decorates the Christmas tree in his house (Simona Granati - Corbis/Getty Images)

In December 2020, the end of the first year of the pandemic, only one-quarter of Americans traveled for the holidays — a fraction of the normal one-third who do. This year is different: air travel is triple what it was in 2020, and 109 million Americans — almost exactly one-third of the country — are traveling. The timing couldn't be worse: the incredibly contagious omicron variant of COVID-19 is causing a vast surge in cases. That's causing many to rethink plans — particularly those with children under the age of five, who are not yet eligible for vaccination. Indeed, the lack of a vaccine for the youngest means young children, toddlers and babies are unprotected this holiday season.

That omicron is still not fully understood is understandably making traveling parents more nervous. Different variants have been known to infect children at different rates. And in the case of omicron, early data is already pouring in regarding how the new variant affects children compared to previous ones. 

In Texas, doctors are reporting an increase in hospitalizations of children under the ages of 18.

"We can confidently say at this point that we are now at the beginning of a new omicron surge, and that surge is affecting children as well as adults," Dr. Jim Versalovic, co-chair of the TCH COVID-19, said about hospitalizations at Texas Children's Hospital. Specifically, there were 10 pediatric hospitalizations due to COVID-19 over the last week. "Our hospitalizations for those under 18 years of age have more than doubled in the past four days," Versalovic added.

Doctors saw an increase in hospitalizations of children under the age of 5 during their omicron surge, too, and suspected it was because of omicron's increased infectious rate. Notably, doctors said there was one common theme among the hospitalized children: their parents were unvaccinated.

"All these young children being admitted, most of them, the parents have not been vaccinated either," Dr. Waasila Jassat of South Africa's National Institute for Communicable Diseases told CBS News. "So I think, certainly the value of vaccination in the adults, protecting the children in the homes, is something to keep in mind."

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This week, the Centers for Disease Control and Prevention reported that the omicron variant now accounts for nearly 73 percent of new coronavirus infections in the United States. That rise is astonishing given that, in the beginning of December, the new variant only made up less than 1 percent of new infections. While the jury is still out regarding omicron's virulence — meaning its potential to cause severe disease — the variant's increased transmissibility means more people are at risk of getting infected, including children.

It is important to note that relatively low numbers of children have been hospitalized or died from COVID-19 throughout the pandemic. Age seems to be linearly correlated with risk from COVID-19, a trend that has stayed true throughout the pandemic.

Dean Blumberg, chief of pediatric infectious diseases and associate professor in the department of pediatrics at the University of California, Davis, told Salon that there is no data on how children will be affected by omicron yet.

"We know is that it's probably two to five times more transmissible than delta," Blumberg said. "That makes it extraordinarily infectious, so everybody is at risk for infection. And we know that it has mutations that allow it to evade previous immunity either immunity from vaccination or immunity from previous infection."

Blumberg stressed that children are at lower risk for severe disease. 

"Children who are healthy without underlying conditions should not have risk factors for more severe disease, so if they do get an infection — either unvaccinated or get a breakthrough infection — they're less likely to have severe disease and require hospitalization."

Of course, Blumberg said children who are considered to be high-risk for COVID-19, perhaps because they have immunocompromised conditions, could be at a higher risk with omicron. If you have a child with such a condition, it is something to consider in the risk calculus of holiday travel.

"We know that although COVID is generally more mild in children than compared to adults, in the U.S. there has been more than million hospitalizations of children and more than 700 deaths," Blumberg said. "So although it's less severe on children, it can be severe, and that's why I would encourage parents to vaccinate their children and make sure they're fully vaccinated."

Of course, not all children are eligible for vaccinations yet. In the meantime, Blumberg stressed the importance of masking for children.

"Vaccinations are the first line of defense — the second line of defense is masking, and children as young as two can mask," Blumberg noted. "I would have those children mask when they're around others outside of their household, especially people who you don't know their vaccination status. For children less than two where masking is not feasible and may not be safe, it's a risk for them to be around unvaccinated individuals."

Blumberg added that children between the ages of six months and four years old will likely be eligible for vaccination during the first quarter of 2022.

So, is omicron a reason for parents with young children to cancel holiday and travel plans? Blumberg stressed the need to weigh your own "risk tolerance." 

"I think that we all can respect that people are tired of the impacts that all the lockdowns have had on people," Blumberg said. "If people have underlying risk factors for more severe disease, you might want to rethink your plans. If everybody is healthy and you think that infection or breakthrough infections can likely result in mild disease and you have to get together, you think it's important for the mental and emotional health of your family then you should do that."

Read more on the omicron variant:

By Nicole Karlis

Nicole Karlis is a senior writer at Salon, specializing in health and science. Tweet her @nicolekarlis.

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Children Holidays Omicron Surge Pandemic Parenting Reporting Travel