Why are children less affected by COVID-19?

As a paediatric doctor, many of my patients’ parents are worried about the risk of COVID-19 to their children. Evidence is showing that so far children are not as severely affected as adults.

I have been using the following analogy to try and explain how our immune system works and why children so far have been less affected:

Think of the virus as a fire. If you don’t understand how to put out a fire, you will panic and throw everything you have to extinguish it – water, extinguishers, blankets etc. It will take time – some minimal damage will occur – but eventually you put it out.

This is the same for a toddler/child’s immune system. Each time they are exposed to a new virus, their body throws everything at it, hoping something will work. It takes a while for their immune system to find the way to deal with the virus but eventually they fight it off.

Now imagine there’s another fire, but this time you know much more about fires and you know the exact fire extinguisher to use. You put the fire out almost immediately and there is hardly any damage.

This is like an adult’s immune system. It is highly intelligent and specialised. Each time it comes into contact with a known virus, it already has memory cells to fight it off and gain control very rapidly.

However problems occur when there’s a new kind of fire that you know nothing about. You try the usual means to extinguish it but it isn’t controlled and nothing works. Eventually you may manage to put it out but it takes much longer and there is a lot of damage. This is what happens when an adult is exposed to a new (novel) virus, their body will fight it off but it can take a long time and leave extensive damage or unfortunately in some cases the damage will be too great, for example in the elderly or those adults with other medical problems.

This is why children are less affected than adults. The exceptions to this are young children under 1 years old. Their immune system relies heavily on maternal antibodies so they will not be able to cope with a novel virus, and extra precautions will be needed to stop them from being exposed.

I hope this is helpful. This is a scary time for us all. Please be sensible and by doing the following we can all try and keep us and our little ones safe:

  • Hand washing
  • Social distancing
  • Keep children away from young babies, elderly and those with other medical conditions.
  • Stop all unnecessary travelling.


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