Of all the modern medical interventions we have at our disposal, few have been victim to as much falsehood as vaccines. As the world battles a pandemic, stripping the truth from the lies is more urgent than ever.

According to the World Health Organization (WHO), between 2010 and 2015, vaccines prevented an estimated 10 million deaths.

Scientists have worked tirelessly to create safe and effective vaccines to protect us against SARS-CoV-2. Now, as many governments roll out COVID-19 vaccines, scientists and medical experts are facing a new challenge: misinformation and associated vaccine hesitancy.

Some anti-vaxxers — individuals who believe vaccines cause a range of medical ills — dedicate their entire lives to railing against vaccines. In reality, vaccines have saved lives of millions of people.

Vaccine hesitancy is nothing new and, in many ways, perfectly reasonable. For instance, misinformation about the vaccines’ safety and potential effects on the body is rife on the internet. Also, the COVID-19 vaccines were developed unusually swiftly and use relatively new technology.

Today, a significant percentage of the United States population, and the world at large, are nervous to take a shot that could save their lives.

In this article, we tackle some of the most common myths associated with the COVID-19 vaccines. Although it will not convince dyed-in-the-wool anti-vaxxers, we hope that this information will prove useful for those who are hesitant.

1. The vaccines are not safe, because they were developed so fast

It is true that scientists developed the COVID-19 vaccines faster than any other vaccine to date — under 1 year. The previous record breaker was the mumps vaccine, which was developed in 4 years.

There are a number of reasons the COVID-19 vaccines were developed more quickly, none of which reduces its safety profile.

For instance, scientists were not starting from scratch. Although SARS-CoV-2 was new to science, researchers have been studying coronaviruses for decades.

Also, because COVID-19 has touched every continent on earth, the process of vaccine development involved an unprecedented worldwide collaboration. And, while many scientific endeavors face funding difficulties, COVID-19 researchers received funding from a wide range of sponsors.

Another factor that slows vaccine development is recruiting volunteers. In the case of COVID-19, there was no shortage of people who wanted to help.

Also, under normal circumstances, clinical trials are run sequentially. But in this instance, scientists could run some trials simultaneously, which saved a great deal of time.

These factors and more meant that the vaccine could be developed swiftly without compromising safety.

In short: identifying the virus was quicker; we already had experience with similar pathogens; technology has moved on since the 1980s; every government on earth had a vested interest; and there were few financial restraints.

2. The vaccine will alter my DNA

Some COVID-19 vaccines, including the Pfizer-BioNTech and Moderna vaccines, are based on messenger RNA (mRNA) technology. These vaccines work differently to traditional types of vaccine.

Classical vaccines introduce an inactivated pathogen or part of a pathogen to the body to “teach” it how to produce an immune response.

By contrast, an mRNA vaccine delivers the instructions for making a pathogen’s protein to our cells. Once the protein is created, the immune system responds to it, priming it to respond to future attacks by the same pathogen.

However, the mRNA does not hang around in the body, and it is not integrated into our DNA. Once it has provided the instructions, the cell breaks it down.

In fact, the mRNA will not even reach the cell’s nucleus, which is where our DNA is housed.

3. COVID-19 vaccines can give you COVID-19

The COVID-19 vaccines cannot give an individual COVID-19. Regardless of the type of vaccine, none contains the live virus. Any side effects, such as headache or chills, are due to the immune response and not an infection.

4. The vaccine contains a microchip

A YouGov poll conducted in the U.S. last year asked 1,640 people a range of questions about COVID-19. An incredible 28% of respondents believe that Bill Gates plans to use the COVID-19 vaccinations as a vehicle to implant microchips into the population.

According to some, this microchip will allow shadowy elites to track their every move. In reality, our mobile phones already complete that task effortlessly.

There is no evidence that any of the COVID-19 vaccines contains a microchip.

Although the specifics vary from conspiracy theory to conspiracy theory, some believe that the vaccine contains radio-frequency identification tags. These consist of a radio transponder, radio receiver, and transmitter. It is not possible to shrink these components to a size small enough to fit through the end of a needle.

5. COVID-19 vaccines can make you infertile

There is no evidence that the COVID-19 vaccines impact fertility. Similarly, there is no evidence that they will endanger future pregnancies.

This rumor began because of a link between the spike protein that is coded by the mRNA-based vaccines and a protein called syncytin-1. Syncytin-1 is vital for the placenta to remain attached to the uterus during pregnancy.

