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When it comes to Covid, the children have largely survived. They can become infected and spread the virus, but the risk of becoming seriously ill or dying is very small. Still, just like adults, they can have symptoms that persist far beyond the initial infection. Officially known as the post-acute sequelae of SARS-CoV-2 infection (PASC), this condition is often referred to as “long” covid.

It should be taken seriously, says Alok Patel, a pediatrician at Lucile Packard Children’s Hospital Stanford. “Although Covid itself (acute infection) is less severe in children, prolonged covid is very debilitating, isolating and frightening for families.”

Why are we talking about this now?

The vaccine is changing the demographics of the pandemic. Children and young adults represent an increasing proportion of cases as more adults are vaccinated. The absolute number of cases among children is still lower than at the peak of the pandemic, but infection rates in children have not fallen as fast as in adults.

This makes sense. While the virus is still circulating, it will “hit the most vulnerable people, the unvaccinated” Sean O’Leary, vice chair of the AAP’s Communicable Diseases Committee, told NPR:. Children under 12 are not yet eligible for the vaccine, and young people who may be vaccinated have some of the lowest vaccination rates in the United States. “There has been a lot of focus on these post-covid symptoms in adults,” Patel says. But “we don’t have the kind of robust data we really need in the pediatric population.” This is slowly starting to change.

How common is long covid in children?

That’s the problem – we just don’t know. “There is a dearth of good, peer-reviewed medical literature on this topic,” says Alicia Johnston, infectious disease specialist and head of the new post-covid clinic at Boston Children’s Hospital. And the handful of studies in existence report wildly different rates.

For example, researchers in Italy surveyed caregivers of 109 infected children and found that: 42% of children had at least one symptom two months after their diagnosis. Four months later, the number had dropped to 27%.