“We immediately called the pediatrician who initially said it was unlikely for him to have COVID-19 again so quickly,” Christine recalls. “But his test came back positive. He had it again.” COVID-19 reinfection is definitely possible and there are a few reasons why we are starting to see more kids testing positive two or even three times. “The virus wants to evolve so that it can survive,” explains Ilan Shapiro, MD, FAAP, FACHE, chief health correspondent and medical affairs officer at AltaMed Health Services and a fellow of the American Academy of Pediatrics (AAP). “We are seeing it evolve to be more infectious and contagious. It can outsmart our immune system, leading to reinfection.”
Why Are Kids Getting Reinfected?
Reinfection isn’t necessarily specific to children, but there are a few reasons why it may be more common in kids. Many children were not exposed to the original version of the virus at the start of the pandemic. They may have been under a strict lockdown and some were not even born yet. So their bodies may not have built up the same immunity that adults going to work and grocery shopping may have. While kids may have had less exposure early on, they may have more chances to become infected now that schools are open. “Kids are in close proximity in classrooms and a lot of schools are no longer asking them to wear a mask,” notes Dr. Shapiro. Lower vaccination rates may also contribute to more reinfection in children.
How Common Is Reinfection in Children?
Fortunately, reinfection is not particularly common in children, though it is possible. Research indicates that kids have a much higher immune response to COVID-19 than adults, which would presumably make reinfection less likely.
How Soon Can My Child Get COVID-19 Again?
The exact time when reinfection becomes possible will vary from person to person, but generally, a COVID-19 infection will offer immunity for three to five months before that immunity begins to wane. Being vaccinated adds another layer of protection by further boosting immunity. In Ryan’s case, it only took eight weeks. “Our first thought when he became symptomatic shortly after we tested positive was ‘No way can he have COVID-19 again so quickly!’ because we felt like he just had it,” says Christine. “The pediatrician really had no insight on why he tested positive again so quickly, but did mention that it had to be a different variant the second time.”
Do Variants Like BA.5 Play A Role in Reinfection?
Immunity fades over time, but the virus also changes and evolves. This is why we are seeing variants, including the latest, BA.5. Even if your immunity is still strong for a previous version of the virus, your body may not recognize or be prepared to fight the latest variant. The BA.5 variant is highly transmissible, and appears to be better at sidestepping prior immunity from infections and vaccines, meaning it has an increased ability to reinfect people.
Should I Be Concerned If My Child Is Reinfected?
If your kids get COVID-19 more than once, it does not mean that anything is wrong with them. “Becoming infected is not a sign of a weak immune system,” says Dr. Shapiro. “It’s actually the virus adapting to us and trying to jump from one person to another in a better and more efficient way.” There is not currently enough data to know whether multiple infections have any long-term negative effects. Becoming reinfected does increase the risk of long-haul COVID-19 or Multisystem Inflammatory Syndrome in Children (MIS-C), but that is only because the additional infections provide another chance for these conditions to develop.
Preventing COVID-19 Reinfection in Children
If your child is age 6 months or older, getting vaccinated will reduce the chance of reinfection. On top of vaccination, the best way to prevent reinfection in children is to continue teaching them protocols that reduce the virus’s chance of entering their bodies. Unfortunately, we can’t assume that a prior infection will prevent our kids from testing positive for COVID-19 a second or third time. Although it makes it less likely and symptoms tend to be milder in those who are vaccinated. As tired as we are all getting of hearing how can prevent COVID-19, the same basic rules do apply. Emphasize hand washing and have your kids do outdoor activities whenever possible. In situations where kids will be in close proximity to one another and indoors, consider having them wear a mask. “This virus is giving us a lot of surprises, so it is important to make sure that we are creating as many barriers as we can,” says Dr. Shapiro. “We want to make it a little more difficult for the virus to jump from one person to another.” After her son’s reinfection, Christine says she is quicker to reach for a test kit if anyone in her family is not feeling well. The family continues to be especially vigilant about large gatherings. “Ryan definitely gets a bit nervous when he is not feeling well, but keeps a good sense of humor about it,” she says. Luckily, no one in her household has gotten COVID-19 since.