However, although the spike protein does share a few amino acids in common with syncytin-1, they are not even nearly similar enough to confuse the immune system.

The rumor appears to have begun courtesy of Dr. Wolfgang Wodarg. In December of last year, he petitioned the European Medicines Agency to halt COVID-19 vaccine trials in the European Union. Among his concerns was the syncytin-1 “issue” mentioned above.

Dr. Wodarg has a history of skepticism toward vaccines and has downplayed the severity of the COVID-19 pandemic. Dr. Wodarg and the former vice president and chief scientist of Pfizer Inc. pharmaceuticals joined voices to make claims about the vaccine producing infertility, thus stoking widespread fears.

However, there is no evidence that any COVID-19 vaccine affects fertility.

6. The COVID-19 vaccine contains fetal tissue

Over the years, anti-vaxxers have spread rumors that vaccines contain fetal tissue. Neither the COVID-19 vaccines nor any other vaccine contains any tissue from fetuses.

As Dr. Michael Head, a senior research fellow at the University of Southampton in the United Kingdom, told the BBC, “There are no fetal cells used in any vaccine production process.”

7. People who have had COVID-19 do not need the vaccine

Even people who have tested positive for SARS-CoV-2 in the past should be vaccinated. As the Centers for Disease Control and Prevention (CDC) write:

“Due to the severe health risks associated with COVID-19 and the fact that reinfection with COVID-19 is possible, [a] vaccine should be offered to you regardless of whether you already had [a SARS-CoV-2] infection.”

There is also a chance that the initial test produced a false positive — in other words, the test was positive, but there was no viral infection. For this reason, it is better to err on the side of caution.

8. After receiving the vaccine, you cannot transmit the virus

COVID-19 vaccines are designed to prevent people from becoming ill following a SARS-CoV-2 infection. However, a person who has been vaccinated may still be able to carry the virus, which means that they might also be able to transmit it.

Because scientists do not yet know whether the vaccines will prevent infection, once a person has been vaccinated, they should continue to wear a mask in public, wash their hands, and practice physical distancing as recommended by regional authorities.

9. Once I have been vaccinated, I can resume a normal life

Unfortunately, for the reasons mentioned above, this is not true.

10. The vaccine will protect against COVID-19 for life

Because scientists have only been studying the virus for around 1 year, we do not know how long immunity will last. According to the WHO:

“It’s too early to know if COVID-19 vaccines will provide long-term protection. […] However, it’s encouraging that available data suggest that most people who recover from COVID-19 develop an immune response that provides at least some period of protection against reinfection — although we’re still learning how strong this protection is and how long it lasts.”

It may be that we will need to have an annual COVID-19 shot, in the same way that we do with the flu shot.

11. People with preexisting conditions cannot take the vaccine

This is untrue. People with most preexisting conditions — including heart disease, diabetes, and lung disease — can take a COVID-19 vaccine. However, if anyone is concerned, it is always advisable to speak with a doctor.

In fact, because preexisting conditions, such as obesity and heart disease, can increase the risk of developing more severe COVID-19 symptoms, being vaccinated is even more important for people with preexisting health issues.

There is an exception: individuals who are allergic to any of the components of the vaccine should not have the shot. Anyone who has had an allergic reaction to any vaccine in the past should speak with their doctor.

However, the CDC recommend “that people with a history of severe allergic reactions not related to vaccines or injectable medications — such as food, pet, venom, environmental, or latex allergies — get vaccinated. People with a history of allergies to oral medications or a family history of severe allergic reactions may also get vaccinated.”

12. People with compromised immune systems cannot have the vaccine

Because the vaccine does not contain a live pathogen, it will not cause an infection. Therefore, individuals who have a compromised immune system can still take the vaccine. However, they may not build up immune protection to the same degree as someone with a fully functioning immune system.

The CDC also explain that few people who have a compromised immune system were involved in the vaccine trials:

“Immunocompromised individuals may receive [a] COVID-19 vaccination if they have no contraindications to vaccination. However, they should be counseled about the unknown vaccine safety profile and effectiveness in immunocompromised populations.”

13. Older adults cannot have the vaccine

This is a myth. Currently, in most countries where officials are rolling out the vaccine, older adults are being prioritized, as they are most at risk of severe illness.

