Federal COVID-19 guidance released in March said it’s safe for fully vaccinated adults from different households to meet indoors without masks. It was the nation’s first step back to normal social gatherings since the coronavirus pandemic started.
But can unvaccinated kids join?
Evidence shows children are more likely to have mild cases of COVID-19, while young kids are less likely to spread the virus than adults. But they can still infect others around them, and although rare, some kids may experience severe disease.
“Children aren’t risk-free,” Dr. Kelly Fradin, a pediatrician in New York City, told NBC News. “We want to balance, realistically, that they are low-risk but not absolutely no risk.”
The Centers for Disease Control and Prevention says unvaccinated children can visit their grandparents and spend time indoors without masks as long as their grandparents are vaccinated, provided none of the unvaccinated family members are at risk of severe COVID-19.
But freedom narrows once unvaccinated people from other households are involved, the agency says. In the scenario above, if the neighbors, who are not vaccinated, decide to join the gathering, then the visit should be moved outdoors, masks should be worn and physical distancing should take place.
“This is due to the risk two unvaccinated households pose to one another,” the CDC says.
What the agency doesn’t address, however, is what to do if two unvaccinated kids from different homes want to hang out.
“As long as community spread is relatively low, and as long as none of the children are involved in outside activities that would increase their risk of contracting or spreading the virus, I would say that kids from two families can be included in small gatherings, and that the families can decide about mask use and other precautions individually, based on their comfort levels,” said Dr. Shawn Ferullo, the associate medical director at MIT Medical in Massachusetts.
And as more people get vaccinated against COVID-19, “the CDC is likely to loosen restrictions further,” Ferullo added. “In the meantime, vaccinated adults can allow the kids in their lives to begin to do some things they couldn’t do last year, and we can find ways to allow them to do these things relatively safely.”
What’s more, Dr. Ed Levy, a pediatrician at the same medical center, said he sees “more negative mental health effects in kids, as a result of isolation, than I see serious COVID disease.”
Experts agree it comes down to considering the risks: Do any of the unvaccinated people have medical conditions that increase their risks for severe disease? Do those involved in the gathering live with older adults or visit older loved ones who are not vaccinated in nursing homes?
Some doctors say to err on the side of caution
Other doctors worry the coronavirus variants, which appear to be more contagious, might complicate how comfortable people become with mixing unvaccinated children with others.
“There are some variants going around that increase the likelihood of spread … so the most important thing is to continue to physically distance for kids. When they’re at school, they need to mask,” Dr. Kate Williamson, a pediatrician at Children’s Hospital of Orange County in California, told ABC7. “When they’re around anybody else who is not vaccinated, they need to continue to mask.”
Dr. Rosemarie Roqué Gordon, a pediatrician at MIT Medical, agrees there are ways to mitigate risks as vaccine developers work on ensuring their COVID-19 shots are safe and effective for kids.
“I would recommend having the kids continue to wear masks,” Gordon said. “And, as the weather gets better, it’ll be easier to keep interactions mostly outdoors, where the risk of transmission is much lower.”
Generally, the older the child, the more precautions should be taken, experts say, because older kids are just as capable of spreading the coronavirus as adults.
Those “under 4 and 5 years, the risk of transmission to and from [these kids] is actually quite low, and the risk of having serious illness is low,” Dr. Michael Chang, a pediatric infectious disease specialist at the McGovern Medical School at UTHealth in Texas, told Vox. “So, [they] can be more flexible,” in the types of activities they share with others.
When will kids be eligible for COVID-19 vaccines?
A recent study found that the two-dose Pfizer coronavirus vaccine, which was the first shot authorized for emergency use in the U.S., reduced risk of coronavirus infection in children 12-15 years old by 100%, meaning no vaccinated kids were infected during the late stage trial.
It’s a stunning boost in protection against COVID-19 compared to people between 16 and 25 years old, who benefit from a 95% reduction in infection risks after receiving their second, final dose.
Top officials in the company said they hope to start vaccinating this age group before the next school year starts this fall.
Pfizer also said it already started vaccinating the first group of kids in its study among children between 6 months and 11 years old. This study is separated into three age groups: children aged 5 to 11 years, 2 to 5 years, and 6 months to 2 years.
Moderna announced in March that children between 6 months and 12 years old have started to receive its vaccine in a mid- to late-stage study. The company plans to enroll about 6,750 children in the U.S. and Canada.
Anyone 18 and older can receive the Moderna and Johnson & Johnson COVID-19 vaccines when they are eligible in their states; the Pfizer shot is authorized for those 16 and older.