COVID-19

Key Health Information

• What is COVID-19?

  COVID-19 is a disease caused by a virus called SARS-CoV-2. Most people with COVID-19 have mild symptoms, but some people become severely ill. Older adults and people who have certain underlying medical conditions are more likely to get severely ill. Long COVID (also known as post-COVID) is a wide range of health problems people can experience 4 or more weeks after they first get COVID-19. Even those who do not become severely ill from COVID-19 may experience post-COVID conditions.

• What is the risk of my child becoming sick with COVID-19?

  Children can be infected with the virus that causes COVID-19 and can get sick with COVID-19. While most children with COVID-19 have mild symptoms or they may have no symptoms at all (asymptomatic), children can still become very ill and even die from COVID-19. Babies younger than 1 and children with certain underlying medical conditions are more likely to become very ill from COVID-19. Some children have developed a rare but serious disease that is linked to COVID-19 called multisystem inflammatory syndrome (MIS-C).

• What are the symptoms of COVID-19?

  People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Symptoms of COVID-19 may include:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

  Learn more information about COVID-19 symptoms and what to do if you think you have been exposed.

  Children and teenagers who have the rare condition known as Multisystem Inflammatory Syndrome in Children (MIS-C) develop symptoms within about 6 weeks after COVID-19 infection. Children should see a doctor if they have had COVID-19 infection (or had close contact with someone with COVID-19) and develop fever plus one or more of the following symptoms: stomach pain, vomiting, diarrhea, skin rash, bloodshot eyes, dizziness or lightheadedness. Take a look at CDC’s infographic that will help you recognize symptoms and learn more about MIS-C.

• How does COVID-19 virus spread and what steps should I take to protect my family?

  COVID-19 is spread in three (3) main ways:

  • Breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus.
  • Having these small droplets and particles that contain virus land on the eyes, nose or mouth, especially through splashes and sprays like a cough or sneeze.
  • Touching eyes, nose or mouth with hands that have the virus on them.

  Learn more about how to prevent the spread of COVID-19.

• What are the treatments for COVID-19?

  The FDA approved the COVID-19 treatment Veklury (remdesivir), which can be administered to pediatric patients 28 days of age and older, weighing at least 7 pounds, who have tested positive for COVID-19. Children that receive this treatment may be hospitalized or not hospitalized. They may have mild-to-moderate COVID-19 and a higher risk for progression to severe COVID-19 which may result in hospitalization or death.

• What do I need to know about COVID variants?

  The virus that causes COVID-19 is constantly changing, and new variants of the virus are expected to occur. Sometimes new variants develop and disappear. Other times, new variants persist. Many variants of the virus that causes COVID-19 are being tracked in the United States and globally during this pandemic.

Exposure and Diagnosis

• What should I do if I am concerned that I may have been exposed to COVID-19?

  If you are concerned that you may have been exposed to COVID-19, you should immediately contact your primary care provider and follow their instructions. Learn what you should do if you think your child has been exposed to COVID-19.

• What should I do if my child has been diagnosed with COVID-19?

  If you or your child is diagnosed with COVID-19, the CDC recommends taking these steps.

• If I suspect that my child has COVID-19, should I come to the Emergency Department?

  We always recommend first contacting your pediatrician’s office. However, if you are concerned that your child is ill and needs immediate medical evaluation, we offer specialized pediatric emergency medicine services at three locations.

• What has Children's National done to prepare for COVID-19?

  Children’s National has closely monitored the outbreak of COVID-19 since it was first reported. The Children’s National Division of Infectious Diseases and Office of Infection Control/Epidemiology has developed institutional guidelines based on the CDC’s recommendations for the identification, isolation and treatment of patients who are under investigation for or have a confirmed case of COVID-19.

• How do I get my child tested for COVID-19 even if they do not have any symptoms?

  Now that children and teens are back in school, there is a high demand for testing. To help you navigate the current situation, please follow these instructions: 

  • Use over-the-counter rapid antigen tests when children need testing due to mild disease.  
  • Save visits to the doctor’s office or Emergency Department for situations where your child has more severe symptoms such as trouble breathing or shortness of breath, persistent chest pain or pressure, dehydration (no urine in 8 hours), weakness or difficulty waking up, bluish color to lips, skin or nail beds.
  • Follow your school system’s guidelines with regard to return-to-school after a COVID infection. Some schools, including District public schools, are distributing over-the-counter rapid antigen tests for this purpose. The CDC’s new rules for shortened periods of isolation after testing positive for COVID do not apply to K-12 schools and childcare centers.
  • Children under the age of 2 require a PCR COVID test administered by a physician or health department, as they are too young for over-the-counter rapid antigen tests.

  Learn more about COVID-19 testing.

COVID-19 Vaccine

• Which COVID-19 vaccines are currently available in the United States?

  • Pfizer:
    • The Pfizer vaccine is available for individuals 6 months and up. 

  • Moderna:
    • The Moderna vaccine is available for individuals 6 months and up.

  • Johnson & Johnson:
    • The Johnson & Johnson/Janssen COVID-19 vaccine is available for individuals 18 years and older.

