Cases of COVID-19 among children are increasing far faster than all other age groups in Maine, creating concerns among pediatricians that children are spreading the virus to older and more at-risk residents while facing risks to their own health, as well.

Over the last month, Maine’s overall seven-day case average has increased by 49 percent, from 463 on average in late October to 688 cases on average this week, according to data from the Maine Center for Disease Control and Prevention. Among individuals under the age of 20, however, the increase has been 83 percent during that time, more than 100 cases per day on average.

The larger increase among children makes sense given that they also have the lowest rates of vaccination. Children between the ages of 5 and 11 have only been eligible to get vaccine for a few weeks and those under the age of 5 are still not eligible. By comparison, Mainers with the highest rate of vaccination – 60-79-year-olds – have seen cases increase by about 19 percent in the last month.

Children and young adults do sometimes become seriously ill from the disease, although the chances are lower than among older age groups. Even if they don’t become ill, children can play a major role in keeping the virus transmission line going and can sometimes do so unknowingly because they are not exhibiting symptoms.

“It’s the same with influenza. Kids are major transmitters,” said Dr. Dora Anne Mills, chief health improvement officer for MaineHealth, the state largest health care network. “Even if they don’t die or get sick, they are carriers, and often silent carriers.”

The longer the virus is able to spread, the greater chance other variants might develop, too. Some could be worse than the highly contagious delta variant that is dominating right now, and some could even prove vaccine-resistant. The Associated Press reported last week that estimates by the COVID-19 Scenario Modeling Hub, a collection of university and medical research organizations, suggest vaccines could make a big difference.

The hub’s latest estimates show that for November through March 12, 2022, vaccinating a high percentage of 5- to 11-year-olds could avert about 430,000 COVID cases in the overall U.S. population if no new variant arose.

Dr. Gretchen Pianka, a pediatrician with Central Maine Pediatrics, said some of the recent surge in transmission among the young is likely a function of fatigue. Parents have been making decisions constantly for the last year and a half about how best to keep their kids safe, but schools are fully open now and extracurricular activities are far more prevalent than a year ago.

“Families are relaxed,” she said. “They think, ‘I have a healthy child and they should do fine,’ and it can be hard to expand that lens.”

Pianka said it’s true children have been at lower risk of serious illness, but she’s seen young patients get “super sick.”

“And we still don’t have a sense of the long-term effects,” she said.

The trend of increasing transmission among children is happening across the country, too. The American Academy of Pediatrics this week released a report that showed, as of last week, pediatric cases of COVID-19 have increased by 32 percent from two weeks earlier. It was the 15th consecutive week that cases among Americans 18 or younger have been above 100,000.

At least some of the virus spread has been happening in schools and extracurricular activities in Maine. During the last school year, many communities took measures to limit the number of children in a classroom and mask mandates were near-universal. Now, fewer measures are in place, although many schools still do require masks.

Over the last 30 days, 5,181 cases of COVID-19 have been reported in public schools and 200 schools have seen an outbreak, which means at least three cases are linked epidemiologically.

According to U.S. Census data, there are approximately 280,000 Maine residents under the age of 20. That’s about 21 percent of the population. Since the pandemic began, there have been 26,524 cases in that age group, or 22.5 percent of all cases. But that number has been rising steadily recently. Younger people make up a higher percentage of cases than ever before.

The Maine CDC also has recorded 76 hospitalizations among those under 25, which is as specific as the agency breaks down COVID-19 patients by age. Maine has not had any pediatric COVID-19 deaths, but nationwide, at least 731 deaths from COVID-19 have occurred in individuals ages 18 or younger, according to the U.S. CDC.

Dr. Mills said past studies have shown that with infectious diseases, especially when vaccines are scarce, it’s prudent to vaccinate children first because they are the biggest spreaders. That hasn’t happened with COVID-19 because it took many months for federal officials to authorize vaccines for children.

The vaccine has only been approved for 5- to 11-year-olds since the beginning of the month. Those between the age of 12 and 15 have been eligible since mid-May.

The rate of vaccination among 12- to 19-year-olds in Maine is 62.6 percent, or about 5 percentage points lower than the state’s overall rate. Among 5- to 11-year-olds, 26 percent have gotten first doses thus far. Vaccines haven’t been in use long enough to help slow the spread among that age group.

But as has been the case throughout the state’s vaccination effort, people are far less likely to get vaccinated in rural, inland Maine counties. For example, 77 percent of all Cumberland County residents age 12 through 19 are fully vaccinated, but just 43 percent of Franklin County residents in that age group are.

The PlayPlace at the McDonald’s restaurant in Waterville is transformed into a pop-up vaccination clinic where children as young as 5 received shots and people 18 and older could get boosters. National experts estimate that vaccinating a high percentage of 5- to 11-year-olds could avert about 430,000 cases of COVID-19 in the U.S. population if no new variant erodes the protections. Rich Abrahamson/Morning Sentinel

Among 5- to 11-year-olds, 45 percent in Cumberland County have gotten a first dose, while just 8 percent of elementary school age children in Somerset County have.

Pianka said she still hears from parents who have concerns about vaccinating their children. She said she listens to those concerns and, if needed, dispels any misinformation.

“I tell them it does one thing and one thing only,” she said. “It sends a message to cells that says ‘Make antibodies to protect against this virus.’ That’s all it does.”

One example of a concern, she said, is risk of myocarditis, an inflammation of heart muscles. Early studies of the vaccines showed a small number of cases of this condition.

But Pianka said subsequent studies have shown that the risk of myocarditis is 10 times greater for those who contract COVID-19 than the general population, and the risk for those who have been vaccinated is actually lower than the risk level for the general population at the moment.