How serious is COVID-19 in children?

COVID-19 is usually milder in children than in adults — only very rarely does it cause severe illness. Around 98% of children and adolescents either get mild infection or have no symptoms at all.

Of those who do get symptoms, the illness is usually very similar to other respiratory viral illnesses — the most common symptoms are fever and cough. Children can also have symptoms like a runny nose and tiredness. Some children may have gastrointestinal symptoms like abdominal pain, diarrhea or vomiting.

Some children may require hospitalisation and a smaller number may need to have intensive care. Studies have shown that children and adolescents with underlying medical conditions have a greater risk of developing severe disease and complications from COVID-19.

The conditions in children that increase the risk of being hospitalised with COVID-19 include —but are not limited to:

• type 1 diabetes
• obesity
• a history of prematurity
• heart disease, including some congenital conditions
• immunocompromising conditions
• complex and chronic illnesses

Studies show that although children can get ‘long COVID’ — that is, the persistence of COVID-19 symptoms, such as fatigue and breathlessness, for over 3 months — it’s uncommon. It appears to occur less commonly in children than in adults.

What should I do if my child gets COVID-19?

Children with COVID-19 will often have similar symptoms to other viral infections — such as fever, runny nose, sore throat, cough, vomiting, diarrhoea and lethargy.

A small number may develop other symptoms such as tummy or chest pain, headache, body aches, breathing difficulties or loss of taste or smell. Up to half of the children who get COVID-19 may have no symptoms at all.

There is a small risk of severe disease from COVID-19 in children, but this is very rare.

If their symptoms are mild, most children who get COVID-19 can be cared for at home.

You should seek medical care for your child if they are:

• less than 3 months old
• your child's symptoms seem to be worsening
• your child has a chronic illness and your GP has told you to seek help if your child gets a respiratory or gastrointestinal illness
• you are worried about your child as a parent
• your child's mental health is suffering because of isolation
• your child is immunocompromised
• your child has a significant physical or intellectual disability
• you have any concerns about caring for your child

Parents and carers should use the same general guidelines that they would for other viral infections:

• children should be dressed in comfortable clothing, to prevent any sweating or shivering
• make sure they drink lots of fluids
• encourage them to rest and not overdo it

Children can also take paracetamol or ibuprofen if they’re uncomfortable because of the pain or fever (ibuprofen should not be used for children under 3 months of age).

Watch your child for signs that their illness is getting worse. Warning signs to look out for include:

• persistent fever that is not responding to treatment
• difficulty breathing or chest pain
• severe abdominal pain, vomiting and/or diarrhoea
• if they’re drinking less or passing less than half the amount of urine they usually would
• if they’re excessively sleepy or irritable

In case of these or other serious concerns, parents and carers should seek urgent advice from their care team. In an emergency, they should request ambulance assistance and tell the operator the child has COVID-19.

Is there an age limit in children for a rapid antigen test?

Children can be tested with a rapid antigen test, however some kits cannot be used on young children and babies. The TGA don’t specify any age limits but recommend checking the instructions provided if using the test on a child.

Some states do not recommend rapid antigen tests on children under the age of 2 years but also recommend checking the product age recommendations. Some testing kits have no age restrictions, but many are for use over the age of 2 years.

Rapid antigen tests on children should always be done or supervised by an adult. It is important to carefully follow any instructions provided with the test kit.

For a list of tests that the TGA has approved and instructions on how to use them, go to tga.gov.au. This list is updated regularly.

If you can’t obtain a rapid antigen test that is suitable for your child, or you don’t feel confident using a RAT then get a PCR test.

If the rapid antigen test is negative but your child still has symptoms or your child is still unwell, arrange a PCR test.

If the PCR test is negative and your child doesn’t have symptoms or feel unwell, just monitor for symptoms.

If you have concerns about your child, contact your health provider. You can also use the Healthdirect Symptom Checker for advice.

Can children get a COVID-19 vaccine?

It’s recommended that children 5 years and older get a COVID-19 vaccine to protect them from getting severe sickness from COVID-19, reduce the spread of virus between themselves and to adults, prevent other complications such as ‘long COVID’ and to reduce disruptions to schooling and other learning. For advice on which COVID-19 vaccines are available for children in Australia visit the Australian Government Department of Health. If your child is taking other medication, in most cases they can also receive a COVID-19 vaccine, but should discuss the best timing of vaccination with their treating doctor.

COVID-19 vaccination is also recommended for children aged 6 months to less than 5 years with severe immunocompromise or disability, or who have complex or multiple health conditions that increase their risk of getting severe COVID-19.

Parents and carers can use the Service Finder to book in their child’s vaccination.

The Department of Health have provided information for parents and guardians on the COVID-19 vaccine and consent for 5 to 11 year olds.

Does my child need a booster?

For children aged between 5 to 17 years, a booster may be considered if:

• they have medical conditions, disability or complex health needs that increase their risk of severe COVID-19 and
• it has been 6 months or longer since their last COVID-19 dose or COVID infection.

ATAGI do not recommend a 2023 booster for children under the age of 5 years.

Can children get a COVID-19 vaccination if they have already had COVID-19?

COVID-19 vaccination is still strongly recommended in children who have already had COVID-19 infection.

It is recommended to hold off getting a COVID-19 vaccination for 6 months after a confirmed COVID-19 infection. This time between infection and vaccination enhances the protection from vaccination by further boosting the immune response. This immune response is further enhanced by vaccination.

You should still have all the recommended doses. No doses should get missed from the schedule.

You should also hold off getting a COVID-19 vaccination until you are no longer acutely unwell.

You should tell your doctor or immunisation provider if your child has had COVID-19 in the past.

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