Hopp til innhold

Get alerts of updates about «Children and adolescents»

How often would you like to receive alerts from fhi.no? (This affects all your alerts)

The email address you register will only be used to send you these alerts. You can cancel your alerts and delete your email address at any time by following the link in the alerts you receive.
Read more about the privacy policy for fhi.no

You have subscribed to alerts about:

  • Children and adolescents

Advice and information for children and adolescents

Published Updated

Advice and information on issues affecting children and adolescents in connection with coronavirus (COVID-19).

Advice and information on issues affecting children and adolescents in connection with coronavirus (COVID-19).


Skip to content on this page

National and local infection control measures

The Government is continuing with the third step of the plan for a gradual reopening of society from 20 June 2021 at 12 p.m.

Municipalities can introduce stricter measures locally according to the infection situation. Check your municipality's website for information on local measures.

General advice that applies to everyone, including children and adolescents:

  • Sick people should stay at home or go home if they get symptoms
  • Good hand hygiene and cough etiquette
  • Limit contact between people who do not belong to the same household.

About COVID-19 among children and adolescents

Children are infected or become ill with COVID-19 to a lesser degree compared to adolescents and unvaccinated adults. The Norwegian Institute of Public Health monitors knowledge about the role of children in the spread of the disease.

The combined knowledge indicates that: 

  • Children of primary school age and younger are less likely to become sick from coronavirus. When they become ill, they usually have milder symptoms and a mild disease course.
  • Children can be infected and have symptoms, but to a lesser degree than adults. Since they have fewer symptoms than adults, it is assumed that they are less contagious.
  • Transmission in schools and childcare centres contributes only to a small extent in the spread of COVID-19 in the society. The start of the school year in August did not appear to be the cause of the second wave of COVID-19 seen from October 2020. 

Adolescents are probably more contagious than children because they get more symptoms when infected with COVID-19. Adolescents may also have a lifestyle that increases the risk of transmission, such as a larger and more geographically dispersed network of contacts, the need for close contact with peers, as well as pandemic fatigue. Their ability to infect others appears to increase gradually until adulthood. 

In December 2020, a new variant of the coronavirus was detected in the United Kingdom. This has dominated a number of outbreaks in Norway during winter 2021. Reports show that the age distribution of the UK virus variant (Alpha) appears to be similar to other virus variants, but that it is more easily transmitted in all age groups. Public Health England has reported that there appears to be lower transmission among children than adults, about half as contagious in the age group under 10 years compared to adults.

Children with chronic diseases have a low risk of severe COVID-19

The risk of severe COVID-19 disease course is very low, both among children and adolescents in general, but also among children and adolescents with serious and chronic diseases or conditions.

Multi-inflammatory syndrome in children, MIS-C 

Some countries have reported an inflammatory condition after COVID-19 among children and adolescents, known as MIS-C (multi-inflammatory syndrome in children) or PIMS (paediatric inflammatory multisystem syndrome temporarily associated with COVID-19). The condition is rare, but serious. When treated for this syndrome the prognosis is good.

Should children and adolescents be vaccinated with coronavirus vaccines?

The vaccines that are now available are approved for use from 18 years and older, with the exception of the BioNTech and Pfizer vaccine that is approved from 12 years.

For children and adolescents, the risk of severe COVID-19 disease is low, even with chronic underlying disease. However, vaccination of adolescents is possible with the BioNTech and Pfizer vaccine, which is approved from the age of 12 and can be used in adolescents with a high risk of serious illness.

Symptoms of COVID-19 in children

Children who get COVID-19 usually have a mild disease course. The symptoms are usually mild and short-lived, and it can be difficult to distinguish them from other respiratory tract infections.

Examples of respiratory tract symptoms can be cough, sore throat, nasal congestion and runny nose. Children with COVID-19 may not have a fever and cough. The youngest children often do not complain about sore throats and body aches, but it is often noticed that they are getting sick when they whine more than usual, or that they do not want to eat. This is called poor general condition. Some children may also have symptoms from the stomach and intestines, with abdominal pain, decreased appetite or diarrhoea.

If you are worried about your sick child or adolescent

In most cases, children and adolescents who are sick do not have COVID-19, but have another infection or condition. If you are worried about your child or adolescent, contact the health service to see if they should be assessed by a doctor. Do not delay seeking medical attention due to concerns about being infected with COVID-19.

