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Ask a Pediatrician: Should My Vaxxed Child Mask Up at School to Protect My Unvaxxed Child at Home?

“Our elementary school just became mask-optional, and I don’t know what to do! My 7 year-old daughter is vaccinated, but her 3 year-old brother is not. Should she mask up to protect him? Or are the risks low enough that it doesn’t really matter?”

As if we parents haven’t had enough anxiety about doing everything we can to keep our children safe during the past few years, recent changes to public health protective measures like masking have added to the stress of many, especially those with children too young to be eligible for the COVID-19 vaccine. And there’s no denying that many parents and caregivers have experienced a wave of mixed emotions over the last several months.

I’ve heard from many who are concerned about allowing their vaccinated children to go mask-free at school when they have unvaccinated children at home. But while I know many of you want definitive answers, it’s important to remember that the decision-making process on this is nuanced, can be somewhat fluid and definitely is not “one size fits all.” Some families may wish to continue to mask and “see how things go” over the next month or so, and then decide what is most comfortable for their individual situation. That’s a totally reasonable position to take.

For those who are weighing the option, there are five key points I would encourage you to consider:

1. Evaluate your community’s positivity rates

The CDC creates overall public health guidance but it’s important to know that mask mandates are determined by local departments of health. Track the positive case rate within the community where you live and where your child goes to school to confirm if the numbers are in fact low and/or on a decline. Overall case rates must be low at baseline before considering unmasking.

2. Consider your younger child's risk factor, as well as other vulnerable people in your home

While the risk of severe illness from COVID-19 is low for otherwise healthy children, it is not zero. But if you are comfortable taking this small risk, it's not unrealistic to allow your older child to remove her mask. Just remember, your younger child isn't the only one this might affect. Think about if there are other immunocompromised or medically fragile persons in your household. Just because the state in which you live has made masks optional in schools does not mean those concerns disappear. The pandemic isn’t over. It’s important to remember there is still risk of COVID-19 to vulnerable persons in your home, such as live-in grandparents, and this needs to be considered when weighing your decision.

3. Different scenarios may dictate difference practices

Whether or not to wear a mask doesn’t need to be an “either/or” decision to be applied to every situation at all times. There’s more nuance involved in our consideration now, so it’s time for us to stop thinking about the topic in a binary way. If they are older, involve your children in the discussion about various classroom settings and determine if there are sessions during the day where it may be lower risk and therefore reasonable to unmask. For instance, a colleague of mine recently told me she sat down with her vaccinated elementary schooler and they decided together that he was going to wear a mask during math class because he and his classmates are seated close together, but he will go mask-free during art class because the students are much more spread out in that particular room. This approach won’t work for everyone, but does afford the opportunity to help children learn an early lesson about risk analysis.

4. Consider layered protective measures being taken at your child’s school

Don’t be afraid to ask administrators at your child’s school what specific layered protective measures are being taken to ensure lower risk of virus transmission. Will students continue to eat lunch in their classrooms vs. a cafeteria? Have improvements in ventilation been made? Are children still being taken outdoors for certain activities whenever possible? Are there hand washing and sanitizing protocols in place before and after meals, etc.? Is distancing still being implemented when possible? These practices, when deployed together as part of a layered strategy, have proven to be effective in mitigating virus transmission and should continue to be championed in schools.

5. Keep in mind the implications if a household member tests positive

When deciding on your approach, consider the risk tolerance of your individual family and household. What would happen if your 3 year-old did in fact test positive for COVID-19? Would you and other adults in your house be able to take the required time off of work and isolate with your young child, or would that present a challenge for your family? This is a factor that can play a role in your decision. 

There are very few definitively right or wrong approaches here. Masking has clear benefits so erring on the side of caution is never the wrong move. Whether you’re eager to get rid of masks or feel that unmasking children in schools is premature, be okay with allowing your decision to be nuanced and fluid. Take certain risk factors into consideration when carving out the path that feels comfortable for you and your family, but remember, it’s okay to give yourself grace and change your mind.

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