What The New Mask Guidance Means For Unvaccinated Kids — And Their Parents

When the CDC announced on Thursday that fully vaccinated people can safely take off their masks in most settings, one group that did not necessarily breathe a sigh of relief was the parents of young children.

Some noted that the CDC's new guidance does not have any specific advice for vaccinated parents with unvaccinated kids in their households.

So we dug into the current guidance for kids and parents, and talked with infection prevention expert Dr. Emily Landon about the risks – and how her family is handling this complicated limbo.

What are the COVID-19 risks for kids?

While children and adolescents who get infected by the coronavirus tend to have less severe cases of COVID-19, they can get sick and they can spread the virus to others. And some children have developed serious complications from the disease, including a rare but serious medical condition associated with COVID-19 called Multisystem Inflammatory Syndrome in Children (MIS-C).

There are also increasing concerns about persistent, long-term effects of the viral infection — such as fatigue, respiratory issues and stomach problems — for some children who get COVID-19.

So what's the mask guidance now for adolescents aged 12 and up?

As of this week, the Pfizer vaccine is available to people age 12 and up. (The Moderna and Johnson & Johnson vaccines are currently approved only for those 18 and older.) That means kids age 12-15 who get their first Pfizer vaccine dose now will be fully vaccinated in about five weeks – two weeks after they receive their second dose.

Once they are fully vaccinated, the CDC says it's safe for them to remove their masks in most settings, just like fully vaccinated adults. But state and local laws apply, as do school and business policies. And masks will still be required for all on buses, trains and planes, and at stations and airports.

What about kids under 12?

There aren't any vaccines currently approved for their use in the U.S. – which means the younger set need to keep masking for the time being.

The CDC says all unvaccinated people age 2 and older "should wear masks in public settings and when around people who don't live in their household."

Experts at the American Academy of Pediatrics recommend unvaccinated children 2 and older continue to wear masks around others when indoors, especially when they are among at-risk adults such as those who are immunocompromised or over 65.

"We know children over age 2 can safely wear masks to protect themselves and others from transmitting the COVID-19 virus. We've already seen how the masks have helped prevent the spread of respiratory infections within schools, camps and other community settings, particularly when everyone wears them, washes hands and follows other infection control guidance," Dr. Yvonne Maldonado, chair of the AAP Committee on Infectious Diseases, said in a statement.

All three makers of U.S.-authorized vaccines are currently studying the safety and effectiveness of their vaccines in children, including as young as 6 months.

But it will likely be at least a few more months until there's a vaccine approved for those under 12. Pfizer says it won't be ready to ask for FDA approval for its COVID-19 vaccine in younger kids until September.

I'm fully vaccinated, but my kids aren't. Can I safely take off my mask in most places?

According to the CDC's guidance, the answer is yes.

In its updated guidance for fully vaccinated people, the CDC doesn't list an exception for parents with unvaccinated children in their household. (People with immunocompromising conditions, however, including those taking immunosuppressive medications, should talk to their doctor after they've been vaccinated to discuss what protective measures they might need.)

Dr. Emily Landon, who leads the infection control and prevention efforts at University of Chicago Medicine, says the data supports the idea that fully vaccinated parents of unvaccinated children can safely take off their own masks.

"The vast majority of the data that's coming out — and what we're seeing anecdotally on the ground, taking care of patients — is that individuals who get COVID after they've been vaccinated, as long as they're not immunocompromised, they get really mild disease and they have such low viral loads that they're not passing it on to their family members," Landon says.

For vaccinated parents, it's okay to remove your masks, Landon says: "As long as everybody in your family, including yourself, are low-risk, it's probably fine for you to have an unmasked lifestyle now."

But she says parents might want to keep wearing a mask when they're out with their kids, to set a good example for them.

"Kids often do what they see their parents do. And I know a lot of my close friends who are physicians who have children under the age of 12, and I have a child who's not fully vaccinated yet because he's only 12. And we think it's really important to continue to wear masks, in solidarity with our kids, to help them feel like they're not an outlier and to make sure that we're setting a good example for them," Landon says.

What if my child is immunocompromised?

"You may want to be more careful and make sure that you're not even bringing home asymptomatic COVID," Landon says. "This is going to be a personal decision for parents. But there is nothing wrong with continuing to wear your mask if you want to be continue to take extra precautions against COVID."

And when you're indoors in a crowded environment, you should protect your eyes as well, she says. [Copyright 2021 NPR]