In general, the younger the child is, the lower the threshold should be for contacting a doctor. As a general rule, this applies to children who are 2 years and younger, especially children aged 0–6 months. Other reasons to contact a doctor are when the child/ adolescent has: 

  • poor general condition (the child / adolescent is lethargic, whining, lost appetite and/or feeling unwell)
  • difficulty breathing and / or breathing faster than usual when resting
  • fever combined with respiratory tract symptoms and / or poor general condition

When shall children with respiratory tract symptoms stay at home?

If the child has had symptoms of respiratory tract infection in the last 24 hours (newly arisen), the child should be kept at home, especially if the child has several symptoms at the same time or has a reduced general condition. Children with newly arisen symptoms of respiratory tract infection should be tested, in consultation with their parents. In order for children to experience the sampling as less uncomfortable, the sample can be taken in the front part of the nose or from the throat.

Children of primary school and childcare age who only have a runny nose and are otherwise in good form with no other signs of a new respiratory tract infection do not need to stay at home or be tested.

Although we recommend liberal testing of children as well, testing is not compulsory and must always be performed in consultation with parents. If the child is not tested and there is no strong suspicion of COVID-19 (for example, where there are no other people around the child who have tested positive for COVID-19), the same recommendations apply as for other respiratory tract infections - i.e., the child should be kept at home until they are back to normal and considered to be well.

Illustration: NIPH
Illustration: NIPH

When can the child return to childcare or school?

If the child has developed symptoms of respiratory tract infection during the last 24 hours and has been tested for COVID-19, the negative test result must be available before the child can return to childcare / school, regardless of whether the child no longer has symptoms. 

The child's general health condition determines when they can return to childcare/ school after recovery from a respiratory tract infection. This applies even if the child still has residual symptoms such as a runny nose (regardless of the colour and consistency of the mucus/ snot) or a cough. Such symptoms are common after a respiratory tract infection among younger children.

Symptoms of COVID-19 can be difficult to distinguish from allergies. If you are in doubt about whether the symptoms are due to a recent respiratory tract infection or allergy, testing is recommended. Children with known allergies where the symptoms are recognised as allergy problems can go back to childcare / school.

When should adolescents with respiratory tract symptoms stay at home?

For adolescents with COVID-19 the symptoms resemble those in adults, especially for older adolescents. Adolescents who have developed symptoms of respiratory tract infection in the past 24 hours should stay home from school and contact the local testing centre for a COVID-19 test. This also applies to adolescents with mild symptoms.

Adolescents with known allergies where symptoms are recognised as allergy problems can go to school as normal.

Children staying in several homes

Many children have several homes. Most often, these are children with guardians who have two different households after a break-up, but they can also be children and adolescents who have different forms of relief families or have part-time stays in care homes.

The main rule is that planned meetings can be maintained as agreed. 

Care for children when several people in the household are ill

It is important that the child /adolescent's need for care is taken care of, even if their guardian has COVID-19. Similarly, if the child has COVID-19, they must receive adequate care and attention from parents or others, even though this may mean that it is not possible to keep a distance. If caregivers are ill and unable to care for children for whom they are responsible, the municipal health services must be informed to implement relief from child welfare or others, as in other situations where caregivers are ill.

Follow-up at public health clinics, school health service and other health services

The municipalities should ensure that health services offered to children and adolescents are adequate. It is recommended that the health station and school health services maintain normal activity in line with national professional guidelines and necessary infection control measures.

For more information about the public health clinics and school health services, see the Norwegian Directorate of Health's website Helsestasjon, svangerskapsomsorg og skolehelsetjeneste and your municipality's website or contact the municipality for updated information. If you suspect that your child / adolescent has COVID-19, you should visit the test station before contacting the school health service

Childcare centres, schools and after-school programmes

The Norwegian Institute of Public Health and the Directorate of Education and Training have prepared infection control guidelines for childcare centres, schools and after-school programmes. The guidelines describe measures to reduce transmission and provide advice and support to ensure good infection control for staff, children and adolescents.

For information about infection control measures in childcare centres and schools see:

The main principles for infection prevention are that sick people stay at home, that there are contact-reducing measures between people, as well as good hand hygiene and cough etiquette and thorough cleaning.

Contact-reducing measures in the infection control guides for schools and childcare centres are adapted to the teaching and care situation and are based on the infectivity of children and adolescents, their right to education and social needs.

