COVID-19 information for parents and carers

What parents need to know about COVID-19

COVID-19 appears to generally cause mild illness in children. This includes the Omicron variant that we’ve started seeing since December 2021. Even though it transmits more easily (in children and adults) compared to previous variants, it does not appear to cause more severe disease in adults or children.

However, at this time, when everyone is preoccupied with COVID-19, it's really important to realise that not every illness your child has is due to COVID-19. All the 'normal' infections that can make children and babies really unwell still remain and there is a major risk that parents may delay bringing their child to the attention of a healthcare professionals even if they are unwellIf you are not sure if your child is unwell and whether they need to be seen by someone, click here to help you decide. GPs and hospitals are still providing the same safe care that they always do for children.

LAST UPDATE: 04.10.2022

There is no evidence to suggest that the Delta or Omicron variants are more likely to infect children compared to previous strains. And even if children are infected, they generally experience mild illness. There have been relatively few children across the UK admitted to hospital with severe COVID infection. This includes children with other health conditions, including those undergoing treatment for cancer or those with weakened immune systems or underlying chest problems - even when they have been infected with COVID, they have generally experienced mild infection.

Hospital admission rates in the week ending 5 December 2021.

There are still little data available about the severity of the Omicron variant but there is no suggestion so far that this will lead to severe infection in children, including those who are unvaccinated (such as children under 12 years of age).

For specific information for children and young people with cancer undergoing cancer treatment, click here.

If you are worried about your child's breathing and are not sure if they need to be seen by a healthcare professional, click here to help you decide. Our local and regional paediatric services are well set up and have detailed plans in place to treat and support all children who have severe COVID-19 disease. There is a national plan in place for children that require intensive care support (PICU).

It is extremely important to realise that not every child with a fever has COVID-19. All the other conditions that can make children unwell are still ongoing during the COVID-19 pandemic. If you are not sure if your child is unwell and whether they need to be seen by someone, take a look at the red / amber / green criteria below to help you decide.

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to the touch
  • Has pauses in their breathing (apnoeas), has an irregular breathing pattern or starts grunting
  • Severe breathing difficulty - to breathless to talk/ eat or drink
  • Is going blue round the lips
  • Has a fit/seizure
  • Becomes extremely distressed (crying inconsolably despite distraction), confused, very lethargic (difficult to wake) or unresponsive
  • Develops a rash that does not disappear with pressure (the ‘Glass test’)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 
  • Has testicular pain, especially in teenage boys

You need urgent help:

Go to the nearest Emergency (A&E) department or call 999

If your child has any of the following:

  • Is finding it hard to breathe including drawing in of the muscles below their lower ribs, at their neck or between their ribs (recession)
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down
  • Has extreme shivering or complains of muscle pain
  • Infants 3-6 months of age with a temperature of 39°C / 102.2°F or above
  • For all infants and children with a fever of 38°C or above for more than 5 days
  • Has persistent vomiting and/or persistent severe abdominal pain
  • Has blood in their poo or wee
  • Any limb injury causing reduced movement, persistent pain or head injury causing persistent crying or drowsiness
  • Is getting worse or if you are worried

Immediately contact your GP and make an appointment for your child to be seen that day.

We recognise that at peak times, access to a healthcare professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest Emergency (A&E) Department.

If none of the above features are present

  • You can continue to provide your child care at home. Information is also available on NHS Choices
  • Additional advice is available to families for coping with crying of well babies
  • Additional advice is available for children with complex health needs and disabilities

Self Care:

Continue providing your child's care at home. If you are still concerned about your child, call NHS 111 - dial 111 or visit 111 online

The key messages from this guidance are:

  • Nationally, education and childcare settings are open, and attendance is mandatory (for schools) and strongly encouraged (at childminders, nurseries and colleges)
  • The Royal College of Paediatrics and Child Health has made it clear that the overwhelming majority of children and young people still have no symptoms or very mild illness only

  • Secondary school pupils in England and Wales are no longer required to wear face masks

  • All children aged 12 and over are now eligible for a COVID-19 vaccination

If you have concerns about your child attending, you should discuss these with your school or college.

Further advice on living safely with COVID can be found here.

What is PIMS?

PIMS TS was first reported in April 2020 and cases continue to be low in number but we need to remain vigilant.

The children had serious inflammation throughout their body. Inflammation is a normal response of the body’s immune system to fight infection. But sometimes the immune system can go into overdrive and begin to attack the whole body and if this happens, it is important that children receive urgent medical attention.

Doctors are concerned that in severe cases of PIMS the inflammation can spread to blood vessels (vasculitis), particularly those around the heart. If untreated, the inflammation can cause tissue damage, organ failure or even death,

Some of the symptoms of PIMS can overlap with other rare conditions, such as Kawasaki disease and Toxic Shock Syndrome. Some people have referred to the condition as ‘Kawasaki-like disease’. Like PIMS, complications from Kawasaki can cause damage to the heart. Kawasaki tends to affect children under five whereas PIMS seems to affect older children and teenagers.

Can PIMS be treated?

