OBJECTIVES: Coronavirus disease 2019 (COVID-19) has had a significant impact on adult residents and staff in long-term care facilities. Little is known, however, about the impact of COVID-19 and the uptake of COVID-19 vaccination in pediatric long-term care facilities (pLTCFs). METHODS: A survey was designed, piloted, and e-mailed to facilities participating in the Pediatric Complex Care Association, an organization consisting of 43 pLTCFs. Respondents were sent 1 reminder and given 1 month (April 2021) to report retrospective data from March 2020 to March 2021. In the survey, pLTCFs were asked to report data on COVID-19 infections and outcomes among residents and staff as well as COVID-19 vaccination status among residents and staff. RESULTS: Twenty-five centers participated, representing a 56% survey response rate. Of the residents, 7.0% (117 cases) were infected with COVID-19. The proportion of residents with COVID-19 by site varied from 0% to 41%. Among staff members, 22% (1665 cases) were infected with COVID-19, with a range of 8% to 44% of staff by site. Of residents, 1.3% were transferred to acute care. There were 3 resident deaths and 4 staff deaths. Early uptake of COVID-19 vaccination was common for residents (76%), whereas for staff, the rate was lower at 62%. At individual pLTCFs, vaccination ranged from 5 to 83 residents and 46 to 499 staff. CONCLUSIONS: Pediatric residents and staff of long-term care facilities were impacted by COVID-19, but mortality was low. COVID-19 vaccination rates among the children and staff were similar and higher than that reported from early national data in skilled nursing facilities.