Also, some of the clinical trials had specific subgroups that included older adults to check the vaccine’s safety in this population.

In Norway, 23 frail older adults died shortly after they received the Pfizer-BioNTech vaccine. This, perhaps, helps explain why this myth is gaining traction.

The Norwegian Medicines Agency (NOMA) are currently investigating the situation. Steinar Madsen, a medical director at NOMA, believes that common adverse reactions, such as fever, nausea, and diarrhea, “may aggravate underlying disease in the elderly.”

Madsen also explained that “these are very rare occurrences, and they occurred in very frail patients with very serious disease.” He went on to add,

“We are now asking for doctors to continue with the vaccination but to carry out extra evaluation of very sick people whose underlying condition might be aggravated by it.”

The take-home

It is hard to believe that not much more than 1 year ago, COVID-19 and SARS-CoV-2 were entirely unknown. Now, we have a number of viable, effective, and safe vaccines.

In this internet-fueled era, rumors grow and spread like wildfire. The addition of a significant dose of fear and anxiety provides the perfect petri dish in which to grow stubborn, dangerous myths.

The situation and the science are moving quickly, and the best advice is to ensure that you always take information from reliable sources and do not pay attention to powerful but misleading social media posts.

The novelty of the COVID-19 vaccines may seem daunting for some, and it is natural for questions to arise on their effectiveness. In this feature, we examine the difference between effectiveness and efficacy, compare the COVID-19 frontrunner vaccines to other vaccines, such as the flu shot, and compare their safety considerations.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub and follow our live updates page for the most recent information on the COVID-19 pandemic.

As Pfizer/BioNTech roll out their COVID-19 vaccine throughout the United Kingdom and the United States, the world wonders how effective it will be.

Looking at the three leading vaccines that we have previously reported on, Pfizer/BioNTech boasts 95% efficacy, the Oxford/AstraZeneca vaccine candidate has an average of 70% efficacy, while the Moderna vaccine candidate reportedly has 94.1% efficacy.

Effectiveness vs. efficacy — what is the difference?

Firstly, it is worth noting that “effectiveness” and “efficacy” are not the same. Despite news outlets frequently using them interchangeably, efficacy refers to how a vaccine performs under ideal lab conditions, such as those in a clinical trial. In contrast, effectiveness refers to how it performs in the real world.

In other words, in a clinical trial, a 90% efficacy means that there are 90% fewer cases of disease in the group receiving the vaccine compared with the placebo group.

However, the participants chosen for a clinical trial tend to be healthier and younger than those in the general population, and they generally have no underlying conditions. Furthermore, researchers do not normally include certain groups in these studies, such as children or pregnant people.

So, while a vaccine can prevent disease in a trial, we might see this effectiveness drop when administered to the wider population.

However, that is not in itself a bad thing.

Globally, diabetes is becoming increasingly prevalent, as are the myths and misconceptions that surround it. Here, we discuss 11 of these repeated untruths.

Currently, around 1 in 10 people in the United States have diabetes. Globally, more than 422 million people are living with the disease.

Although diabetes is a familiar word, symptoms vary, and the biological mechanisms involved are complex. Because it is both common and complicated, half-truths abound.

Unfortunately, some of the myths we cover in this article increase the stigma attached to diabetes. For this reason alone, it is essential to challenge these falsehoods.

Firstly, we will briefly explain what diabetes is and highlight the differences between the three most common forms of diabetes: type 1, type 2, and gestational diabetes.

Type 1 diabetes is an autoimmune disease in which the immune system attacks the pancreas cells that create insulin. It tends to occur earlier in life than type 2 diabetes. In type 2 diabetes, the body does not make enough insulin, does not respond well to insulin, or both.

At least 90% of people with diabetes in the U.S. have type 2.

Gestational diabetes, as the name suggests, occurs during pregnancy. During pregnancy, the body needs more insulin. Gestational diabetes occurs when the body cannot meet these new requirements.

Although gestational diabetes usually goes away after birth, there is a risk of developing it again during future pregnancies and developing type 2 diabetes later in life.

1. Eating sugar causes diabetes

Eating sugar does not directly cause diabetes. However, consuming a sugary diet can lead to overweight and obesity, which are risk factors for type 2 diabetes.

This is a common myth, perhaps understandably — blood sugar levels play an essential role in diabetes. Sugar itself, though, is not a causal factor.

