Masks & Kids
Vaccinated People Can Ditch Masks. Where Does That Leave Kids?
Experts weigh in on the new CDC mask guidelines and what they mean for children and families.
The CDC’s newest mask guidelines exploded into the news yesterday, declaring that vaccinated people no longer need to wear a mask (or socially distance) either indoors or out. There were caveats (people must still abide by state and local mask mandates, which vary widely, and many businesses say they plan to continue to ask customers and employees to mask) but it was one of the biggest signals yet that the pandemic has turned a significant corner and that vaccinated people will return to something like “normal” life.
But almost immediately came questions from parents and families: What about kids? My 6-year-old is not a vaccinated adult; she’s not even a vaccinated kid. She has been so good about wearing her mask every day of in person 1st grade and into Publix and while waiting on line for ice cream. I can’t wait to tell her she can ditch it. Where does this leave her? And where does this leave my unvaccinated 2.5-year-old and the absolute hysteria she unleashes after wearing a mask for more than two seconds?
Will Parents Go Maskless While Kids Wear Masks?
If we’re following the CDC’s guidelines, both my girls still need to be masked up. Which of course means I’ll also be masking up, because how can I ask them to wear a mask alone? They’re not vaccinated, and they’re still at risk — albeit a low one — and a lot of the fear surrounding the CDC’s new mask guideline is that unvaccinated people will ditch their masks and pretend like they are vaccinated, potentially infecting young children.
Because I’m in Georgia where there’s never been a mask mandate, this doesn’t worry me as much as it seems to concern my colleagues in places with greater mask adherence. People have been walking around without masks since March 2020 — I don’t assume that a mask-free face means someone has been vaccinated.
Do Little Kids Even Need Masks — The WHO And CDC Disagree
Dr. Monica Gandhi, an infectious diseases doctor at UCSF, is a mom who understands the complicated position this new guidance puts parents in and how it feels like the CDC just isn’t offering any good guidelines for children. But Gandhi believes the CDC’s guidelines on children and masks have been off for quite some time.
“The CDC is wrong on this and the WHO is right,” she tells me. “No masking of little children. No masking outside, period.”
While the CDC’s guidelines have remained pretty steadfast when it comes to children — kids over the age of 2 are expected to wear a mask — they have been very different from the World Health Organization’s list of guidelines. One of the main components of WHO’s guidelines is that children under the age of 5, in general, don’t need a mask unless there’s a very specific situation — like if they’re very close to someone who is ill. In fact, it’s only children 12 and up who are expected to wear a mask like an adult, according to WHO, and masks are recommended for children between the ages of 6 and 11 only if there is widespread transmission in the area, but not if it compromises their psychosocial development or learning.
Should Masks Outside Be A Thing At All?
Outdoor masking is another wrinkle. The WHO says children should not be wearing a mask at all if they are outside running, playing, and/or involved in outdoor sports. Just limit the number of children playing together. Compare this to the recent CDC guidelines for summer camp — so far still in place — which suggest that children attending even an outdoor camp should remain masked.
“I’ve begun telling my patients that their kids, vaccinated or not, do not need to wear masks outside—despite the fact that the CDC recently issued summer-camp guidelines that recommend kids wear masks whenever physical distancing is difficult, including outside,” Dr. Lucy McBride, a practicing internist in Washington D.C., wrote for The Atlantic. “I know that parents in some communities get dirty looks at the playground if they let their kids run around without masks, but doing so is not a sign of recalcitrance; it’s a sign that they’re following the science.”
Kids May Be Low Risk — But They’re Not No Risk
So the CDC tells us that only fully vaccinated people can go maskless, which doesn’t include children. WHO tells us that our little kids — the ones in that sweet spot of “can’t get vaccinated, but are older than 5” — shouldn’t be masked, even back when most people were not vaccinated. It’s... confusing.
Dr. Purvi Parikh, an allergist/immunologist with Allergy & Asthma Network, disagrees with letting children go unmasked. “One in five COVID cases are pediatrics,” she tells Romper. “Given new guidelines, they need to be stricter than a fully vaccinated adult.” She agrees that outdoors is low risk, especially with room to distance. “But again, would recommend masking until child is vaccinated.”
