With no COVID-19 vaccine available yet for children younger than 12, parents are asking how to keep them safe, especially now with the highly contagious delta variant gripping the metro and schools starting up again soon.
The short answer: Mask up indoors in public, including schools — even if it’s not required. Get sick children tested — remember COVID testing? And make sure Mom and Dad are vaccinated.
“It is true that kids are affected by COVID at a smaller percentage than adults. But they are getting very sick,” said Kristin Sohl, president of the Missouri chapter of the American Academy of Pediatrics.
“It’s really difficult for physicians to be able to talk about their patients because we have privacy protections. And yet, we have lots of children here in mid-Missouri who are hospitalized right now and some are intubated, on a breathing tube, and they’re 9 and 10.”
It’s unclear when a vaccine will be available to children under 12 — fall at the earliest.
So we asked medical experts to answer parents’ questions about school, travel, visiting unvaccinated relatives and more:
Should my unvaccinated child wear a mask back to school?
Yes, many experts say, even if the school does not mandate it — and as of now, most in the Kansas City area do not.
The Centers for Disease Control and Prevention recommends masks indoors for unvaccinated students and staff. The American Academy of Pediatrics went further, recommending everyone wear masks in schools, vaccinated or not.
“The CDC was pretty clear about fully vaccinated people not needing to wear masks out in public,” said Dr. Angela Myers, division director of infectious diseases at Children’s Mercy. “But kids under 12 have not been able to be vaccinated up until this point, so they should have continued to be masked.
“I’m not talking about while outside and playing outside. I’m talking about when they’re in groups of people or when they’re indoors and things like that.”
Like at school.
“I hope that for schools that aren’t requiring masks, if a child is wearing a mask at school and they’re one of the few or only ones, that the school has a very tough anti-bullying policy,” said Myers.
“Because it’s going to be really important to support those kids who are bravely wearing their masks when others aren’t doing it when they know their parents want them to and they want to keep themselves safe. Or maybe they have a disease that makes them at higher risk for severe infection.”
Vaccination rates among eligible older children are lower than health officials would like. So the majority of kids going back to school won’t be vaccinated, said Myers. And public health officials expect COVID cases among children to rise when school starts
“Until we have better vaccine uptake, it’s really hard to not be masking,” she said.
Should my unvaccinated child wear a mask in other public places?
Anyone who is unvaccinated, including children older than 2, should be masking up in public, especially in crowded, indoor spaces, the CDC says.
But look around. Not many adults or children are wearing masks now that mandates and restrictions have been lifted.
Masking up might be a bother, “but kids are tough, kids are resilient,” and some might even understand better than adults why it’s necessary, said Sohl, a Columbia pediatrician.
A quick pediatrician tip: If your unvaccinated child wears a mask, consider wearing one too in solidarity, even if you are fully vaccinated.
What activities are safe?
Crowded indoor spaces? Not so good.
The CDC offers guidance for safe activities for unvaccinated people of all ages, and precautions to take.
The safest activities for unvaccinated with no mask required: Outdoor activities with members of your own household or small outdoor gatherings with vaccinated people.
The least safe, even when masked? Movie theaters, eating indoors at a restaurant and full-capacity indoor worship services.
Do I really need to get vaccinated?
Parents of unvaccinated children need to get the shot themselves so they don’t infect their kids, pediatricians said.
“Of course I’m going to get on my soap box,” said Ginny Boos, Saint Luke’s Health System director of infection prevention. “Parents should be vaccinated. And when their kids are able to be vaccinated they need to do that.”
Pediatricians describe a defense strategy called cocooning, more commonly used in protecting unvaccinated babies, making sure adults around them get all their shots for influenza, tetanus, etc.
“We cocoon them and protect them by protecting everyone around them,” said Sohl. That holds true for COVID-19.
What about being around unvaccinated people?
Unvaccinated people are infecting local children, pediatricians report.
“What I’m seeing in the office this week, and this is just like it was in the height of January and February, the kids are getting it from unvaccinated adults,” said Overland Park pediatrician Natasha Burgert.
“This is an adult problem, not a kid problem. And quite honestly, I would not be even worried about masks, I would not even be that concerned about delaying the 12 and unders from getting vaccinated if I knew that my Kansas City adults had taken that responsibility upon themselves to protect the children.”
Be selective about where you take your unvaccinated children, said Boos.
“It doesn’t mean that you can’t go to the park, doesn’t mean you can’t have some entertainment. But let’s be smart about where we do go,” Boos said. “Is it really necessary to take my child and go out shopping in a big mart?
“Would you go around a group of people that you know have the flu? Or that have been exposed to the flu?”
What about being around unvaccinated family members?
Parents have to weigh the benefits and risks, pediatricians said.
“I’m not here to cause a war in family units,” said Burgert. “Those have already been done this last year. We have to remember that vaccination is probably one of the most important risk mitigation measures, but it’s not the only one.”
For instance at gatherings where other people might not be vaccinated, being outdoors is better than being indoors.
“I think part of the thing you have to think through is, are the people who are unvaccinated typically very careful, meaning are they wearing a mask out in public, not going to large gatherings, (being) really good about hand washing and kind of keeping their distance from people?” Myers said.
“Or, are they kind of on a different wavelength and they’re not concerned at all and they’re going about their normal life?”
Parents can have their unvaccinated child wear a mask at gatherings where they know people will be unvaccinated, Myers said.
“You can also ask the unvaccinated relative to wear a mask,” she said. “As a parent, your goal is to keep your child safe. Ultimately you have to do what you feel is right for your child and advocate for them.
“And I understand that those conversations can be tricky and difficult. It’s just imperative that we all give each other a little bit of grace right now as we kind of work through this.”
Can we go on vacation?
Yes. But parents might reconsider vacationing in places with high COVID and low vaccination rates, pediatricians recommend.
“I think probably now is not the time to be hanging out at the Lake of the Ozarks or Branson because the case rates are so high,” said Myers.
Even if you travel to a hot spot, Burgert said, there are ways to be safe.
“It doesn’t mean you can’t go, but this is going to be a situation where we’re going to choose to stay at the hotel and go to the pool instead of go to the amusement park,” said Burgert. “Or maybe we’re going to play outdoor putt-putt golf instead of go to that indoor show. We have to remain appropriately flexible while we continue to live our lives.”
How do I know if my child has COVID-19?
Symptoms vary. For instance, adults tend to lose taste and smell more than children do, Burgert said.
Complicating things right now is an unusual spike in respiratory viruses in children “that we wouldn’t normally see this time of year,” said Myers.
“It does somewhat depend on the age of a child,” said Myers. “The older the child, the more consistent their symptoms are with adults, especially over the age of 10.
“Under the age of 10 they may have more mild symptoms. They might just have the sniffles and cough, maybe a little bit of a low-grade fever and abdominal pain. Nausea, vomiting, diarrhea. Sometimes sore throat.”
Myers said some people might think their children have a cold when, in fact, they have COVID.
Children need to be tested for COVID if they show symptoms, said Myers, even if they are mild “because it changes what your behavior should be if you’re positive. You should be at home in isolation until you’re no longer infectious.”
Where can I get my child tested for COVID-19?
Children can get tested at many places — their pediatrician’s office, local pharmacies. County health department websites list testing locations. You can even test at home now— some FDA-authorized at-home tests give results within minutes.
Testing children, and keeping sick ones at home, will be even more important as kids head back to school, Burgert said.
“I’ve been around the sun quite a few times doing this job and we know that under different conditions and for different reasons, parents send their kids to school sick,” she said. “Testing is not going to save us from the pandemic, vaccination is. But it’s a very relevant tool.”