The American Academy of Pediatrics on Monday recommended that all children over the age of 2 wear masks when returning to school this year, regardless of vaccination status.
The AAP, which said its important for children to return to in-person learning this year, recommends that school staff also wear masks. The AAP is calling the new guidance a "layered approach."
“We need to prioritize getting children back into schools alongside their friends and their teachers — and we all play a role in making sure it happens safely,” said Sonja O’Leary, chair of the AAP Council on School Health. "Combining layers of protection that include vaccinations, masking and clean hands hygiene will make in-person learning safe and possible for everyone.”
The AAP said universal masking is necessary because much of the student population is not vaccinated, and it's hard for schools to determine who is as new variants emerge that might spread more easily among children.
Children 12 and over are eligible for Covid-19 vaccinations in the U.S. And the FDA said last week that emergency authorization for vaccines for children under 12 could come in early to midwinter.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and chief medical adviser to the president, said on CNN Monday that the guidance makes sense.
"When you have a degree of viral dynamics in the community, and you have a substantial proportion of the population that is unvaccinated, that you really want to go the extra step, the extra mile to make sure that there's not a lot of transmission, even breakthrough infections among vaccinated individuals," he said.
“I think that the American Academy of Pediatrics, you know, they're a thoughtful group, they analyze the situation and if they feel that that's the way to go, I think that's a reasonable thing to do," Fauci added.
Universal masking will also protect students and staff from other respiratory illnesses that could keep kids out of school, the AAP said.
The AAP also said that campers should wear masks during indoor activities.
The Centers for Disease Control and Prevention recommended this month that vaccinated students do not have to wear masks in classrooms.
Dr. Francis Collins, director of the National Institutes of Health, said on MSNBC that the CDC may have been trying to be a little more lenient, allowing people to make judgment calls "depending on the circumstances in your school and your community."
But he said he understands where the AAP is coming from.
"They will not be popular amongst parents and kids who are sick of masks, but you know what? The virus doesn't care that we're sick of masks," Collins said. "The virus is having another version of its wonderful party for itself. And to the degree that we can squash that by doing something that maybe is a little uncomfortable, a little inconvenient ... if it looks like it's going to help, put the mask back on for a while."
What has not changed is guidance for children under the age of 2, which says it is dangerous for newborns and infants to wear masks because they can pose a suffocation risk, and babies and toddlers may try to remove them, actually increasing their chance of catching the virus.
All children should get caught up on vaccines they may have missed getting in the midst of the pandemic, like the flu shot, the AAP said.
“The last thing we want as we come out of this pandemic is an outbreak of another vaccine-preventable disease,” O’Leary said. “Now is the time for all of us to work together to keep our kids healthy and safe."