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It is the purpose of this narrative review to examine the impact of COVID-19 and the countermeasures deployed by central authorities on the health and wellbeing of children in the UK and in Sweden.

The COVID-19 pandemic of 2020-2023 was the most momentous and impactful public health event since the “Spanish Flu” pandemic of 1918-1920. Many fatalities ensued, largely but not completely confined to older subjects. However, taking a broader lens than just counting fatalities, it is clear that the pandemic exposed dramatic societal inequalities, whose impacts also were felt differently by different age groups. Health policy interventions were conceived in the main around the needs of adults, not children.

The special focus of this paper is the comparison between a full “lock down” country such as the UK, which had amongst the longest COVID-mandated school closures in the free world, and Sweden, which almost uniquely declined to impose distance learning on school children aged 15 and under. Similarly, the opportunity afforded by the immunisation of children against COVID-19 using novel vaccines was taken up to a very variable degree with some countries strongly advocating its routine use, while others only administered such vaccines to those at the highest risk of adverse outcomes (Sweden).

The authors searched (using Google Scholar and PubMed) for relevant pre-print/fully-published articles, periodicals, books, press reports, government policy pronouncements and publications for the period January 2020 to October 2023; in addition, the publicly-available outputs of the completed Swedish and ongoing UK COVID-19 enquiries were examined. Finally, a detailed in-person interview was undertaken in 2023 by one of the authors (DG) with the former State Epidemiologist of Sweden (Dr Anders Tegnell), who was in day-to-day charge of that country’s actions between 2020 and 2022.

Using these diverse lines of evidence, the authors have attempted to understand what measures were undertaken in the two countries which directly affected children’s health, why those policy choices were made, and any lessons learned which may be useful in the certain expectation of similar if not worse future pandemics.