As ever, the story is complex: there does appear to be a link between regularly drinking soda and risk for type 2 diabetes.

One large study published in 2013 found that, even after controlling for energy intake and body mass index (BMI), drinking soda has links with an increased risk of developing the disease. The study did not find this association in relation to other drinks, such as artificially-sweetened beverages and fruit juices.

Scientists still do not understand why some people develop type 1 diabetes, and others do not. However, nutrition is not a risk factor.

2. Diabetes is not serious

Perhaps because diabetes is so common, some people believe that it is not a serious disease. This is incorrect. There is no cure for diabetes, and there are a host of complications that can occur if a person does not manage the condition well.

Complications include cardiovascular disease, nerve damage, kidney damage, blindness, skin conditions, and hearing impairment.

In 2018, diabetes was the underlying cause of 84,946 deaths in the U.S. The World Health Organization estimate that diabetes caused the death of 1.6 million people in 2016.

3. Diabetes only affects people with obesity

Overweight and obesity are risk factors for type 2 diabetes and gestational diabetes, but the condition can occur in people of any weight. According to data from the Centers for Disease Control and Prevention (CDC) National Diabetes Statistic Report, 2020, 11% of people with type 2 diabetes in the U.S. are neither overweight nor obese.

Type 1 diabetes has no associations with body weight.

4. Obesity always leads to diabetes

Although obesity increases the risk of diabetes, it does not inevitably lead to the disease. According to the CDC, an estimated 39.8% of adults in the U.S. have obesity, but 13% have diabetes.

5. People with diabetes cannot eat sugar

People with diabetes certainly do need to manage their diets carefully: monitoring carbohydrate intake is important. However, they can still incorporate treats.

The American Diabetes Association explain:

“The key to sweets is to have a very small portion and save them for special occasions, so you focus your meals on healthier foods.”

Individuals with diabetes need to carefully plan what and when they will eat to ensure that their blood sugar levels remain balanced.

A related myth is that people with diabetes need to eat special “diabetes-friendly” foods. These products are often more expensive, and some can still raise glucose levels.

6. Diabetes always leads to blindness and amputation

Thankfully, this is a myth. While it is true that diabetes can lead to blindness and amputations in some cases, it is not inevitable. And for individuals who manage their condition carefully, these outcomes are rare.

The CDC estimate that 11.7% of adults with diabetes have some level of vision impairment. Lower-extremity amputation occurs in around 0.56% of people with diabetes in the U.S.

Experts have identified several risk factors that increase the likelihood of experiencing diabetes-related complications. These include obesity and overweight, smoking, physical inactivity, high blood pressure, and high cholesterol.

7. People with diabetes should not drive

A diabetes diagnosis does not automatically mean that someone needs to stop driving. In a position statement on diabetes and driving, the American Diabetes Association explain:

“Most people with diabetes safely operate motor vehicles without creating any meaningful risk of injury to themselves or others.”

However, they also explain that, if concerns arise, people should undergo assessment on an individual basis. According to the U.S. Department of Transportation:

“People with diabetes are able to drive unless they are limited by certain complications of diabetes. These include severely low blood glucose levels or vision problems. If you are experiencing diabetes-related complications, you should work closely with your diabetes healthcare team to find out if diabetes affects your ability to drive.”

8. Prediabetes always leads to diabetes

In the U.S., an estimated 88 million, or 1 in 3, adults have prediabetes. Prediabetes is a condition where blood sugar levels are higher than normal but not quite high enough to classify as diabetes. If left unchecked, prediabetes can develop into type 2 diabetes.

However, it is not a given. Lifestyle changes can turn the tide. Regular physical activity and a more healthful diet can stop diabetes in its tracks.

9. People with diabetes cannot be active

Once again, this is untrue. In fact, exercise is an important component in the management of diabetes. Among other things, exercise helps drive weight loss and reduces blood pressure, both of which are risk factors for complications. It can also help the body use insulin better.

However, exercise can impact blood sugar levels in various ways, sometimes increasing it and, at other times, decreasing it.

According to Diabetes U.K., “Some days, you’ll do exactly the same type of activity and eat the same foods, but your blood sugar levels may act differently to what you’d expect.”

They also offer tips for managing blood sugar during activity:

• Check your blood sugar while exercising and keep a record of how it behaves to show your doctor. This can help guide any necessary changes in insulin.
• For people who are at risk of hypos, keep fast-acting carbohydrates close to hand.
• Wear diabetes identification so that people can help if needed.