The advice is graded at three different levels - green, yellow and red level measures - so that operations can be best adapted to the current infection situation and the different levels of education. The health authorities decide which level schools and childcare centres should use. This is based on the infection situation locally and nationally.

In consultation with the Norwegian Paediatric Association, the Norwegian Institute of Public Health considers that the vast majority of children and young people with chronic diseases and conditions can go to childcare and school as normal.

Graduations and other events in school and childcare centres

Graduation from school and childcare centres is traditionally a family event. There is a wide span from childcare centre to upper secondary school and ceremonies will be implemented differently.

Closing ceremonies for childcare departments or school classes are normally considered a private gathering in a public place, where you can be up to 100 people inside and outside (current national advice). 

Teachers or guardians can be organisers and should familiarise themselves with the current advice for events. There may be stricter rules locally, and it is important to check what applies in each municipality.

Advice for school and childcare centre graduations for children and young people

  • Must comply with national and any local regulations (see above).
  • The event should be held outdoors where possible.
  • Children from the same cohort in childcare centre or primary school can socialise without distance rules. Parents and others (who are not from the same household) must be able to keep at least one metre distance.
  • Avoid congestion, for example when serving food, arranging toys, etc.
  • Ensure the availability of good hand hygiene facilities and thorough cleaning, with a focus on frequent contact points, such as food service and toilets.

Graduation ceremonies for 10th grade or 3rd year in upper secondary school, as well as the distribution of vocational diplomas, can be compared to a cultural event where the audience (parents) sit in fixed, assigned places. If the school is the organiser, such ceremonies can be carried out in a safe environment on a par with cultural events. Then it is allowed to gather up to 1000 people split into two cohorts indoors, if there is space in the premises and there are no stricter regulations in the municipality. In such cases, only the actual awarding of diplomas is considered an event. Gatherings after the ceremony are considered private gatherings in a public place, as described above.

Advice for diploma awards at the 10th grade or 3rd year at upper secondary school, as well as the distribution of vocational diplomas

  • We recommend that the school is the responsible organiser of the event.
  • The audience sits in fixed, designated places with a sufficient distance (at least 1 metre).
  • The audience participates as spectators and is not active in the event itself.
  • Avoid congestion at the beginning and end.
  • Otherwise, the usual infection control recommendations for events apply.

Play and social contact

Limit the number of guests that are present at the same time. This applies to both indoor and outdoor gatherings for both children and adults. The risk of transmission is lower outdoors than indoors, and when playing in small groups. 

The general infection control measures referred to at the top of the article apply when children, adolescents and adults are together in leisure time:  

Play and social contact in their leisure time should first and foremost be with children who are in the same group in childcare centres / school / organised leisure activities. Outside these groups, children can also play with a few close friends, preferably from the same local environment.

  • Children who play together do not have to keep a distance.
  • Children can have friends for sleepovers if everyone is well and the guests are among the same close contacts as in school and leisure time. 

Adolescents can also have a few friends / contacts that they do not need to keep their distance from, and who are considered to be their close contacts. They should be the same over time. They should keep at least one metre away from others who are not close contacts.

Birthday parties and other celebrations

For birthdays and other celebrations in or outside the home, limit the number according to th current advice and guidelines for events. Both children and adults are included. In most cases it is possible to include the whole cohort, but in some cases may be necessary to split a class in two to ensure that not too many children and adults are  present at the same time.

If possible, guardians of invited children should not go inside. If this is necessary for some children, the guardian should keep a safe distance from other children and adults and follow normal infection control advice.

Remember clean hands for everyone, especially when food is served.  

Organised leisure activities and importance for children and adolescents

Leisure activities are important for the physical and mental well-being of children and adolescents. The outbreak has lasted for a long time and it is uncertain how long it is necessary to have strict infection control measures. It is therefore of great importance that children and adolescents can engage in leisure activities in a safe way that will reduce the risk of infection.

Where there is a need for strict infection control measures, try to maintain some activity as long as possible.

For many children and adolescents, participation in leisure activities can be of great importance, because the setting is a safe and familiar arena that can be an important point in a difficult everyday life. It is especially important to be aware of vulnerable children and adolescents, including those who under normal circumstances would not have been exposed, but who have become so as a consequence of the pandemic.

