Many families are asking when their children should be tested for COVID-19. Your pediatrician can help determine when testing may be a good idea, and which type of test would be best. They can also help you follow up on your child's test results.
When to test
To determine which test to recommend, your pediatrician will consider:
COVID-19 has similar symptoms to other illnesses such as
influenza and respiratory syncytial virus (RSV). It's also possible to have two of these illnesses
at the same time. Because of this, children and teens with COVID-19
symptoms may be tested for more than one virus (such as flu and COVID-19).
Children and teens who have symptoms of COVID-19 should be tested without delay to find out if they have an active infection. This is especially important if they have in-person activities, so that anyone who may have been exposed can be alerted.
Where should my child be tested?
Your pediatrician can test or refer your child for testing. You can also find a
free onsite testing location near you.
There are many ways to get at-home rapid tests for free, too, including:
Online: Families can receive a package of 4 free at-home COVID-19 tests by mail. Visit www.covidtests.gov.
Through your health plan: Insurance companies and health plans are now required to
cover 8 free over-the-counter at-home tests per person per month. That means a family of four, all on the same plan, would be able to get up to 32 of these tests covered by their health plan each month.
In the community: If you have
Original Medicare or do not have private health insurance, at-home tests are available at a community health center or clinic.
What if my child was in close contact with someone who has COVID-19?
They should quarantine and be tested right away if not fully vaccinated—even if they don't have symptoms. If the test is negative, test again 5 to 7 days after the last contact with the person who has COVID-19. Test right away if symptoms develop.
If they are fully vaccinated and do not have symptoms, test 5 to 7 days after the last contact with the person who has COVID-19. Test right away if symptoms develop.
If your child has recovered from COVID-19 within the past 90 days, call your doctor about testing or if new symptoms develop.
Testing may be recommended at other times. The Centers for Disease Control and Prevention (CDC) recommends using a self-test before joining indoor gatherings with others who are not in your household, or if you live with someone at higher risk for severe COVID-19. Testing also is useful before a scheduled medical procedure or travel.
What if my child was diagnosed with COVID-19 previously or got a COVID-19 vaccine?
COVID-19 vaccines are safe, highly effective, and children should get them as soon as they are eligible. However, no vaccine provides 100% protection against SARS-CoV-2. In addition, some SARS-CoV-2 variant strains are more contagious and may still infect people who have been vaccinated or who have already had COVID-19. Typically, COVID-19 infection after vaccination results in mild or even no symptoms, but your child can still spread the virus.
Types of COVID-19 tests
There are currently two main types of COVID-19 tests available to detect a current infection: molecular tests and antigen tests. Your pediatrician can help describe what each test can and cannot do, and when tests can be most useful for your child's situation.
Molecular tests, also called nucleic acid amplification tests, look for pieces of SARS-CoV-2 virus in the respiratory tract. They generally use a nasal or throat swab or sometimes saliva for the test sample. You might get results the same day or up to a week later.
They are "diagnostic tests," which means they are used to check if your child has an active infection. These tests will not tell if your child had COVID-19 in the past.
Types of molecular tests include:
Polymerase chain reaction (PCR) tests. These are highly accurate. A PCR test authorized or approved by the U.S. Food and Drug Administration (FDA) is considered the "gold standard" to determine if a child has an active COVID-19 infection. It can detect COVID-19 variants, including the
delta variant and the
Until we know more about how well they work for children, other tests such as the "loop-mediated isothermal amplification" (LAMP) and "nicking enzyme amplification reaction" (NEAR) tests are not a replacement for PCR tests. They are not to be used to clear children for return to activity after exposure to or symptoms of COVID-19.
Another kind of diagnostic test is an antigen test. It uses a nasal or throat swab. Some antigen tests are approved to give results in 30 minutes or less. These tests are generally reliable. Sometimes, PCR tests are useful for confirming results, such as during later points in an illness or if a child had no symptoms.
How do antibody tests work?
Antibody (serology) tests are not useful to diagnose a current infection. These tests check a sample of blood for special proteins called antibodies. The body makes antibodies to get rid of viruses and bacteria that cause us to get sick. An antibody test can tell if your child has had COVID-19 at some point in the past, even if there were no symptoms. Some antibody tests can detect that your child was vaccinated. After your child first shows symptoms of being sick, it can take up to two weeks before a antibodies in the blood can be detected by a test.
Does a positive antibody test mean my child is immune to COVID-19?
Based on what we know today, a positive antibody test does not confirm protection against the COVID-19 virus. Research shows that people who have recovered from a COVID infection can still get infected again with SARS-CoV-2. Antibody tests should not be used to make decisions about safe entering or returning to group settings like schools, child care, or dorms.
After your child has a diagnostic or antibody test, it is important to talk with your pediatrician about positive or negative test results and what to do next. Continue to follow steps to prevent the spread of COVID-19 such as wearing face masks, physical distancing and hand washing. Finally, everyone age 5 and older should get the
vaccine and everyone age 12 and older should get a booster shot
when it is time. If you have any concerns about your child's health, call your pediatrician.