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Minimizing COVID-19 Risk in Kids With Asthma

Mother helping daughter use nebulizer during inhalation therapy

The past two years have been stressful for everyone, including parents of children with asthma. Asthma can be a scary health problem even without a global pandemic. If it’s poorly controlled, asthma may also make COVID-19 more dangerous for children who have it, and vaccine approvals for children have lagged behind those for adults. This combination of factors has been very anxiety provoking for many parents.

However, we got some good news in January 2021: In the first year of the pandemic, children had fewer serious asthma attacks that required an ER visit. The data also showed a drastic reduction in cases of the flu and respiratory syncytial virus (RSV).

Looking at All the Possibilities

There are many theories about why we saw this reduction in severe asthma attacks among children. One is that children are better protected against respiratory viruses by wearing masks. This, in turn, may help prevent asthma attacks.

Social distancing also helps reduce exposure to viruses of all sorts. Other possible explanations include:

  • Less air pollution
  • Reduced travel
  • Less stress due to slower daily schedules
  • Fewer exposures to school toxins/triggers
  • Fewer sports/exercise-induced triggers

There may also be more of an infectious component to asthma than previously thought.

Whatever the reason, there is some concern that as COVID-19 levels improve and restrictions ease, the number of severe asthma attacks will likely go up again. Here’s what parents should know about keeping their children’s asthma well controlled and protecting them against severe COVID-19 disease.

Graphic: Three steps to help manage your child’s asthma: • Understand asthma triggers • Continue mask-wearing • Continue daily controller medication, regardless of symptoms

Managing Asthma Triggers at Home

There are many asthma triggers in our homes, including pets, seasonal pollen, animal dander, cigarette smoke, cleaning products, air pollution, mold, pests (such as mice and cockroaches), and dust mites.

If allergies are triggering your child’s asthma, it may be helpful to know exactly what your child is allergic to. A pediatrician or allergy specialist can do testing to identify these allergies and can help you come up with a plan to minimize your child’s exposure.

Luckily, there are ways to help reduce your child’s asthma triggers at home. An air filter is a simple and cost-effective tool to reduce environmental triggers and improve the air your child breathes. And anything you can do to minimize the presence of triggers such as dust and mold (and cigarette smoke) in your home will also be beneficial.

Home repairs and pest control can help, too. If you need help making repairs, there are programs in Philadelphia (for example, Rebuilding Together Philadelphia and Habitat for Humanity) that may be able to help.

Managing Asthma Triggers at School

In school, kids should be aware of their triggers and have an asthma action plan, which should be shared with caregivers, friends, and family. The child’s school/school nurse should have a copy of the child’s asthma action plan on file.

Your child should also have their rescue medication and inhaler with them in case of an emergency. Families and their children should learn the correct way to use an inhaler including how to use a spacer if required.

Some schools won’t allow children to carry and self-administer medications. But the school nurse can assist with this if you give them an inhaler to keep in their office.

You might also consider taking advantage of Propeller, a breakthrough asthma management tool that’s available to Independence members at no cost. A sensor attaches easily to the inhaler your child already uses, and sends information on your child’s medication usage to a smartphone app using Bluetooth®. The app can remind you and your child to follow their treatment plan, and can give you and your child’s doctor better insights into what is causing asthma flare-ups and how to better keep the asthma under control.

Health Maintenance and Preventive Medicine

Children who’ve been prescribed daily asthma control medicines should keep taking them, even if they’re completely symptom-free, and also attend all their scheduled asthma office visits.

Make sure you always have enough supply of your child’s asthma medicines. These medicines do expire, so make sure they’re still okay to use. Mail-order pharmacies allow you to easily order prescriptions ahead of time so that you can have a three-month supply on hand.

Being Careful About COVID-19

It’s important to be aware of the impact of COVID-19 on those with asthma. To minimize the risk of severe complications, all children with asthma should get the COVID-19 vaccine if they are eligible. (It hasn’t yet been authorized in children under the age of 5, though that may change soon.)

Families whose children with asthma are unvaccinated should continue wearing masks and practicing social distancing. Despite myths to the contrary, masks are safe to wear for those with asthma, and they are safe for children with asthma (over age 2).


There are numerous resources available for families of children with asthma:

  • The Children’s Hospital of Philadelphia’s Community Asthma Prevention Program offers free asthma education in schools, churches, and community centers throughout Philadelphia. They may also offer asthma prevention home visits for eligible children.
  • As part of the Independence Blue Cross Asthma Case Management Program, members can call 1-833-444-6428 and connect directly with a pediatric Registered Nurse Health Coach who can help them manage their child’s asthma. The Health Coach can provide support and education, collaborate directly with the child’s pediatrician/specialist, and recommend additional resources.
  • The American Lung Association has an online library of asthma education videos, articles, and other resources available for those with asthma.
Stephen Higgins, MD, FAAP

Dr Higgins graduated from Hahnemann Medical School (now Drexel University College of Medicine) in 1989 and went on to train as a Pediatrician and Neonatologist at DuPont Hospital for Children/Thomas Jefferson University Hospital. He spent most of his career as a Neonatologist at Crozer Chester Medical Center where he worked clinically in neonatal intensive care. He was actively involved in medical education rising to the level of Associate Dean at Crozer for Temple Medical School and more recently as the Associate Dean for Drexel’s Clinical Campus at Crozer. In addition to his role as Associate Dean, was the Chief Academic Officer and Pediatric Residency Director at Crozer before joining the Independence Blue Cross family in April of 2019.