Children With CF and COVID-19

As a community, we are very good at masking and keeping a safe distance to reduce risk from germs. And just like we have highly effective therapies to treat CF, we now have highly effective vaccines to protect our kids from COVID-19.

| 5 min read
Lael Yonker headshot
Lael Yonker, MD
Handwritten sign from a child thanking doctors for their research for COVID-19.

When the pandemic first hit, cystic fibrosis was considered a major risk factor for hospitalization for COVID-19, so people with CF followed a familiar routine: they masked up and kept their distance. People with CF followed these safety precautions so well that we began to wonder if CF, in some way, could be protective against COVID-19. But this has not born out. People of all ages and all health statuses are equally likely to become infected with COVID-19. Clear risk factors have emerged for developing severe disease (like obesity, diabetes, older age), and CF remains on this list. So, as a community we have to stay vigilant.

Handwritten sign from a child thanking doctors for their research for COVID-19.

As a pediatric pulmonologist and physician-scientist focused on infection and inflammation in CF, I collect samples like blood and sputum to understand why people get sick. When COVID-19 hit, I pivoted my skills to focus on COVID-19 and how the virus affects children. I’ve been closely tracking the CF community to see if there are reasons people with CF should be more careful or follow any specific guidance. What I’ve learned is to never assume anything, to keep an open mind through the ebb and flow of the pandemic, and that none of us are safe from this virus. Not people with CF, not children. To date, more than 250 adults with CF and almost 61 children with CF have been hospitalized due to COVID-19, and 17 people with CF have died. In the general pediatric population, roughly 25,000 children have been hospitalized for COVID and hundreds have died. But there’s been a clear shift: people vaccinated against COVID-19 are much less likely to be hospitalized or die from COVID-19. 

This is a graph of the number of COVID-19 cases in children each week in the United States from April 23, 2020 to November 4, 2021.
The number of COVID-19 cases in children each week in the United States from April 23, 2020 to November 4, 2021.

Of course, there are caveats. Individuals who have undergone lung or liver transplantation and are immunosuppressed may not respond fully to vaccines, leaving them vulnerable. And we are learning that vaccines wane over time and we’ll all eventually need boosters.

But vaccines are one of the essential ways for us to make our way to the other side of this pandemic -- to hug, comfortably dine inside, and lose the masks (*except for walking to/from the doctor’s office).

Thankfully, COVID-19 vaccines are here and more than one-third of individuals with CF report that they have been fully vaccinated. What are the other two-thirds waiting for?

Perhaps your child with CF is too young. Good news -- vaccines have been authorized for children ages 5-11 years and my two children will be getting vaccinated the day they become available. We’ve seen cases rise as schools started, and they are anticipated to rise even more over the winter. It’s now time to protect these kids so they can more safely enjoy the holidays with family. There have been concerns about developing myocarditis after the vaccine but none of the nearly 2,000 patients in Pfizer’s vaccine study developed myocarditis. And bear in mind, people, including children, infected with COVID-19 can also develop myocarditis at much higher rates, and these kids tend to be much sicker than people who develop transient myocarditis following vaccination. So, the benefits of vaccination far outweigh the unlikely risks.

The left graph shows that children with mild infection can carry high viral loads, and viral load does not impact severity of COVID-19. The right graph shows that age does not impact how infectious a child may be.
Left graph: Even children with mild infection can carry high viral loads, and viral load does not impact severity of COVID-19. Right graph: Age does not impact how infectious a child may be.

Perhaps people aren’t getting vaccinated because the vaccine is too new. But now more than 190 million people in the U.S. are now fully vaccinated. We’ve learned vaccines continue to be highly effective at preventing severe COVID-19, just like the studies showed.

Compare these COVID-19 vaccines to Trikafta®. We trusted Trikafta and it works! Trikafta (and the other highly effective CFTR modulators) improves lung function and keeps people healthy so they can live longer, healthier lives. It has been extensively studied in the CF community, and although it’s relatively new, we are confident in the data from the research studies and from real-world use from tens of thousands of people on Trikafta. So, let’s give vaccines the same opportunity to keep us healthy.

Parents should talk with their doctors about the COVID-19 vaccine if they have questions and you can find local vaccination sites at vaccines.gov, via local health departments, local school systems, and pediatrician’s offices.

This pandemic is far from over. We’ve endured more than 18 months of mask use and social distancing. We are tired and want normalcy. We must protect ourselves, our children, and the more vulnerable members of our community to get through this pandemic. Vaccinate yourselves and your kids, get the booster, and hang in there.

Interested in sharing your story? The CF Community Blog wants to hear from you.

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Coronavirus (COVID-19) | Parents & Guardians
Lael Yonker headshot

Dr. Yonker is a pediatric pulmonary physician-scientist, committed to improving the care of children with cystic fibrosis. Since the outset of the COVID-19 pandemic, she has led the Pediatric COVID-19 Biorepository at the Massachusetts General Hospital and has helped shape our understanding of how SARS-CoV-2 effects newborns, infants, children, and young adults. She is investigating the impacts of viral load and immune responses in children with SARS-CoV-2 infection or the late COVID-19-related inflammatory illness, multisystem inflammatory syndrome in children. She is also studying how people with CF respond to the COVID-19 vaccine.   

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This site contains general information about cystic fibrosis, as well as personal insight from the CF community. Opinions and experiences shared by members of our community, including but not limited to people with CF and their families, belong solely to the blog post author and do not represent those of the Cystic Fibrosis Foundation, unless explicitly stated. In addition, the site is not intended as a substitute for treatment advice from a medical professional. Consult your doctor before making any changes to your treatment.