But Parikh — and other experts — are clear that if a child’s parents and other adults around them are vaccinated, they are still protected in some way. “Kids get indirect protection from COVID as the people around them are vaccinated,” Dr. McBride tells Romper.
All this feels like even more risk management. (And parents are very tired of all the managing they’ve had to do in the last 14 months.) We can’t just throw away our masks and be done with it (not that anyone I know is actually doing this) — they’ve got to constantly weigh the options. Will I be masking my kid up so she can swing on the swings? Will she need to wear a mask next year for second grade? Will I keep reminding her to pull it up over her nose, to stop taking it off to talk, to just leave the mask on already as we walk down an empty aisle at Publix?
What it boils down to is what level of risk is acceptable to me for my children. “Kids should be allowed to unmask as long as they and their parents/guardians are willing to undertake the risk of getting COVID which — for kids — is small,” says McBride.
Many professionals have been trying to explain for a while now that parents’ fear of their children contracting COVID-19 is exacerbated by extreme headlines. Remember all of that terror last summer about MIS-C? “The prevalence of long COVID in kids is low and the risk of contracting MIS-C is tiny,” wrote Dr. McBride, adding that MIS-C is also treatable. Some experts even took to The Washington Post to suggest that kids are such a low risk, we should send vaccines to countries who need it, like India, before making children ages 2 to 11 a vaccine priority.
The Risk Of Covid — For Everyone — Is Fading
Because my husband and I are vaccinated, I feel like we’re protecting our unvaccinated children, and Dr. Gandhi agrees. On Twitter, she wrote to a person asking about their 8-month-old being unvaccinated, “I understand why people feel nervous but honestly, your 8 month old is safe around maskless vaccinated people (and they are asymptomatic).” Her theory is that, as more vaccines are distributed and as cases go down, masks just won’t be necessary — even for unvaccinated children — because the general threat of Covid has been reduced so much. In response to a parent asking about kids under the age of 12 who need masks, Gandhi tweeted, “But masking will not be necessary when anyone for case rates are so low...think of it like 2019, do you see what I mean?”
Dr. McBride wrote about this, too. “The big picture is that we’re entering a new phase of the pandemic. As more than half of adults in the United States have received at least one vaccine dose and case rates drop, the risk of transmitting COVID-19 to unvaccinated people also lowers. In Israel, more than 60 percent of adults are fully vaccinated (kids under 16 are not), and cases in kids have fallen 99 percent since January.”
I ask Dr. McBride what she thinks about children wearing masks indoors for summer camps or school in the fall. My first grader wears her mask all day, every day, but do we think she’ll have to wear them into second grade if all the teachers around her are vaccinated? “I think we need to lift mask mandates for kids — and put the responsibility on adults to get vaccinated and understand that each child has different risks, so should mask up if they need/want to,” she says.
You Can Always Wear A Mask If You Want To
It’s also worth noting that if you’re concerned for those who aren’t and can’t be vaccinated — or you just feel safer — masks still work and you can wear one. Dr. Parikh recommends that masks still be worn in public transport of any kind — bus, train, or plane. “If unvaccinated, indoors is a must if in large groups or in public places. Also if a person or child has underlying immune issues, I would continue to mask until fully vaccinated and/or cleared by doctor,” she told me. She says that there are certain immune conditions that will still require masking up.
It’s frustrating that there’s no clear Here’s What Parents Need To Do recommendation from the CDC, but then again, has there ever been that kind of guide in any situation? Everything is about risk management, figuring out what makes you and your family comfortable, and going from there. Nobody is saying you can’t continue to mask your family up, and what most experts told me is that you shouldn’t judge a family whose child isn’t masked.
But that’s parenting — there’s judgment everywhere. Add COVID masks to the list along with car seats, breastfeeding, co-sleeping, and Montessori toys versus loud, plastic, singing toys. My take? Get vaccinated to protect yourself and your kids — so they can have a bit of normalcy back as well.
Monica Gandhi, MD, MPH; infectious diseases and HIV doctor at UCSF
Dr. Lucy McBride, a practicing internist
Dr. Purvi Parikh, allergist/immunologist with Allergy & Asthma Network