American Academy of Pediatrics recommends all kids older than 2 wear masks at school come fall. Experts weigh in.

Korin Miller
·4 min read

The American Academy of Pediatrics (AAP) has released updated guidance for the 2021-2022 school year, with an important point that differs from advice from the Centers for Disease Control and Prevention: The AAP recommends that all students and staff wear masks, regardless of vaccination status.

“All students older than 2 years and all school staff should wear face masks at school (unless medical or developmental conditions prohibit use),” the updated guidance reads. The AAP specifically listed the reasons for the universal masking recommendation:

  • A “significant portion” of students are not eligible for vaccination.

  • Universal masking will protect unvaccinated students from COVID-19 and “reduce transmission.”

  • A “lack of a system” to monitor vaccine status in students, teachers and staff.

  • It would be difficult to monitor or enforce mask policies for those who are not vaccinated. “In the absence of schools being able to conduct this monitoring, universal masking is the best and most effective strategy to create consistent messages, expectations, enforcement, and compliance without the added burden of needing to monitor vaccination status,” the AAP says.

  • Possibility of low vaccination rates in the surrounding school community.

  • Continued concerns about variants that are more easily spread in children, teens and adults.

  • An added benefit of protecting students and staff against other respiratory viruses.

Students wearing masks during third-grade summer school in Los Angeles, California. The AAP recommends that all students and staff wear masks, regardless of vaccination status. (Carolyn Cole / Los Angeles Times via Getty Images)
Students wearing masks during third-grade summer school in Los Angeles. (Carolyn Cole/Los Angeles Times via Getty Images)

Currently, children aged 12 and up are eligible to get the COVID-19 vaccine in the U.S. However, most elementary school students and some middle school students are not yet eligible.

The CDC’s guidance for COVID-19 prevention in schools, which was updated July 9, says that “masks should be worn indoors by all individuals (age 2 and older) who are not fully vaccinated.”

Some doctors are supportive of the news. Dr. Richard Watkins, an infectious disease physician and professor of internal medicine at Northeast Ohio Medical University, tells Yahoo Life that the AAP’s guidance is “fantastic,” adding that he “completely agrees” with the organization’s decision.

Dr. Daniel Ganjian, a pediatrician at Providence Saint John’s Health Center in Santa Monica, Calif., also supports the AAP’s recommendation. “We should continue to wear the masks until the pandemic is officially over — not preemptively stopping with the masks and popping champagne early on,” he tells Yahoo Life.

“This is the right thing to do,” Dr. Dennis Kuo, chief of the Division of General Pediatrics at Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, tells Yahoo Life.

Kuo also cites the coronavirus’s Delta variant, which is spreading rapidly in unvaccinated Americans, as a concern. “The Delta variant looks like it’s behaving much more aggressively than prior strains of the virus — it’s much more contagious and seems to be impacting kids more,” he says. “As a pediatrician, I want to see the kids in schools with the goals of schools staying open and all kids in schools. Masking can help.”

“There is a strong rationale for this recommendation,” Dr. Rosemary Olivero, a pediatric infectious disease physician at Helen DeVos Children’s Hospital in Grand Rapids, Mich., tells Yahoo Life. “The uptake of COVID-19 vaccinations in those who are currently eligible under the current emergency use authorization is still quite low. For children younger than 12 years, there is no current COVID-19 vaccination. Taking this together, and knowing the astounding success most districts had with preventing the spread of COVID-19 in schools with simple strategies such as universal mask wearing, it makes great sense to continue to use masks universally.”

But not everyone is on board. Infectious disease expert Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, doesn’t agree with the AAP’s guidance. “I am unaware of any science supporting the notion that fully vaccinated individuals need to wear masks,” he tells Yahoo Life. “The data show that once you are fully vaccinated, this virus is not a risk to you and you are not a risk to others.”

Adalja says that the CDC’s guidance “is correct that fully vaccinated individuals do not need to wear a mask.” And, he says, schools following the CDC’s recommendations may prompt others to get vaccinated. “If the goal is to get more children vaccinated, asking them to wear masks despite vaccination status is not a good incentive,” he says.

As for whether schools will adopt the AAP’s recommendation, it’s unclear at this point. “I really hope this is not going to be politically motivated, but medically driven,” Ganjian says. “Schools should follow the advice of the AAP.” But Olivero says that it’s “very difficult to say” which way schools will go. “Many school districts have already communicated expectations for the start of the school year,” she says. “However, we encourage physicians, school administrators and the public to remain flexible and be willing to bend to the needs that we will have as the pandemic continues to evolve.”

Ganjian offers this advice for parents before the start of the new school year: “Stock up on masks.”

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