Children and COVID-19 Research Library

The aim of the document is to identify and articulate salient ethical considerations regarding mandatory vaccinations against COVID-19. This document updates a policy brief initially published in April 2021 in response to changes in the COVID-19 vaccine landscape, including authorization of vaccines for children and additional information about, and experiences with, vaccination mandates for COVID-19.

This is the first position paper to be published by WHO on the behavioural and social drivers (BeSD) of vaccine uptake. It summarizes the development of new tools and indicators to assess the BeSD of vaccine uptake for childhood and COVID-19 vaccination, enabling decision-makers on immunization policy, programme managers, and partners to address under-vaccination through an enhanced understanding of the underlying causes. This paper also reports the main findings of a scoping review that examined existing systematic reviews and meta-analyses on interventions to improve vaccine uptake – a first step towards understanding which interventions work to increase vaccine uptake, for whom, and in what settings. Finally, this paper makes recommendations for using the new tools and the resulting data to prioritize local interventions, and concludes with future research directions.

While the world was gripped by the unfolding COVID-19 pandemic in 2020, children continued to face the same crisis they have for decades: intolerably high mortality rates and vastly inequitable chances at life. In total, more than 5.0 million children under age 5, including 2.4 million newborns, along with 2.2 million children and youth aged 5 to 24 years – 43 per cent of whom are adolescents – died in 2020. This tragic and massive loss of life, most of which was due to preventable or treatable causes, is a stark reminder of the urgent need to end preventable deaths of children and young people. Data gaps remain a serious challenge to child mortality estimation and monitoring. Almost two thirds of low and middle income countries (97 out of 135) have no reliable mortality data in the past three years. And just 40 countries had high-quality national data for 2020 included in the estimation model, though national or subnational data were available for more than 80 countries or areas to help analyse excess mortality due to COVID-19.

This study aims to assess the prevalence and exacerbating factors of violence against women and children in Germany during the coronavirus disease 2019 pandemic. It conducted a representative online survey with partnered women (18–65 years) between 22 April and 8 May 2020, when participants had been under lockdown for a month. It determined the prevalence of several forms of violence within the previous month using both direct elicitation and a list experiment. It also conducted a multivariable logistic regression to assess the impact of pandemic associated risk factors.

This action brief summarizes the latest status and trends of key areas related to women’s, children’s and adolescents’ health and well-being from a global perspective. It aims to promote coordinated action among global and national partners to recognize and overcome the disproportionate impact of the COVID-19 pandemic on women, children and adolescents and to accelerate progress to meet the Sustainable Development Goals (SDGs). Rise, Respond, Recover is an update to Protect the Progress: 2020 progress report on Every Woman Every Child Global Strategy for Women’s, Childrens’ and Adolescents’ Health (September 2020), capturing key evidence points presented in May 2021 to the World Health Assembly as well as top priorities and activities among partners.

In the context of the coronavirus disease (COVID-19) pandemic response, WHO identifies young people as a priority target audience with specific concerns, experiences and behaviours. This policy brief provides relevant insights from behavioural evidence and a set of behavioural considerations for those promoting COVID-19 preventive behaviours among young people. Designers of programmes and initiatives targeting youth may find it helpful to refer to the youth-specific barriers and drivers identified in this policy brief and to prioritize these for testing when planning initiatives targeted at young people.

Refugees and migrants have been disproportionately affected by both the direct effects of the COVID-19 pandemic and the restrictive migration measures put in place, which, in turn, have hampered coordinated and consistent public health responses. This report maps how the needs of refugee and migrant have been addressed in COVID-19 responses across countries and how these have varied considerably from inclusive policies to discriminatory practices. Many countries ensured access to health care for refugees and migrants regardless of migration status, and several countries also suspended forced returns and prioritized alternatives to immigration detention. An integrated approach to migration and public health policies covering protection-sensitive access to territories, a flexible approach to migration status and non-discriminatory access to health care is suggested as a policy consideration to uphold international conventions protecting the right to health without discrimination for refugees and migrants.

This scientific brief was prepared based on results of evidence synthesis and a WHO expert consultation. The WHO COVID-19 LENS (Living Evidence Synthesis) working group consolidated available evidence, based on rapid reviews of the literature and results of a living systematic review on pregnancy and COVID-19 (up to October 7, 2020), on potential mechanisms of vertical transmission of infectious pathogens, feasibility of vertical transmission of SARS-CoV-2, data related to interpretation of positive SARS-CoV-2 virologic and serologic neonatal tests, lessons from diagnosis of other congenital infections, and existing proposed definitions to classify timing of vertical transmission of SARS-CoV-2. WHO convened a multidisciplinary, international panel of experts between October and November 2020 to review the evidence and propose a consensus initial classification system for the timing of vertical transmission of SARS-CoV-2. The panel included experts in obstetrics, neonatology, paediatrics, epidemiology, virology, infectious disease, congenital infections, and placental pathology. The selection of the panel ensured geographic representation, gender balance, and no important conflicts of interest, in accordance with WHO standard procedures.