10. You can ‘catch’ diabetes

This is a myth. Pathogens do not cause diabetes, so a person cannot pass it to someone else. Doctors classify it as a noncommunicable disease.

11. Some natural products cure diabetes

Currently, there is no cure for diabetes. Any claims that a product can cure diabetes are false. Many herbal or natural products will do little or nothing and, in some cases, they can potentially cause harm; diabetes.co.uk explain:

“Because certain herbs, vitamins, and supplements may interact with diabetes medications (including insulin) and increase their hypoglycemic effects, it is often argued that using natural therapies could reduce blood sugars to dangerously low levels and raise the risk of other diabetes complications.”

Diabetes is a complex but common disease. As its prevalence increases, it is essential to overturn myths as we find them.

Although obesity is common, there are many misconceptions associated with it — and these myths often fuel social stigma. In this edition of Medical Myths, we tackle five of the most common misunderstandings about obesity.

According to the Centers for Disease Control and Prevention (CDC), in the United States, 42.4% of adults have obesity. Globally, the World Health Organization (WHO) estimate that around 650 million adults have obesity.

People are growing increasingly aware of the health issues associated with obesity. However, despite public health campaigns, myths continue unabated. Many of the most common myths drive stigma that can impact the mental health of people with obesity.

For instance, the results of one 2020 meta-analysis on the subject indicate “a stronger association between weight stigma and diminished mental health with increasing body mass index [BMI].”

Addressing the myths that surround obesity is important. With this in mind, this article will tackle five of the most prevalent misunderstandings around this condition.

1. To reduce obesity, just eat less and move more

In many cases, consuming more calories than the body needs for a prolonged amount of time is the direct cause of obesity. Indeed, the vast majority of measures for reducing obesity aim to lower caloric intake, increase physical activity, or both.

Although diet and exercise are important factors, several unrelated factors can also play a significant part in obesity.

These factors, which people often forget about, include insufficient sleep, psychological stress, chronic pain, endocrine (hormone) disruptors, and the use of certain medications.

In these cases, overeating, for instance, may be a symptom rather than a cause.

Also, some of these factors work together to increase the chance of obesity. As an example, stress can increase the chance of obesity. Due to the prevalence of weight stigma, obesity can be stressful for some people, thereby increasing stress levels and sparking a negative feedback loop.

Added to this, stress can impact sleep quality, and this, in turn, might cause sleep deprivation, which is another factor in the development of obesity. Sleep deprivation also appears to increase stress levels. As one paper explains, “stress hormone levels correlate positively with decreased sleep duration.”

Sleep apnea, wherein a person stops breathing for short periods during sleep, is more prevalent in people with overweight or obesity. Again, a cycle can form: As they gain weight, their sleep apnea may worsen, which can lead to sleep deprivation, which can lead to further weight gain.

As another example, there appears to be an association between chronic pain and obesity. The reasons for this relationship are sure to be complex and differ from person to person, but they likely include chemical factors, sleep, depression, and lifestyle.

It is not difficult to see how chronic pain would both increase stress levels and impact sleep, adding to the negative loops outlined above.

Stress, sleep, and pain are just three interlinking factors that can drive obesity. Each person’s case will be different, but simply receiving an instruction to “move more and eat less” might not be an adequate intervention.

As this article will continue to reiterate, calorie intake and exercise are vital factors in reducing obesity, but they do not tell the whole tale.

2. Obesity causes diabetes

Obesity does not directly cause diabetes. It is a risk factor for type 2 diabetes, but not everyone with obesity will develop type 2 diabetes, and not everyone with type 2 diabetes has obesity.

Obesity is also a risk factor for gestational diabetes, which occurs during pregnancy, but it is not a risk factor for type 1 diabetes.

3. People with obesity are lazy

An inactive lifestyle is a factor in obesity, and becoming more active can aid weight loss, but there is more to obesity than inactivity.

One 2011 study used accelerometers to measure the activity levels of 2,832 adults, aged 20–79 years, for 4 days. Their step counts reduced as their weight increased, but the differences were not as significant as one might predict, particularly for women.

The list below shows the women’s weights and how many steps they took per day during this study:

• those with a “healthy” weight: 8,819 steps
• those with overweight: 8,506 steps
• those with obesity: 7,546 steps

When one considers that someone with overweight or obesity expends more energy with each step, the difference between the groups’ overall energy expenditures may be even more slight.