The pandemic may have changed participation in leisure activities. Instructors / leaders should be aware of dropouts from organised leisure activities, and if there are some children who have not participated in the activity for a while, the association can contact parents to look at possible solutions for participation.

Activities of longer duration

For more information and recommendations regarding activities of longer duration for children and adolescents, such as summer schools, summer camps etc., see: 

Information for the general public

For general advice about coronavirus: our topic page and helsenorge.no 

Information helpline for questions about coronavirus: 815 55 015 (weekdays 08-15.30)

The Norwegian Directorate of Immigration has answers to many frequently asked questions about travelling to Norway, and a helpline 23351600 that is open on weekdays from 10:00-14:00. 

The Ministry of Foreign Affairs also has answers to many frequently asked questions.

If you need acute medical attention, contact your doctor. If you cannot reach your doctor, contact the emergency out-of-hours clinic on 116117. If life is in danger, call 113.

References

1. Gudbjartsson DF, Helgason A, Jonsson H, Magnusson OT, Melsted P, Norddahl GL, et al. Spread of SARS-CoV-2 in the Icelandic Population. The New England Journal of Medicine. 2020.

2. Folkhälsomyndigheten, Sverige. Bekräftade fall i Sverige

3. Statens Serum Institut, Danmark. Epidemiologisk overvåkingsrapport. 

4. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020.

5. Balduzzi, Adriana and Brivio, Erica and Rovelli, Attilio and Rizzari, Carmelo and Gasperini, Serena and Melzi, Maria Luisa and Conter, Valentino and Biondi, Andrea. Lessons After the Early Management of the COVID-19 Outbreak in a Pediatric Transplant and Hemato-Oncology Center Embedded within a COVID-19 Dedicated Hospital in Lombardia, Italy. Estote Parati. (Be Ready.) (3/19/2020). Available at SSRN. Sammendrag på engelsk. DOI: dx.doi.org/10.2139/ssrn.3559560

6. D'Antiga L. Coronaviruses and immunosuppressed patients. The facts during the third epidemic. Liver Transpl. 2020. 

7. Lu et al. NEJM. 2020. DOI: 10.1056/NEJMc2005073.

8. Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020 (CDC) 

History

20.06.2021: Updated according to the Government's reopening plan.

16.06.2021: Updated flow chart Children with symptoms.

11.06.2021: Added section about symptoms in children, revised section «About covid-19 in children and adolescents». Revised section on MIS-C. General shortening of text and language changes. Changes in the order of paragraphs.

08.06.2021: Added paragraph about closing ceremonies in schools and childcare centres

02.06.2021: Updated with age for vaccination for children - changed from 16 to 12

25.03.2021: Added updated test recommendations for children and adjusted the section on when children can attend kindergarten / school

05.03.2021: Removed flowcharts for when children and adolescents should be home - pending new versions.

03.02.2021: Updated information - vaccination, play and social contact , importance of leisure activities, removed film

26.01.2021: New paragraph under "When should adolescents with respiratory tract symptoms stay at home?" about children staying in several homes. New paragraph regarding a new variant of the coronavirus that was detected in the United Kingdom.

19.01.2021: Updated according to the Government's recommendations

14.01.2021 Clarification about visits from children and adolescents until 19 January.

06.01.2021: Updated according to the Government's recommendations about limiting social contact from 04.01 for two weeks

05.11.2020: Emphasised that adolescents should have the same close contacts over time.

09.10.2020 New paragraph under Play and Social contact, about private vs public events and outdoors vs indoors.

05.10.2020 Minor revisions to English version - added paragraphs under "play and social contact."

01.10.2020 Updated according to Norwegian version

12.06.2020
Removed "of longer duration" in paragraph title "Events and summer activities of longer duration for children and adolescents". Removed heading "Transport"

08.06.2020: 
Emphasised that the 1 metre rule does not allow in all circumstances for children, as per Norwegian version.

29.05.2020:
Added link to page about sport and organised leisure activities.

20.05.2020: 
General changes as per Norwegian version. 

08.05.2020
General changes as per Norwegian version. 

30.04.2020

Added sentence about children who are back at school or nursery.

22.04.2020
Added references

21.04.2020
Updated with revised text, as per Norwegian version.

23.03.2020
Article created. Content transferred from a joint article about information to pregnant women, children and adolescents, as per Norwegian version.