Yes. Doctors know what to look out for and will do tests to diagnose what’s wrong and what treatment to give the child. Even where doctors aren’t 100% sure whether a child or teenager has PIMS, they know how to treat the symptoms associated with it. Doctors use the same type of treatments to ‘reset’ the immune system for both PIMS and Kawasaki disease.

Researchers hope to find out more about how to diagnose patients as quickly as possible and which are the most suitable treatments for each patient.

What symptoms should I look out for?

There’s a very wide range of symptoms and children with PIMS can be affected very differently. Some children may have a rash. Some, but not all, may have abdominal symptoms such as stomach ache, diarrhoea or being sick. All the children diagnosed with PIMS had a high temperature for more than three days, although this can be a symptom in many other illnesses and on its own is not a sign of PIMS.

While most won’t, some children may be severely affected by the syndrome. The most important thing is to remember that any child who is seriously unwell needs to be treated quickly – whatever the illness. The advice to parents remains the same: COVID-19 is extremely unlikely to make your child unwell; if you are worried about them, take a look at the red/amber/green symptom guide above and if required, contact NHS 111 or your family doctor for urgent advice, or 999 in an emergency, and if a professional tells you to go to hospital, please go to hospital.

If your child doesn’t have these signs of being seriously unwell but you are still concerned, talk to you GP.

How many children have been affected?

It’s difficult to say because doctors are still in the process of reporting back – and also because there isn’t a definitive test. We think around 75-100 children may have been seriously affected and admitted to an intensive care unit. Almost all these children have since recovered.

A survey has been sent to 2,500 paediatricians (doctors who treat children) to gain a more complete picture of the condition. It asked doctors for details of every potential case seen since the beginning of March so we expect it to report a lot more cases – e.g. around 200 cases in England. But many of these children will not have been seriously ill and almost all children diagnosed with PIMS are now well again. The survey is likely to pick up cases which later turn out to be a different illness, eg Kawasaki disease. Some doctors believe a much large number of children may have had the condition but were very mildly affected and recovered without seeing a doctor.

Doctors have reported seeing a big reduction in cases in recent weeks but this could rise if cases of COVID-19 go up again.

Have any children died from PIMS?

We don’t know for sure because there isn’t a test for this condition. Doctors think two children may have died but they can’t be certain that there weren’t other reasons why the children died. These deaths are very sad indeed but doctors believe deaths in children related to PIMS are very, very rare. Many more children die of other infections such as flu or even chicken pox every year.

Is PIMS caused by COVID-19?

PIMS seems to be linked to COVID-19 because most of the children either had the virus or tested positive for antibodies indicating they had been infected (even if they hadn’t seemed ill at the time). But a very small number of the children with PIMS symptoms didn’t test positive for either.

How can doctors tell if a child has PIMS?

There currently isn’t a test which will say whether a child definitely has the syndrome. A syndrome is a collection of many different symptoms which, together, can give doctors an indication of whether or not someone has a particular illness. Doctors will look for a pattern of symptoms relating to PIMS and then do more tests, such as blood pressure and blood analysis, to make a diagnosis. Researchers are currently trying to develop a blood test which can quickly indicate whether a child has PIMS.

Are black or Asian children more likely to be affected?

When the first few cases were identified in the UK there seemed to be a larger number of children from an Afro-Caribbean or Asian background. Doctors don’t yet know the reason for this and it may turn out that these children are not at a higher risk than other children – in some other countries where the syndrome has been written about the children were white. But it is important for families with these backgrounds to be aware of the signs and symptoms of the condition, however rare.

Doctors are learning more and more about this condition all the time and we hope to have more information over the next weeks and months. We will update our guidance regularly.

For more information, click here.

COVID-19 is spread by droplets. That means your child needs to be in extremely close contact with someone with COVID-19 (who is coughing) to become infected (within 1-2 metres of them). However, the droplets containing COVID-19 can survive for hours on hard surfaces (door handles, handrails etc). This means that your child is much more likely to get infected by picking up COVID-19 on their hands and then infecting themselves by touching their face (which allows the virus to enter via their mouth, nose or eyes).


This is why washing hands with soap and water is so important, especially after being in areas containing other people:

In addition, trying to stop your child touching their face (unless they have just washed their hands) will also reduce the risk of them getting infected:

For more information about reducing the risk of you or your child catching COVID-19, click here.

Previously specific groups of children had to shield but that has now paused for now. More information on shielding can be found here.

If the number of positive cases substantially increases in your nursery, school, or college, or if your nursery, school, or college is in an enhanced response area, you might be advised that face coverings should temporarily be worn in communal areas or classrooms (by pupils, staff and visitors, unless exempt).

However, face masks should NOT be used for babies and children under 3 years

Wearing a face mask in this age group can put babies and children at serious risk of harm or death:

  • Babies and young children have smaller airways so breathing through a mask is harder for them
  • Masks could increase the risk of suffocation because they are harder to breathe through
  • Babies are unable to remove the mask should they have trouble breathing
  • Infants could be at risk of becoming tangled, especially if they try to remove a mask, potentially causing serious injury
  • Older infants or young toddlers are not likely to keep the mask on and will touch their face more to try and remove it

There is no evidence showing that ibuprofen is associated with harm in children with COVID-19. If your child has symptoms of COVID-19 such as fever and headache, you can treat your child with either paracetamol or ibuprofen.

