Since early reports from China stated that severe COVID-19 disease was rare in children, 1 we have analysed child COVID-19 mortality in seven countries. To put the deaths into a context that would help the understanding of parents, clinicians, and policy makers, we previously made comparisons of COVID-19 deaths with modelled mortality from all causes and other causes. Our first publication in April, 2020, 2 was followed by a trend analysis up to August, 2020. 3 We also update a data table online. Here, we update this analysis to February, 2021, in light of increases in adult mortality through the 2020–21 winter, and concerns about variant B. 1.1. 7, first identified in the UK in December, 2020 (probably circulating since September). 4 In the USA, UK, Italy, Germany, Spain, France, and South Korea, deaths from COVID-19 in children remained rare up to February, 2021, at 0· 17 per 100 000 popu lation, comprising 0· 48% of the estimated total mortality from all causes in a normal year (table, appendix p 2). Deaths from COVID-19 were relatively more frequent in older children compared with younger age groups. The differences between countries need careful interpretation because of small numbers, possible differences in case definition and death reporting mechanisms, and the related condition paediatric inflammatory multi system syn drome temporally associated with COVID-19, which might not always be captured in these data. Overall, there was no clear evidence of a trend of increasing mortality through out the period up to February, 2021, but additional deaths have clearly occurred in children and young people during periods of high community transmission (appendix p 3).