Good nutrition during childhood and adolescence is key to ensuring optimal growth, health and well-being. Healthy dietary practices in early life have an immediate impact on healthy growth and help prevent noncommunicable diseases (NCDs) later in life and across generations. Good nutrition in childhood is also good for school performance and educational outcomes, impacting on nations’ economic and social development. Since children spend so much time in school, the school environment is an important setting for children to acquire habits, skills and knowledge related to healthy diets and physical activity. In 2016-17, the vast majority of countries (89%) reported implementation of school health and nutrition programmes although inclusion of a comprehensive set of interventions was rare and implementation of such programmes appears to have weakened since the start of the decade.

This global progress report on water, sanitation, hygiene, waste management and cleaning (WASH) in health care facilities comes at an unprecedented moment, when coronavirus disease (COVID-19) is exposing key vulnerabilities in health systems, such as inadequate infection prevention and control. WASH services in health care facilities, so often taken for granted – or as this report highlights, outright neglected – are needed more than ever to protect vulnerable health workers and patients. The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities lack basic water services, and one in 10 have no sanitation services.

The COVID-19 pandemic has created the largest disruption of education systems in history, affecting nearly 1.6 billion school-age children in more than 190 countries. Already last year, 250 million school-age children being out of school, the world was facing a “learning crisis”. But now with the COVID-19 pandemic, this crisis could turn into a generational catastrophe. While many children will continue with their education once schools reopen, others may never return to school. Current estimates indicate that 24 million children will never return to the classroom and among those, disproportional number of girls. To avert this crisis, we need to reimagine how we deliver good quality and inclusive education to the world children. Among other things, this calls for urgent investments in school health and nutrition programmes and create the conditions for children to lead healthy lives. This also includes health and nutrition literacy offered through the curriculum and through counselling in the school health services which provides young people with knowledge, skills, values, culture and behaviours they need to lead healthy, empowered lives.

There is a high risk that the COVID-19 pandemic may reverse decades-long progress on reducing child mortality and affect the number of stillbirths. This new release of the first-ever joint stillbirth estimates by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) presents the number of babies that are stillborn every year due to pregnancy and birth-related complications, the absence of health workers and basic services. The issue has become an essential part of global child survival initiatives. UNICEF calls on international organizations, governments and partners for increased and strong political will, sound policies and targeted investment along the continuum of care for every mother and child.

This brief provides guidance for governments, policymakers, UN agencies and development partners to address non-communicable diseases (NCDs) as an integral part of the COVID-19 response and in broader efforts for achieving the 2030 Agenda for Sustainable Development. NCDs, such as cardiovascular disease, cancer, diabetes and chronic respiratory disease, are amplifying the impacts of COVID-19, and COVID-19 is exacerbating the burden of NCDs, particularly in already disadvantaged communities. Almost one fourth (22%) of the global population is estimated to have an underlying condition that increases their vulnerability to COVID-19, and most of these conditions are NCDs. Urgent action across sectors is needed to address the root causes of NCDs and increase access to affordable and quality treatments and prevention.

Since the Every Woman Every Child movement was launched 10 years ago, there has been remarkable progress in improving the health of the world’s women, children, and adolescents, including reducing maternal and child mortality and improving child nutrition and education. However, conflict, climate instability, and the COVID-19 pandemic are putting all children and adolescents at risk . In particular, the COVID-19 crisis is exacerbating inequities, with reported disruptions in essential health interventions disproportionately impacting the most vulnerable women and children.
This report notes that the COVID-19 pandemic has made clear how fundamental good data are across sectors; that greater investments are needed to build resilient systems to provide high-quality and integrated services consistently; and COVID-19 recovery efforts  require multilateral action and continued investment in development.

There have been dramatic reductions in child and youth mortality over the last 29 years. Globally, under-five mortality has dropped by 59% since 1990—from 93 deaths per 1,000 live births then to 38 deaths in 2019. Initial evidence suggests that the impact of COVID-19 on direct mortality for children and youth may be small, but indirect effects can be severe. Many life-saving services have already been disrupted by COVID-19.