  • Novavax:
    • The Novavax vaccine is available for individuals 18 years and older.

  Booster shots: Individuals may be eligible for booster shots based on their age. The CDC’s COVID-19 booster tool will tell you if and when your child can get boosters to stay up to date with their COVID-19 vaccines.

  The CDC website also has detailed information about the vaccines and how long you should wait between shots.

• Is Children’s National offering the COVID-19 vaccine?

  Yes. Based on recommendations from the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), Children’s National is administering the Pfizer vaccine depending on age/situation:

  • Families can schedule a COVID-19 vaccine for children 6 months and older in our primary care practices. The vaccine is also available during certain specialty care appointments and for hospitalized children when medically appropriate.
  • There are several other safe and convenient options available to families seeking vaccines for their children. We encourage families to call their pediatrician or to use schools and retail drug stores like Walgreens or CVS. Also, consider public health distribution centers in the county or city you live in to obtain the vaccine for your child. Families can visit vaccines.gov to find a location to receive the vaccine.

  Learn more in our COVID-19 vaccine FAQs.

• Was Children’s National offering the Johnson & Johnson vaccine to patients?

  Yes, after the FDA issued the Emergency Use Authorization for the Johnson & Johnson vaccine, we developed a plan to administer the vaccine to inpatients. Between April 1 and April 12, 2021, we administered 15 doses.

• Why did Children’s National pause the Johnson & Johnson vaccinations?

  We suspended our use of the Johnson & Johnson vaccine based on guidance from the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). On April 23, 2021, the CDC and the FDA recommended that the use of Johnson & Johnson’s COVID-19 vaccine could resume in the United States, after a temporary pause. We are currently only offering the Pfizer vaccine to individuals age 6 months-22.

• Do the vaccines have any short-term side effects?

  The COVID-19 vaccines are safe and effective. Millions of people in the United States have received these vaccines under the most intense safety monitoring in U.S. history.

  You may have some side effects, which are normal signs that your body is building protection. These side effects may affect your ability to do daily activities, but they should go away in a few days. Some people have no side effects. Read more from the CDC about potential side effects.

  The CDC and the FDA continue to monitor potential side effects and/or rare adverse reactions. Learn more about the ongoing safety monitoring of the COVID-19 vaccines.

• Are there any long-term side effects for the Pfizer COVID-19 vaccine?

  Some people have expressed concerns that the Pfizer vaccine may have long-term side effects. Although it is always important to consider the risks and benefits of any medical choice we make, there is no vaccine that has caused late-onset side effects (beginning more than 2 months after receiving the vaccine). All vaccines are made to disintegrate safely in your body. Vaccines introduce a non-harmful ingredient that looks like the true virus or bacteria, allowing your body to build antibodies against the virus/bacteria without getting infected.

  For the Pfizer vaccine, the non-harmful ingredient is mRNA. This acts like a recipe that our body uses to build protein. This protein is harmless but does look exactly like the protein on the outside of the novel COVID-19, so our antibodies can be prepared if it sees the real virus. mRNA, however, is literally used up as it is read by the body. In fact, the end of the mRNA recipe has instructions to break down the mRNA and stop the production of the protein.

• Will I receive official documentation of my child’s vaccination?

  We provide an official CDC-issued vaccination card with the first dose of vaccine. Please bring that card with you when your child receives their second dose. The card serves as the official documentation of the COVID-19 vaccination, so it is important not to misplace the card.

  Take a picture of the card after each dose is given and register for digital vaccine documentation with your state health department to maintain back-up proof of vaccination.

• If I misplace my child’s vaccination card; how can I receive another copy?

  Children's National Hospital cannot issue replacement vaccine cards. Please take a photo of the card as soon as you receive it. If you need to obtain documentation of your child's vaccine, please go to the health department of the state/city where you received the vaccine.

  • If your child received the vaccine in D.C. you can obtain documentation of your child’s vaccine here.
  • If your child received the vaccine in Maryland you can obtain documentation of your child’s vaccine here.

• Is the COVID-19 vaccine safe for pregnant women?

  Yes. The Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine all recommend pregnant people get vaccinated against COVID-19. 

  Because people who are pregnant or recently pregnant are more likely to get severely ill with COVID-19 compared with people who are not pregnant, getting a COVID-19 vaccine can help protect from severe illness from COVID-19. Evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy has been growing and suggests that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks of vaccination during pregnancy. Vaccination during pregnancy also builds antibodies that might protect the baby.

  Learn more about the COVID-19 vaccines and pregnancy.

Booster Shots

• What is a booster shot?

  A booster shot refers to an extra dose of a vaccine given after the original series of shots. It can be given months or years later. This is common for many vaccines and is now also recommended for the COVID-19 vaccine. The initial booster shot developed for COVID-19 is known as the monovalent booster and it contains a component from the original strain of the virus that was present in 2019. 

  The updated bivalent booster came out in fall 2022 and contains components of two strains of the virus – the original strain and the more recent omicron variant. Both Pfizer and Moderna developed bivalent boosters. The bivalent booster protects more fully against the omicron variant.

• Why is a COVID-19 booster shot recommended?

