Purpose of Review This investigation aims to understand the role and burden of viral co-infections for acute respiratory illnesses in children. Co-infection can be either viral-viral or viral-bacterial and with new technology there is more information on the role they play on the health of children.Recent Findings With the proliferation of multiplex PCR for rapid diagnosis of multiple viruses as well as innovations on identification of bacterial infections, research has been attempting to discover how these co-infections affect each other and the host. Studies are aiming to discern if the epidemiology of viruses seen at a population level is related to the interaction between different viruses on a host level. Studies are also attempting to discover the burden of morbidity and mortality of these viral-viral co-infections on the pediatric population. It is also becoming important to understand the interplay of certain viruses with specific bacteria and understanding the impact of viral-bacterial co-infections. Summary RSV continues to contribute to a large burden of disease for pediatric patients with acute respiratory illnesses. However, recent literature suggests that viral-viral co-infections do not add to this burden and might, in some cases, be protective of severe disease. Viral-bacterial co-infections, on the other hand, are most likely adding to the burden of morbidity in pediatric patients because of the synergistic way they can infect the nasopharyngeal space. Future research needs to focus on confirming these conclusions as it could affect hospital cohorting, role of molecular testing, and therapeutic interventions.

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Objective At a time when the COVID19 vaccine was approved for everyone > 12 years of age, we sought to identify characteristics and beliefs associated with COVID-19 vaccination acceptance. Methods We conducted a cross-sectional survey study of parents of children aged 3-16 years presenting to one of 9 emergency departments from June-August 2021 to assess parental acceptance of COVID-19 vaccines. Using multiple variable regression, we ascertained which factors were associated with parental and pediatric COVID-19 vaccination acceptance. Results Of 1491 parents approached, 1298 (87%) participated of which 50% of parents and 27% of their children > 12 years of age were vaccinated. Characteristics associated with parental COVID-19 vaccination were trust in scientists [adjusted odds ratio (aOR) 5.11, 95% confidence interval (CI) 3.65-7.15], recent influenza vaccination (aOR 2.66, 95% CI 1.98-3.58), college degree (aOR 1.97, 95% CI: 1.36-2.85), increasing parental age (aOR 1.80, 95% CI 1.45-2.22), friend/family member hospitalized with COVID-19 (aOR 1.34, 95% CI 1.05-1.72) and higher income (aOR 1.60, 95% CI 1.27-2.00). Characteristics associated with pediatric COVID-19 vaccination (≥ 12 years) or intended COVID-19 pediatric vaccination (children < 12 years) were parental trust in scientists (aOR 5.37, 95% CI 3.65-7.88), recent influenza vaccination (aOR 1.89, 95% CI 1.29-2.77), trust in the media (aOR 1.68, 95% CI 1.19-2.37), parental college degree (aOR 1.49, 95% CI: 1.01-2.20), and increasing parental age (aOR 1.26, 95% CI 1.01-1.57). Conclusions COVID-19 vaccination acceptance was low. Trust in scientists had the strongest association with parental COVID-19 vaccine acceptance for both parents and their children.

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