  • The most common signs of COVID-19 are cough and fever
  • To reduce the risk of spread to other household members, get them to cover their mouth and nose with a tissue or sleeve when coughing and sneezing and to throw used tissues in the bin immediately. They should also regularly wash their hands with soap and water (for at least 20 seconds each time)
  • In addition, keep shared spaces and surfaces visibly clean using household detergents, washing hands after cleaning. Household bleach using in accordance with the instructions can be used to disinfect surfaces. Use hot water and detergent or a dishwasher for crockery and cutlery
  • If your child develops moderate breathing difficulty (amber features) whilst your family are self-isolating, you will either need to contact NHS 111 online or call NHS 111. They will arrange for your child to be seen by a healthcare professional. If your child develops severe breathing problems (red features), call 999
  • Further advice for living safely with COVID can be found here

COVID-19 has shown how important it is to protect ourselves against infections. Vaccinations are by far the most effective way of achieving this. That’s why is so important that your child still receives their normal childhood vaccinations; to protect them not just during the COVID-pandemic but also for the rest of their lives. Make sure that your child doesn’t miss out - your GP practice is still open to administer them. Click here for more information.

The COVID-19 vaccination is recommended for all children aged 5 years and over. 

Children should receive their 2nd COVID vaccine 12 weeks after their 1st dose (although a second dose can be given after 8 weeks in children at higher risk of severe COVID-19 infection). Currently, children aged 5 years and older are eligible for an additional seasonal booster if they are at high risk of illness from COVID 19. Click here to book it now. 

Although the risk of severe COVID-infection in children remains extremely low, the main reason for vaccinating children is to offer protection against a future strain that could potentially be more severe. In addition, it has also been shown that the risk of COVID-19 associated inflammatory syndrome (PIMS) is lower in children who have been vaccinated. Most young people are extremely keen to be vaccinated. Some concerns have been raised about the risk of young people developing inflammation of the heart (myocarditis or pericarditis) following the COVID-vaccine. However, we now have a far better understanding of this because many countries (including the UK) have been vaccinating children aged 5 years and over for many months. The risk of myocarditis and pericarditis is low (approximately 1 in 100,000 risk) and is usually very effectively treated with simple treatment such as non-steroidal anti-inflammatory drugs such as ibuprofen. It is slightly more common in boys than in girls and is more likely to occur after the 2nd dose of the vaccine rather than the 1st. Very few cases have been reported in children below 12 years of age. The image below weighs up the benefits and risk of children being vaccinated (thanks to BBC news):

The COVID vaccine is recommended for all children aged 5 years and over; here are some questions commonly asked by parents:

  • Why should I have my child vaccinated? Although COVID has so far been usually extremely mild in children, it is possible that future varients may cause more severe illness in children. In addition, if your child regularly comes into contact with a family member with a weakened immune system (which means that the vaccine will be less effective in them), by having the vaccine they will be less likely to get infected and less likely to transmit COVID to them. 
  • Is it safe? A reduced dose of the vaccine (10mcg) is being offered to children aged 5-11 years compared to a 30mcg dose in older children and adults. Research studied have found the vaccine to be safe and effective in children and real world data from Europe, America and Israel backs this up. Immune responses in vaccinated 5 to 11 year olds are as good as those measured in 15 to 25 year olds and adverse reactions due to vaccination such a having a sore arm or experiencing chills are generally mild and usually only last for a day or two. No cases of myocarditis have been observed so far in this age group.
  • Do I have to give consent? Yes, your child will not be vaccinated without your consent. In all instances, you and your child will be provided with appropriate information to enable you, and those with parental responsibility, to provide informed consent prior to vaccination. Click here for more information about the COVID vaccine in children.
  • How many doses will my child receive? Current guidance recommends two doses (although children with very severely weakened immune systems may need an extra (third) dose from 8 weeks after their second dose).
  • How long does my child need to wait between the first and second dose? There should be interval of 12 weeks between the first and second doses, although an 8 week interval is recommended for children with health conditions that put them at higher risk of more severe COVID. The minimum interval between any vaccine dose and recent COVID-19 infection should be 4 weeks.
  • I am immunosuppressed – is it safe for my child to have the vaccine? Yes. The vaccine is not a live vaccine to poses no risk to you. We would encourage your child to be vaccinated if you are immunosuppressed to protect you from getting COVID.
  • My child is eligible, where can they get the vaccine? You may be contacted by your GP to arrange an appointment at the nearest suitable location. This might be at your GP surgery or in a community location. You can also find your nearest vaccination site via the NHS website, or by calling 119.

  • The situation continues to change day by day. For the most up to date information on the situation, including advice about school attendance, need for testing or attendance to hospital for assessment, look at the updates provided by the UK government.
  • For up to date information about COVID-vaccine recommendations in children, click here
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