Children and COVID-19: State-Level Data Report

On May 11, 2023, the United States ended the Public Health Emergency (PHE) that was declared over three years ago to organize government resources and establish policies needed to respond to the COVID-19 pandemic.

After three years of weekly reporting on the number of child COVID-19 cases in the United States, the American Academy of Pediatrics (AAP) and the Children’s Hospital Association (CHA) will be sunsetting the weekly state COVID-19 reports.

Origins of the Report

The report was created in the early months of the COVID-19 pandemic to measure how COVID-19 was affecting children in the United States. The CDC had begun providing national data on COVID-19 cases, but timely, regular data on pediatric cases were not available. Thus, we turned to data provided by states and territories and began to collect information from their web sites for the most current pediatric data. By compiling this information we could track the number of child cases weekly, as well as provide publicly reported case numbers for children at the state level.

Changes in Data Available

Over the past three years this report has provided a unique and valued resource to understand the impact of COVID-19 on children, and to understand trends in volume of cases and geography as COVID-19 variants emerged.

The data in the report have always been limited by variations in how states categorized and reported COVID-19 cases. Beginning in 2022, as home COVID-19 tests became widely available, an increasing portion of COVID-19 cases were likely unreported. In 2023 an increasing number of states reduced the frequency of reporting and updating cases. As the end of the PHE approached, these trends intensified, and many states announced their posts were ending.

We will continue to monitor COVID-19 with indicators that are available. However, given the decreasing access and reliability of data on the number of child COVID-19 infections, this weekly report was sunset May 11, 2023. We will continue disease surveillance as we do for other infectious diseases.

Final Summary

As of May 11, 2023, nearly 15.6 million children were reported to have tested positive for COVID-19 since the onset of the pandemic according to available state reports. Over the past three years, the highest number of child cases reported in a week was over 1.1 million for the week ending January 20, 2022. Since the pandemic began, children represented 17.9% of total cumulated cases. The portion of reported cases that were children ranged from a low of 2.0% the week ending April 16, 2020 to a high of 28.9% the week ending September 9, 2021 (children, under age 18, make up 22.2% of the US population).

On May 11, an additional 6,848 child COVID-19 cases were reported. Over the past 6 months, weekly reported child cases have plateaued at an average of about 24,000 cases, while in the past month the average reported weekly cases have dropped further to about 9,000. These trends parallel the pattern and decline that has been reported for adults.

It remains important to address the long-lasting impacts of the COVID-19 pandemic on the physical, mental, and social well-being of this generation of children and youth. The AAP compiled a snapshot of the impact of the COVID-19 pandemic on families and provides resources to help pediatricians support them. For a new online course on trauma-informed care and other recommendations, visit AAP.org/TIC.

Summary of Findings (data available as of 5/11/23) :

Cumulative Number of Child COVID-19 Cases*

15,594,079 total child COVID-19 cases reported, and children represented 17.9% (15,594,079/86,881,822) of all cases
Overall rate: 20,718 cases per 100,000 children in the population

See detail in Appendix: Data from 49 states, NYC, DC, PR, and GU; Analysis by American Academy of Pediatrics and Children’s Hospital Association

*Note Data Limitations: The data are based on how public agencies collected, categorized, and posted information. Data reported by some state/local health departments changed across the years; footnotes are included to denote changes. Notably, in the summer of 2021 and winter of 2022, some states revised cases counts previously reported, begun reporting less frequently, or dropped metrics previously reported. For example, due to several changes on their dashboards and the data available, AL, DC, HI, IA, KY, MN, MS, NE, SC, TX, VA, & WI data in this report are not through 5/11/23. Readers should consider these factors. States may have additional information on their web sites.

Changes in testing, changes in how states report, periods when school is not in session, and holiday weeks affect week to week comparisons and might cause irregularities in reporting and trends. Shortages of COVID-19 tests during surges and COVID-19 home tests likely affected the undercounting of COVID-19 cases.

Cumulative hospitalization and mortality data were included on the 5/14/20 to 6/7/22 reports; these measures were removed from the 6/16/22 to 5/11/23 reports due to fewer states that provided updates. For more information regarding US child hospitalization and mortality data from the CDC, visit https://covid.cdc.gov/covid-data-tracker/#pediatric-data.

Download Full Report (5/11/2023)

Download Full Report (5/4/2023)

Download Full Report (4/27/2023)