COVID-19 and Young People - FAQs

COVID-19 is infecting the under 30s in ever-increasing numbers causing concern across the country. We answer your questions.

Those aged between 18 and 29 have the highest rate of COVID-19 across any age group in New South Wales, while children under 9 are accounting for around one in four new cases. The Victor Chang Cardiac Research Institute’s Professor Bob Graham reveals what every parent and young person needs to know about the Delta variant and the vaccine roll-out.

24 August 2021
Update 25 Nov 2021: Information from this article was accurate at the time of publishing and reflected the rules/advice announced by governing bodies at that time. Information has been updated in this article November 2021 to reflect the latest available research and guidelines.

How risky is COVID-19 for younger people?

While we are still learning about how COVID-19 affects people, so far, data suggests that people under 30 have fewer deaths compared to other age groups and usually have mild disease. However, cases of critical illness have been reported. As with older adults, pre-existing medical problems like high blood pressure, heart and lung problems, asthma, diabetes, obesity, cancer, pregnancy, and neurological and developmental conditions are risk factors for severe disease and intensive care admission in people under 30.

A man in his 20s died in Sydney recently of what is believed to be cardiac arrest as a complication of COVID-19. How could this happen given he had no pre-existing medical conditions?

This case highlights the urgent need for people to get vaccinated. If an otherwise healthy 27-year-old can die from COVID-19, then it can happen to anyone. So please get vaccinated. There are many reasons why this person might have died suddenly. Their lungs may have been suddenly overwhelmed by COVID-19, and as a result they couldn’t get enough oxygen in to sustain life. Or COVID-19 may have directly affected their heart, causing acute inflammation, which can result in overwhelming heart failure, or an electrical disturbance of the heart’s rhythm. They may have developed clots that caused a heart attack or a stroke. COVID-19 can also affect the gastrointestinal system, as suggested in this case by the fact that the person vomited and then suddenly died. The vomiting can contribute to an electrical disturbance of the heart by causing a loss of essential electrolytes.

Is the Delta strain of COVID-19 different from other variants in how it affects the heart? Why are we seeing otherwise young and healthy people dying of COVID-19?

The Delta variant is definitely more infectious and may be more virulent than previous strains. While we’re seeing more deaths in otherwise young and healthy people, this may be because it’s more virulent, but it may also be because a larger amount of younger people aged 10-40 years old are getting COVID-19 because fewer of them are vaccinated.

I’m young and healthy, should I still get the COVID-19 vaccine?

Yes. Although you are less likely to get severe disease, deaths have been reported in younger people. Also, while the vaccine doesn’t completely stop the spread of the virus, it certainly does help reduce the chance of transmitting it to your loved ones and friends by between 40-60% according to data from the UK.

We are seeing COVID-19 spreading in daycare centres and schools – should young children be vaccinated too?

Children are in danger of getting COVID-19, but their risk of getting serious illness is much, much lower. However, they can still transmit the disease to others, for example, to their parents and teachers, so it is likely that we might soon be moving towards vaccinating those 12-15 years of age, as the recommendations allow. Indeed, we are seeing the Pfizer vaccine already being offered to those in the 12-15 age group who have an underlying health condition, identify as Aboriginal and Torres Strait Islander, or are on the National Disability Insurance Scheme. In future, if the vaccines are also shown to be safe in children less than 12 years, we may move to vaccinating them as well. Ideally, if we can get to 70-80% of all people, including children vaccinated, we will have achieved herd immunity and the virus will likely die out, or at least it will be at far more manageable levels.

Update 25 November 2021: As of November 2021, in NSW everyone over 12 years of age is eligible to get vaccinated. The Pfizer (Comirnaty) and Moderna (Spikevax) vaccines are approved for use in people aged 12 years and over, while the AstraZeneca (Vaxzevria) vaccine is approved for use in people aged 18 years and over. In future, if the vaccines are also shown to be safe in children less than 12 years, we may move to vaccinating them as well.

Can COVID-19 vaccines cause heart problems in children and young people?

Yes, these mRNA vaccines can cause heart problems, particularly in people less than 36 years, but only very, very rarely. About 60 people per 1 million can get myocarditis with the mRNA vaccines (Pfizer and Moderna) and is generally a mild, short-lived illness. In contrast, the risk of getting heart disease from COVID-19 is about 1000 times higher at ~5-10%.

I have a history of blood clots, but can’t get access to the Pfizer vaccine; should I get the Astra Zeneca (AZ) vaccine instead?

The chance of getting a blood clot from the AZ vaccine is extremely small, even in younger people (less than 50 years). Given the increased infectiousness of the dominant Delta strain, the benefits of the AZ vaccine far outweigh the risks. People who contract COVID-19 are also at far higher risk of developing blood clots than people who receive the vaccine. Also, we now know how to treat vaccine-associated clots much better.

Update 25 November 2021: Nevertheless, there are certain people that have suffered specific types of prior blood clots, such as “cerebral venous sinus thrombosis”, who in NSW and other jurisdictions are recommended to avoid the AstraZeneca vaccine. People who have suffered a prior blood clot should consult their GP and Cardiologist before getting vaccinated.

I’m young and have a heart condition, should I still get vaccinated, and is there a better vaccination to get?

You should consult your GP and Cardiologist before getting vaccinated, but people at any age with an underlying heart condition are at much higher risk of getting severely ill with COVID-19 and should definitely get vaccinated. All vaccines provide good protection against serious illness.

Professor Bob Graham is the former Executive Director of the Victor Chang Cardiac Research Institute and a Fellow of the Australian Academy of Science.