What can unvaccinated kids do?
Experts opine on what’s allowable as socializing restarts
As vaccinated Americans return to many parts of their pre-pandemic lives this summer, one group will be left out: children younger than 12, who cannot yet be vaccinated. So what should families with young children do when everyone else starts socializing again?
We asked experts as part of an informal New York Times survey. The group of 828 who responded included epidemiologists, who study public health, and pediatric infectious disease physicians, who research and treat children sick with diseases like COVID-19.
They noted that this phase was temporary. Pfizer has said vaccines for children ages 2 and older could come as soon as September. Of the survey respondents with young children, 92% said they would vaccinate their own children as soon as a shot was approved. In the meantime, families with young children may need to retain more precautions, like masking and distancing, than their childless friends do. But they said some minimally risky activities could help counteract the mental health effects of pandemic living.
“Kids need to be able to be kids,” said Mac McCullough, an associate professor at Arizona State University. “Outdoor activity isn’t perfectly safe, but its benefits are likely to outweigh its risks across an entire population.”
We asked the experts about a few situations that families could encounter and how they suggested parents and unvaccinated children should behave. There was no consensus, but they
mostly advised weighing the relatively small health risks against the benefits of widening children’s worlds. As always, epidemiologists — who tend to be a very cautious group — emphasized that it would depend on the exact circumstances and on local case rates.
“I think a lot of families are frustrated and feel left out and anxious as to how to navigate life now,” said Dr. Sahera Dirajlal-Fargo, an infectious disease pediatrician at Case Western Reserve University. “Children have asked me, ‘Everyone else gets to move on; what about us?’ I am focusing on what we know families can do safely, and we know so much more than we did last year.”
Here is what they said.
Indoor and crowded outdoor public places:
New guidance from the Centers for Disease Control and Prevention says
that vaccinated people can go almost everywhere without a mask. But what should families with unvaccinated children do, since it is impossible to know whether maskless people in public places are vaccinated? A slight majority said that despite that uncertainty, children could still go inside public places or be in outdoor crowds, as long as they wore masks.
Indoor social gatherings with other unvaccinated children: Vaccinated people can socialize indoors with one other household of unvaccinated people, the CDC says. But what about two families getting together, when the adults are vaccinated but the children are not? More than half of experts said unvaccinated children from different families should not gather indoors. But just over one-third said families
could gather indoors if they limited the number of families they saw this way.
Outdoor activities where masks are not an option:
Unvaccinated children are encouraged to continue wearing masks around other people, but there are some activities when that’s not possible. If they’re outdoors, and at low risk, it’s probably fine, 8 in 10 said.
Indoor activities where masks are not an option: But when it comes to indoor activities where masks cannot be worn at all times, children probably cannot safely do them this summer, three-quarters of the experts said.
Trips by plane: It is most likely safe for children to fly this summer, as long as they are fully masked and everyone else on the plane is, too, 86% of the experts said.
But they said this should be done with caution; consider double-masking and limiting the number and length of flights.
Outdoor playgrounds and sports:
Almost two-thirds of the experts said unvaccinated children should still wear masks while at playgrounds or playing sports outdoors, even though the virus is much less likely to spread outside.
Advice for vaccine-hesitant parents:
As a group, the experts surveyed were not conflicted about vaccinating children. Many cited the risk of long-term physical and neurological effects of COVID-19, which are still unknown in children. And they worried about new variants of the virus that could become more dangerous for children.
“We’re still learning about the long-term effects of COVID-19 in asymptomatic and mildly symptomatic previously healthy individuals,” said Rosa Ergas, syndromic surveillance coordinator of the Massachusetts Department of Public Health. “I’m not panicked about my kids getting COVID, but I’d rather they didn’t.”
Others concerned.
“I suspect that a proportion of children who have a COVID-19 infection will go on to have problems that are due to inflammation,” said Dr. Jessica Ericson, an infectious disease pediatrician at Penn State College of Medicine. “The long-term consequences of COVID-19 are unknown at this point but unlikely to be zero. This is in contrast to vaccination, which has no plausible longterm consequences.”
Beyond children’s health, they said, pediatric vaccines were necessary for the greater good. The pandemic is unlikely to end in the United States until children are vaccinated, they said. were more
The costs of isolation: Even as the experts urged continued caution until a pediatric vaccine arrives, they also emphasized that parents needed to weigh the risks of continued social isolation. Overall, the experts were somewhat more concerned about the mental health consequences of the pandemic for children than about its effects on their physical health.
“Isolation of children is detrimental to their mental and physical health,” said Kevin Andresen, leader of the COVID response team for the Colorado Department of Public Health. “Finding safe ways to have children socialize and play needs our full attention while we continue to evaluate vaccine efficacy in this group.”
The experts urged patience for a little longer.