March 2021 marked the one-year anniversary of the outbreak of Coronavirus 2019 (COVID-19) in the U.S. To date, there have been over 29 million COVID-19 cases, 1.8 million hospitalizations, and 527,000 deaths confirmed in the U.S. Adults have experienced the majority of the COVID-19 illness burden; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been substantially less prevalent in children and youth. Nevertheless, many children and youth with special health care needs (CYSHCN) are at risk for severe COVID-19 illness. Herein, we report on the at-risk health conditions in these children, including how the conditions are being used to prioritize vaccine distribution, how to identify the conditions using health care claims, and how estimating the prevalence of these conditions can help ensure that children and youth receive the care they need during the pandemic.
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