PROJECT SUMMARY SARS CoV2 is the novel coronavirus that presented in Wuhan, China on December of 2019 as a serious disease (COVID-19) associated to a severe acute respiratory syndrome. COVID-19 has spread with unprecedented facility around the world as a pandemic with catastrophic morbidity and mortality rates and widespread social, psychologic, and economic distress. The most severe clinical outcomes of COVID-19, viral pneumonia, severe acute respiratory syndrome, multiorgan failure, and neurologic disease, primarily affect high risk groups, such as the elderly and those with co-morbidities, but critical illness can present in younger persons, including children. Pediatric experts have also expressed concern that children are at higher risk for malnutrition, behavioral and mental problems, child abuse and vaccine preventable diseases during this pandemic. Measures taken to prevent transmission also cause significant distress and increase the risk for long term mental health problems in children and adults. While all in the population are perceiving the biologic, psychological, and systemic stressors of COVID-19, disease outcomes of the most vulnerable in society and those with health disparities are particularly concerning. The main goal of the proposed work is to gain knowledge from “protective responses” and resilience that vulnerable children and families from the Pediatric Outcomes of Prenatal Zika Exposure (POPZE) study are displaying in response to the COVID-19 pandemic. The POPZE children have special needs from a previous biological insult (prenatal Zika) and their mothers and siblings are vulnerable from socio- economic disadvantages and psychological distress. The study will pursue lessons in health equity from the life experiences of these vulnerable children and families through two study aims, Aim 1: To describe the multilevel stressors and needs associated to COVID-19 in a unique group of vulnerable children with prenatal Zika infection consequences and their families, and Aim 2: To determine how COVID-19 associated stressors affect the life experiences of vulnerable children and families and impact their health, family interactions, and quality of life. We expect that the responses that promote resilience will constitute a repertoire of culturally competent solutions that clinical and public health providers can use to promote the health and wellbeing of families at risk for health disparities in the face of adversity.