Consequences of COVID-19 protection measures on children's respiratory health in Aotearoa New Zealand.

Aim: To explore the impact of COVID-19 protection measures on children's respiratory health in Aotearoa New Zealand.

Method: Annual hospitalisation rates (2017/2018 to 2022/2023) for specific respiratory illnesses in children under age 15 years were calculated. Comparisons were made across time and age/sex/ethnicity groups.

Results: Hospitalisation rates for respiratory illnesses were lower for all children in the years when COVID-19 protection measures were strictly enforced, followed by an increase in rates in subsequent years. There was an excess of hospitalisations for tamariki Māori and for Pacific children compared with non-Māori, non-Pacific children. Inequities in influenza that were present before the pandemic re-emerged rapidly following the relaxation of COVID-19 protection measures.

Conclusion: Reducing the burden of respiratory illness in children is a key challenge for health delivery in Aotearoa New Zealand. The re-appearance of inequities across outcomes and age groups following the relaxation or removal of COVID-19 protection measures indicates the need for an effective strategy that embeds learnings from our pandemic response.