It's only July, but the Centers for Disease Control and Prevention is focusing on the coming school year, and its message is clear: It wants students back in the classroom.
On Friday, the agency issued updated guidance for K-12 schools, highlighting the importance of getting as many eligible children vaccinated as possible to return classrooms to normal or near normal and enumerating its list of best practices to prevent transmission of COVID-19.
So far, just 1 out of 3 kids ages 12 to 17 have received a COVID-19 vaccine. The Biden administration is hoping to boost these numbers before school starts in the fall.
"For families who haven't gotten their kids vaccinated yet, now is the time," says Erin Sauber-Schatz, lead for the Community Interventions and Critical Populations Task Force at the CDC. "It takes five weeks to get fully vaccinated. If you got your first shot today, the second would be July 30, and you'd be fully vaccinated on Aug. 13. So now's the time if you haven't gotten vaccinated yet."
If a high school could document that everyone in the building was fully vaccinated, she says, school would look a lot like it did pre-pandemic. Of course, the reality is that most schools will have a mix of vaccinated and unvaccinated students and staff.
The updated guidelines note that fully vaccinated staff and students may not need to wear masks at school. (But because of the CDC order requiring masks on public transportation, they would have to mask up on school buses.)
For students too young to be vaccinated at this time, the CDC suggests multiple strategies to reduce the risk of transmission: notably, mask-wearing for ages 2 and up and physical distancing when possible of a minimum of 3 feet in indoor school settings (even when children are vaccinated).
Additional protective measures advocated in the CDC guidelines include hand-washing and good indoor ventilation and cleaning procedures. In addition, the CDC urges any students or staff with signs of infectious illness to stay home, be tested for the coronavirus and quarantine if indicated.
The guidelines put a priority on in-school instruction and emphasize the need to be flexible. "If 3 feet is not feasible, it should not keep kids out of school," Sauber-Schatz says. "In our guidance we focus on the most important prevention strategies, and they should be removed one at a time and then closely monitored" to make sure infection rates don't rise.
The CDC adds that enforcement of these guidelines is up to local jurisdictions.
Meanwhile, in the immediate weeks ahead, parents may also be wondering about how to keep unvaccinated kids safe during summer vacations and outings.
The CDC recommends not traveling until you're fully vaccinated, but that leaves many families with a conundrum, say Dr. Nipunie Rajapakse, a Mayo Clinic pediatric infectious disease specialist, and Dr. Jill Weatherhead, Baylor College of Medicine assistant professor of adult and pediatric infectious diseases.
"That really puts families in a tough spot when you have parents and older siblings who have been vaccinated and younger siblings who have not," Weatherhead says.
Don't worry: You probably don't need to leave unvaccinated kids at home, say our sources — though much depends on a family's individual circumstances and risk tolerance. But Weatherhead and Rajapakse say that many families will be able to make traveling with unvaccinated kids acceptably safe. Here's how:
Last summer, Weatherhead's husband drove the couple's two young kids from Houston to their annual summer vacation in Michigan. This year, they flew — with plenty of hand sanitizer and distancing whenever possible. They were able to snag flights on a carrier that flies out of an airport that isn't super busy and allowed them to choose their own seats upon boarding. Of course, that's not an option on most carriers, and Delta, one of the last U.S. airlines to leave middle rows vacant, began booking those seats in May.
Flights haven't turned out to be superspreaders, although it matters who is seated near you: On a September flight from Dubai, United Arab Emirates, to New Zealand, at least four people within two rows of a contagious passenger got COVID-19.
"You never know who is seated near you, especially on long flights when you're in close proximity," Rajapakse says. "And at airports, people from different parts of the country and the world are mixing in a confined area."
With no way of knowing which passengers are vaccinated, make sure unvaccinated kids keep their masks on as much as possible. (Masks are still required in airports and on flights.) In addition, unvaccinated kids should also adhere to physical distancing guidelines while traveling and good hand hygiene — and get tested before and after a flight, according to the CDC.
That could mean finding a less busy area in the airport to wait in before your flight, toting your own hand sanitizer, avoiding crowded restaurants and kiosks, and keeping snack and water breaks as brief as possible. If your kids need a snack on board, make sure they wait until other passengers have finished eating and masked up again.
"There's always going to be some risk, but we can reduce it in the healthiest way possible," Weatherhead says.
To avoid awkward scenarios, have the COVID-19 conversation ahead of time, Weatherhead suggests.
"People should have open discussions with the people they're visiting about what makes them feel safe," she says. "The more you can communicate that ahead of time, the more enjoyable it will be for everyone."
For example, Weatherhead suggests saying: "Please, everyone get vaccinated because I'm bringing my 2-year-old and I want to see you, but I want to protect her."
The easiest way to protect everyone in your family is to encourage the adults to get vaccinated and to ensure their tweens and teens are fully vaccinated before the planned gathering, Rajapakse and Weatherhead agree.
"If there are unvaccinated individuals, the risk goes up for everyone," Rajapakse says.
The more you can "cocoon" unvaccinated kids by surrounding them with vaccinated people, the more you can protect them, Weatherhead says. "It's the safest thing you can do besides staying home."
Once you're there, you can further reduce risks by planning outdoor activities and spacing out tables at meals, Weatherhead adds.
Precautions shouldn't end after your trip, even if most people in your community have let their guard down. With the delta variant now accounting for more than half of new COVID-19 cases in the U.S., it's important for anyone who's not vaccinated to adhere to mask-wearing and physical distancing — especially if you live in an area with low vaccination rates and high transmission, Rajapakse says.
Instead of focusing on national numbers, Rajapakse recommends staying on top of your community's rates: "Knowing who you're around and what's going on in your community and who you're interacting with is the more important statistic," she says. "As we see the virus circulation rates go down, we will see risks go down — but the risk to kids is not zero, especially with the delta variant."
If your under-12 kids are reluctant to be the only ones in a store wearing masks, put your own on.
"Even though my husband and I are vaccinated, we wear masks to protect them as much as we can and to model that behavior for them," Weatherhead says.
And remember, vaccines for kids are on the way.
Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She's written about COVID-19 for many publications, including Medscape, Kaiser Health News, Science News for Students and The Washington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia.
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