**1. Introduction**

Coronavirus disease (COVID-19) is caused by a virus in the beta-coronavirus family, SARS-CoV-2. The specific characteristics of COVID-19 infection in children are of particular interest. Little is unknown about the epidemiology of SARS-CoV-2 transmission in children. The transmissibility of COVID-19 in general is greater than other coronaviruses [1]. COVID-19 is typically asymptomatic or presents with mild symptoms [1, 2]. Coronavirus causes up to 14% of respiratory infections in children however influenza virus infections remain the most common pediatric infections. Those most likely to be infected with SARS-CoV-2 are children under three years of age [1] and more specifically, children under one year of age. Furthermore, according to a metanalysis, 50% of children under the age of five infected with COVID-19 were infants under one year of age, male and were exposed to the infection via community transmission [3]. This highlights the importance of testing and disease monitoring in families with infants and young children.

COVID-19 disease is less common in children than adults [1, 2]. The lower incidence of COVID infection in children may be explained by the lower expression of Angiotensin Converting Enzyme 2 (ACE2) and TMORSS2 (protease) in alveolar epithelial cells in children in comparison to adults and decreased viral transmission [2–4]. The higher rates of infection seen in infants may be due to their immature immune system, which not only increases their risk of infection, but also makes vaccination less effective [1, 3]. Maternal immunization may provide maternal-fetal protection [1, 3, 4]. In addition, maternal immunization may protect young children as transmission from COVID-positive mothers to children has been documented [1, 4]. Therefore, targeted maternal vaccination may be an important tool to protect vulnerable infants and children.
