Key messagesRisk assessment for children has been a polarising issue during the Covid-19 pandemic. Governments around the world are preparing to 'open up' before risks to children are fully quantified, with unknown implications for their long-term health.Applying the Precautionary Principle to child health requires decision makers to 1) take preventive action until risks are better understood; 2) ensure that the burden of proof rests with proponents of risk; 3) explore alternatives to the risk;

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... and 4) use participatory approaches to decision-making.Policies relating to children must be centred on the rights and wellbeing of children. We provide a framework for comprehensive Health Impact Assessments to ensure that direct and indirect impacts upon children are taken into account in major policy decisions.Elimination strategies offer an integrated approach to the protection of children's wellbeing, the wellbeing of the population as a whole, and health equity. Where countries are transitioning away from elimination, a tight suppression approach is preferable to loose suppression or mitigation.