This does not mean that physical activity is not essential for good health, but the story is more complex.

Another factor to consider is that not all people are able to perform physical activity. For instance, some physical disabilities can make moving challenging or impossible.

Also, certain mental health issues can severely impact motivation — and there appears to be a relationship between depression and obesity, which further deepens the complexity.

Aside from physical and mental health issues, some people with obesity may also have a negative body image, which might make leaving their home a more daunting prospect.

4. If your close relatives have obesity, so will you

The relationship between obesity and genetics is complex, but someone whose relatives have obesity will not necessarily develop the condition themselves. However, their chance of doing so is higher.

Understanding the role of genes and the environment in isolation is difficult; people who share similar genes often live together and, therefore, may have similar dietary and lifestyle habits.

In 1990, a group of researchers published a study that helped split genes from the environment. The results appeared in The New England Journal of Medicine.

The scientists investigated twins who had been brought up apart and compared them with twins who had been brought up together. In this way, they hoped to tease apart the impact of genetics and the environment. Overall, they conclude:

“Genetic influences on [BMI] are substantial, whereas the childhood environment has little or no influence.”

One twin study from 1986 reached similar conclusions. The researchers found that the weights of adopted children correlated with the weights of their biological parents, but not with those of their adoptive parents.

Although more recent studies have identified a more significant role for the environment, genetics do appear to play an important part in obesity.

In recent years, scientists have searched for the genes that influence the chance of obesity. As the CDC explain, in most people with obesity, “no single genetic cause can be identified. Since 2006, genome-wide association studies have found more than 50 genes associated with obesity, most with very small effects.”

One gene that is linked to obesity is a variant of a gene called FTO. This variant, according to one 2011 study, is associated with a 20–30% increased chance of obesity.

Although genetics are important, this does not mean that obesity is inevitable for someone whose relatives have the condition. The above study, which involved individuals with the FTO gene variant, looked at the role of exercise. As the paper explains:

“Using data from over 218,000 adults, the authors found that carrying a copy of the susceptibility gene increased the odds of obesity by 1.23-fold. But the size of this influence was 27% less in the genetically susceptible adults who were physically active.”

A review and meta-analysis that investigated the same gene variant came to a similar conclusion. The authors explain that people with the FTO variant “respond equally well to […] weight loss interventions and thus genetic predisposition to obesity associated with the FTO minor allele can be at least partly counteracted through such interventions.”

However, it is important to reiterate the point that these interventions alone may not be helpful for some people.

5. Obesity does not impact health

This is a myth. There are several conditions associated with obesity. For instance, obesity increases the risk of diabetes, high blood pressure, cardiovascular disease, osteoarthritis, sleep apnea, and some mental health conditions.

That said, even modest weight loss can provide health benefits. According to the CDC, “weight loss of 5–10% of your total body weight is likely to produce health benefits, such as improvements in blood pressure, blood cholesterol, and blood sugars.”

Also, a review of existing literature in the BMJ concludes that weight loss interventions “may reduce premature all-cause mortality in adults with obesity.”

Obesity is highly prevalent. Currently, the stigma surrounding the condition is unhelpful and can be damaging. We need to address it whenever we encounter it.

Although there are notable exceptions, most evidence suggests that COVID-19 is much less dangerous for children than it is for adults and infants.

Knowing the symptoms of COVID-19 in children can help parents and caregivers identify the emergency warning signs and seek appropriate care.

This article covers the symptoms of COVID-19 in children, some potential complications, and when to see a doctor.

Symptoms of COVID-19 in children

Data from both China and the United States on children with SARS-CoV-2, the virus that causes COVID-19, suggest that the risk of severe illness is lower in children than it is in adults.

A study of 2,752 cases of COVID-19 in children found that three had died, though the exact cause of death in each case is under investigation.

Current evidence suggests that infants have a higher rate of hospitalization, with some requiring treatment in intensive care units.

In China, more than 90% of children with COVID-19 had no symptoms and only mild-to-moderate disease.

