Child and Adolescent Mortality

Although illness and hospitalization are lower among children and adolescents with COVID-19 compared with adults, COVID-19 can lead to severe symptoms that might require admission to an intensive care unit or result in death.22, 23, 24, 25 Children and adolescents with one or more underlying medical conditions are at greater risk of severe symptoms.26 In the United States, one in four children has a chronic condition, including asthma, obesity, diabetes, or neurodevelopmental disorders.27, 28

Figure 16: Number of deaths from COVID-19 among children ages 0–17 by age, gender, and race and Hispanic origin, 2020 and 2021 (provisional)
Number of deaths from COVID-19 among children ages 0–17 by age, gender, and race and Hispanic origin, 2020 and 2021 (provisional)

NOTE: NH = non-Hispanic origin. Deaths from COVID-19 are classified according to the underlying cause-of-death code *U07.1 from the International Classification of Diseases, 10th Revision. It can take several weeks for death records to be submitted to the National Center for Health Statistics, processed, and tabulated. Therefore, the data shown in this figure may be incomplete and will likely not include all deaths that occurred during the given time periods, especially data for 2021. Provisional deaths for 2021 are based on a current flow of mortality data in the National Vital Statistics System. Provisional counts include deaths occurring in the 50 states and the District of Columbia that have been received through April 16, 2022, as of May 1, 2022. Data on race and Hispanic origin are collected and reported separately. The race categories are based on the 1997 U.S. Office of Management and Budget standards on race and ethnicity and all categories are single race. Persons of Hispanic origin may be of any race. The "Total" includes children who classify as American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and "Two or more races." The number of deaths for these race groups are not shown separately because the number of deaths are too small to meet reporting standards.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

  • In 2020, 141 children ages 0–17 died from COVID-19 (0.2 deaths per 100,000 population). In 2021, deaths from COVID-19 among children increased to 434 (0.6).
  • In both 2020 and 2021, the number of deaths due to COVID-19 among children under age 12 were higher than the number among adolescents ages 12–17. However, the rates were higher among adolescents.
  • Males were more likely to die from COVID-19 than females in both 2020 and 2021 based on number of deaths and rates. Among males, deaths increased from 79 in 2020 to 241 in 2021. Among females, deaths increased from 62 in 2020 to 193 in 2021.
  • From 2020 to 2021, deaths from COVID-19 increased for all race and Hispanic-origin groups shown.
  • In both 2020 and 2021, Black, non-Hispanic children had higher death rates from COVID-19 (0.4 and 1.2) than Hispanic (0.3 and 0.6) and White, non-Hispanic (0.1 and 0.4) children.

Figure 17: Number of deaths for selected leading causes of death among children under age 12 by cause of death, 2020
Figure 17: Number of deaths for selected leading causes of death among children under age 12 by cause of death, 2020

NOTE: CLRD = chronic lower respiratory diseases. Cause of death is classified according to the International Classification of Diseases, 10th Revision. Provisional 2021 data are not used for leading causes of death because any reclassifications of cause of death in final data may affect the rank order of causes. Rates are less likely to change due to a few reclassified deaths because they are based on the number of deaths per 100,000 population.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

  • In 2020, unintentional injuries were the leading cause of death among children under age 12, accounting for 12.5% of deaths. Deaths from COVID-19 accounted for only 0.3% of deaths among children.
  • Among children under age 12 in 2020, 3,300 died from unintentional injuries; 893 died from cancer; 806 died from homicide; 438 died from heart disease; 284 died from influenza and pneumonia; 208 died from cerebrovascular diseases; 185 died from septicemia; 120 died from chronic lower respiratory diseases; 87 died from suicide; and 80 died from COVID-19.

Figure 18: Number of deaths for selected leading causes of death among adolescents ages 12–17 by cause of death, 2020
Figure 18: Number of deaths for selected leading causes of death among adolescents ages 12–17 by cause of death, 2020

NOTE: CLRD = chronic lower respiratory diseases. Cause of death is classified according to the International Classification of Diseases, 10th Revision. Provisional 2021 data are not used for leading causes of death because any reclassifications of cause of death in final data may affect the rank order of causes. Rates are less likely to change due to a few reclassified deaths because they are based on the number of deaths per 100,000 population.

SOURCE: National Center for Health Statistics, National Vital Statistics System.

  • In 2020, unintentional injuries accounted for 31.4% of deaths among adolescents ages 12–17, followed by suicide (20.4%) and homicide (16.1%). Deaths from COVID-19 accounted for only 0.8% of deaths among adolescents.
  • Among adolescents ages 12–17 in 2020, 2,446 died from unintentional injuries; 1,592 died from suicide; 1,253 died from homicide; 568 died from cancer; 219 died from heart disease; 102 died from chronic lower respiratory diseases; 75 died from diabetes; 66 died from influenza and pneumonia; 64 died from cerebrovascular diseases; and 61 died from COVID-19.

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22 Siegel, D. A., Reses, H. E., Cool, A. J., Shapiro, C. N., Hsu, J., Boehmer, T. K., ... & Raizes, E. (2021). Trends in COVID-19 cases, emergency department visits, and hospital admissions among children and adolescents aged 0–17 years—United States, August 2020–August 2021. Morbidity and Mortality Weekly Report, 70(36), 1249.

23 Kim, L., Whitaker, M., O'Halloran, A., Kambhampati, A., Chai, S. J., Reingold, A., ... & COVID-NET Surveillance Team. (2020). Hospitalization rates and characteristics of children aged< 18 years hospitalized with laboratory-confirmed COVID-19—COVID-NET, 14 States, March 1–July 25, 2020. Morbidity and Mortality Weekly Report, 69(32), 1081.

24 Bialek, S., Gierke, R., Hughes, M., McNamara, L. A., Pilishvili, T., & Skoff, T. (2020). Coronavirus disease 2019 in children—United States, February 12–April 2, 2020. Morbidity and Mortality Weekly Report, 69(14), 422.

25 Fernandes, D. M., Oliveira, C. R., Guerguis, S., Eisenberg, R., Choi, J., Kim, M., ... & Research Consortium. (2021). Severe acute respiratory syndrome coronavirus 2 clinical syndromes and predictors of disease severity in hospitalized children and youth. Journal of Pediatrics, 230, 23–31.

26 Kompaniyets, L., Agathis, N. T., Nelson, J. M., Preston, L. E., Ko, J. Y., Belay, B., ... & Goodman, A. B. (2021). Underlying medical conditions associated with severe COVID-19 illness among children. JAMA Network Open, 4(6), Article e2111182.

27 Van Cleave, J., Gortmaker, S. L., & Perrin, J. M. (2010). Dynamics of obesity and chronic health conditions among children and youth. JAMA, 303(7), 623–630.

28 Lawrence, J. M., Divers, J., Isom, S., Saydah, S., Imperatore, G., Pihoker, C., ... & SEARCH for Diabetes in Youth Study Group. (2021). Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001–2017. JAMA, 326(8), 717–727.

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