  The effectiveness of the COVID-19 vaccine can wane after several months. Booster shots strengthen your immune response to the COVID-19 virus, increasing your protection against COVID-19 infection, hospitalization and death.

• Who is eligible for a COVID-19 booster shot?

  The CDC’s COVID-19 booster tool can help you learn if and when your child can get boosters to stay up to date with their COVID-19 vaccines. Visit the CDC website to learn more about the COVID-19 booster shots.

• Are immunocompromised children eligible to receive additional doses of vaccine?

  We recommend following CDC guidelines about booster shots for immunocompromised children. Read more.

Multisystem Inflammatory Syndrome

• What is Multisystem Inflammatory Syndrome in Children (MIS-C)?

  Multisystem Inflammatory Syndrome in Children (MIS-C) is a condition in which different body parts become inflamed, such as the heart, lungs, kidneys, brain, gastrointestinal tract, skin or eyes. Children with MIS-C can have a variety of symptoms, including:

  • Fever
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Neck pain
  • Rash
  • Bloodshot eyes
  • Feeling extra tired

  We do not yet know what causes MIS-C, however many children with MIS-C have tested positive for COVID-19. While MIS-C is a serious condition, with proper medical care most children are able to recover. If you have concerns your child is suffering from MIS-C, please call your primary care provider.

  If your child presents these more severe versions of MIS-C symptoms, please seek emergency care immediately:

  • Trouble breathing
  • Pain or pressure in the chest that does not go away
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
  • Severe abdominal pain

  The link between MIS-C and COVID-19 is evolving every day, and pediatricians and researchers at Children’s National and the Centers for Disease Control (CDC) are working tirelessly to understand its current and long-term effects on children. For additional information, please visit the CDC page on MIS-C.

Blood Donation

• Is it still safe to donate blood during COVID-19?

  Yes, blood donation is safe. The blood collectors check the health of all donors before they are allowed to donate. Individuals are not at risk of contracting COVID-19 through the blood donation process or via a blood transfusion, since respiratory viruses are generally not known to be transmitted by donation or transfusion. Learn more about why you should continue to donate blood.

• Is Children’s National accepting blood donations during COVID-19?

  Yes. We are accepting blood donors at our main hospital location on 111 Michigan Avenue NW, Washington, DC.

• Can I donate blood after receiving a COVID-19 vaccine?

  Yes, you can still donate blood after receiving a COVID vaccine. There is no waiting period but make sure you are feeling well. Learn more.

Immunosuppressed Patients

• What do parents of immunosuppressed children need to know?

  We understand that you may have questions about how COVID-19 impacts your child, especially if your child is immunosuppressed due to current treatments. View our COVID-19 information for parents of immunosuppressed patients.

Visual Learning Tools for Children

• What tools are available to explain COVID-19 to visual learners?

  The Center for Autism Spectrum Disorders has developed social story booklets, an infographic and other resources to help parents explain COVID-19 to their children.

  • Autism Booklet (PDF)
  • A Kid's Guide to COVID-19 (PDF)
  • A Kid's Guide to Telehealth Visits (PDF)
  • Infographic: Tips for Your Telehealth Visit (PDF)
  • CASD Chat Newsletter - COVID-19 (PDF)

Mental Health Resources

• What crisis and mental health resources are available for families?

  Families around the world are under increased stress and anxiety due to the pandemic. In response, our team has compiled a variety of crisis and mental health resources to help you and your family get through this challenging time.

• What mental health resources are available for teens?

  We know that unexpected changes and uncertainty can be a source of stress for kids. As schools are rearranging their schedules because of the COVID-19 outbreak, some are continuing their activities via online or distance learning. In light of this, Children’s National Hospital is proud to announce that we have partnered with EVERFI, the leading technology education company, to make available an online course on mental health and wellness.

  The course, Mental Wellness Basics,* is appropriate for middle and high school students, particularly those in grades 8, 9 and 10. It is being offered free of charge to students in D.C., Maryland and Virginia through sponsorship from Children’s National.

  The four-part course offers education on the basics of mental wellness, information on understanding mental health disorders, practical and healthy coping skills that can be used immediately and resources for getting help when it’s needed.

  If your child is in grades 8, 9 or 10, the “Mental Wellness Basics” online course may be a helpful addition to their online coursework.

  *This course is for educational purposes and should not be used as a substitute for clinical care.

  Suicide Awareness Resource

  Now more than ever it is important to know the warning signs of suicide in your child. Learn more about the risk factors and how you can protect your child by communicating effectively about suicide and safety.

• Do you have mental health resources for younger children?

  Art Therapy Services is offering mental health support to patients and families through the creative process during the COVID-19 pandemic. Access our videos and related activities.

Additional Information

• Are there COVID-19 resources available in different languages?

  We offer COVID-19 resources in Spanish, as well as an educational video in American Sign Language that shares the symptoms to look out for and what you can do to help stop the spread of COVID-19.

• Where should I go for additional information?

  In addition to referencing the CDC’s website for the most up-to-date information, take a look at our webinars to help families through the pandemic and Rise and Shine, our parenting blog, COVID-19 resources.