The following are some symptoms that children may experience:

• Fever: Although most adults report a fever with COVID-19, fevers are slightly less common among children, according to data from the Centers for Disease Control and Prevention (CDC).
• Flu-like symptoms: Around 73% of children with COVID-19 had a fever, cough, or shortness of breath. Shortness of breath is much less common in children. In one analysis, 43% of adults and just 13% of children had this symptom.
• Respiratory tract symptoms: Children with mild forms of the illness may develop a runny nose, cough, or sore throat.
• Digestive symptoms: Some children develop vomiting, diarrhea, or nausea.
• Changes in the sense of smell: A 2020 analysis found that most adults with COVID-19 lose their sense of smell. Researchers have not assessed this symptom in young people, but children may also lose their sense of taste or smell.
• Pain: Children with COVID-19 may develop muscle pain or a headache.
• Behavioral changes: Children may be moody or cry more often, especially if they are too young to verbally express their emotions or identify their symptoms. Some children may also be anxious, especially if they know that COVID-19 can be dangerous.

Overall, COVID-19 symptoms tend to be less severe in children. Children are also less likely than adults to report each symptom.

Complications

Children with underlying health conditions — such as lung disease, heart disease, or a weak immune system — are more susceptible to serious COVID-19 complications.

A CDC study that assessed COVID-19 symptoms in children used data on hospitalization and underlying medical conditions for 295 children. In that group, 77% of hospitalized children had at least one other medical condition. This suggests that comorbidities are a significant risk factor for hospitalization in children.

Even among high risk children, however, the risk of dying from COVID-19 is very low. Of 2,143 children included in a Chinese CDC study, just one 14-year-old died. Also, as above, 3 out of 2,572 children in a CDC study died, though the cause in each case is currently unconfirmed.

Some other potential complications include:

• organ failure
• the need to use a ventilator
• sepsis, which is a severe infection that affects many systems in the body
• heart failure
• issues that can cause life threatening blood clots

Children with severe symptoms usually develop them within a week of getting sick.

A small number of children have also developed symptoms of multisystem inflammatory syndrome in children (MIS-C). This syndrome can cause symptoms that resemble those of toxic shock syndrome and Kawasaki disease. Without treatment, it may be fatal.

Children with MIS-C may develop a rash, stomach pain, bloodshot eyes, exhaustion, diarrhea, or vomiting.

The following symptoms require emergency medical attention:

• confusion
• fever
• chest pressure or pain
• neck pain
• difficulty breathing
• blue or white face, fingers, or toes
• an inability to stay awake
• severe stomach pain

When to see a doctor

Most children have either no symptoms or only mild-to-moderate ones. These children do not need to go to the hospital or see a doctor.

However, parents and caregivers should call a pediatrician if their child shows any symptoms of COVID-19. The pediatrician can offer advice on which symptoms to watch and some suggestions for home treatment.

In some areas, a child may also need a referral for COVID-19 testing.

Call a doctor if:

• the child seems very ill
• they develop a rash
• their symptoms get better and then get worse again
• they recover from COVID-19 but then develop inflammatory symptoms, such as a rash, fever, or bloodshot eyes

Go to the emergency room if a child:

• gasps for air or shows signs of respiratory distress, such as bluish lips, breathing very fast, or difficulty breathing
• seems confused, seems lethargic, or cannot wake up
• reports pressure or pain in their chest
• has symptoms of organ failure, such as intense pain in the stomach, difficulty passing urine, an inability to move without help, or an inability to think clearly

Treatment

No medication can cure COVID-19. Although hospitals and researchers are exploring experimental treatments, these are currently only available to very sick people.

Most children can recover with home treatment. To help a child with COVID-19:

• Encourage them to rest.
• Give them lots of fluids to prevent dehydration.
• Check on them regularly to ensure that they are not getting worse.
• Ask a doctor about over-the-counter pain and fever relievers.
• Have them stay in a single area of the house, if possible. Clean and disinfect all surfaces they touch, and encourage other family members to avoid them. Also, wear a face mask when caring for a sick child.

Parents and caregivers may find these guidelines challenging to follow when caring for a child or infant. The CDC offer some advice on how to manage risk around children.

It may also be a good idea to speak to a medical professional about how best to care for a child with a suspected SARS-CoV-2 infection. Children under 2 years of age should not wear a face covering.

Very sick children may need to go to the hospital. In the hospital, doctors will focus on managing the child’s symptoms. They might need oxygen, intravenous fluids, or steroid medications to help them breathe.

Rarely, a child might need a ventilator if they cannot breathe well on their own.