Children should be offered vaccination against COVID-19

Since the start of the COVID-19 pandemic, there has been conflicting evidence on SARS-CoV-2 infection and transmission in children. Early studies reported only anecdotal outbreaks in school settings and low case numbers in children, driving speculation that the virus may not be as easily spread in this age group. However, these reports are unlikely to have represented the true frequency of infections, given the widespread school closures implemented to cut transmission opportunities and limitations of swab testing in children (lower uptake, swab volumes) resulting in missed cases. Indeed, subsequent studies measuring viral load in children reveal similar levels and trajectories as adults, indicating that children can readily transmit the virus and can accelerate infections throughout communities. In the midst of a fourth COVID-19 wave and a resurgence of cases in Canada, the majority with the highly transmissible and virulent B.1.617.2 (delta) variant, we discuss the pressing need for vaccination of children.