A young boy traveling in Hawaii with his family died after contracting COVID-19 — the state’s first pediatric fatality from the coronavirus.

The child reportedly had an underlying medical condition and was traveling with his parents, both fully vaccinated, according to Hawaii News Now.

The boy’s age was not disclosed, but UCSF infectious disease expert Dr. Peter Chin-Hong said he was likely under 5 years old, since individuals over the age of 5 are tested upon arrival in Hawaii, per travel protocol.

The case follows several others involving children in the United States in recent weeks. A child who died from COVID-19 in Michigan became the third reported pediatric death in the state over the course of the pandemic — but the first where the child didn’t have underlying health conditions.

When it comes to children, far fewer have tested positive for the coronavirus compared to adults, according to the Centers for Disease Control and Prevention. Most of those children have mild symptoms or are asymptomatic, but some can get severely ill.

However, deaths among children from COVID-19 are rare. Mortality data in the U.S. found that children made up at most 0.19% of all COVID-19 deaths. And up to 0.03% of all pediatric COVID-19 cases were fatal, according to the American Academy of Pediatrics.

According to the American Academy of Pediatrics, 296 children have died from COVID-19 as of last week. In comparison, flu-related deaths in children during regular flu seasons have ranged from 37 to estimates of 600 each year, since national reporting of pediatric flu deaths began in 2004, according to data from the CDC.

But Bay Area experts warn that parents still should take extra precautions to protect children who are unvaccinated against COVID-19, particularly if there are underlying health conditions or they live in regions where coronavirus cases are surging.

Bay Area infectious disease experts say the cases underscore the need for vaccinations overall and are also a reminder that despite many gains, we still are in the midst of a dangerous pandemic.

“It’s important to remember that although California is doing extremely well right now — wonderfully well — the U.S. as a whole has the number of cases we had at the height of the summer surge,” said UC Berkeley infectious disease expert Dr. John Swartzberg. “We still have an awful lot of people infected in our society, which means that there’s still a tremendous potential of encountering those people.”

The U.S. is reporting an average close to 60,000 new cases a day, and policies from the CDC still advise against nonessential travel.

In Michigan, which is struggling to contain a surge of cases and hospitalizations from COVID-19, state officials have expanded their mask mandate to include children as young as 2 years old in public spaces.

Experts don’t recommend parents have children under 2 wear masks in public settings, but rather continue to practice the same risk-mitigation measures that have become standardized throughout the pandemic: social distancing, hand hygiene and ventilation.