In March, the U.S. Centers for Disease Control and Prevention (CDC) released its long-awaited guidance for people fully vaccinated against COVID-19. Those lucky enough to have received both vaccine doses (or one dose of Janssen/Johnson & Johnson’s single-dose vaccine) can now hang out in a private home, blissfully mask-free, with other fully vaccinated folks, according to the guidelines.
But what about families with kids?
As of now, kids younger than 16 are not authorized to get a COVID-19 vaccine in the U.S., so there’s no way they can be fully protected. Does that mean parents and their children are staring down another year of isolation? Here’s what to know.
Kids get seriously ill far less often than adults
First, the good news: It’s pretty rare for kids to get a severe case of COVID-19. According to CDC estimates, COVID-19 hospitalization rates are 80 times higher among adults older than 85 than they are among children of ages five to 17. Death rates for adults older than 85 are a staggering 7,900 times higher than they are for children.
There are always unfortunate exceptions, of course. Kids certainly have been hospitalized and died from the virus, and some have developed an inflammatory condition known as MIS-C. Some evidence also suggests kids, like adults, can develop long-term symptoms after an infection. But, in general, a child who gets sick with COVID-19 is likely to have a fairly mild case and make a full recovery.
So, what’s safe for my family?
Even though children are at lower risk, families with unvaccinated kids shouldn’t rush straight back into pre-pandemic life, even if both parents are fully immunized, says Dr. David Kimberlin, co-director of the pediatric division of infectious diseases at Children’s of Alabama. “We are beginning to loosen up and emerge from this darkness,” Kimberlin says, but “it’s not full sunlight” yet.
Your family can, however, take small steps. Under CDC guidelines, fully vaccinated people can visit with one household of unvaccinated people, provided none of the unvaccinated individuals has an underlying condition that puts them at risk of complications. That means, for example, that your children’s vaccinated grandparents could come to your house for an indoor, unmasked visit, even if the kids aren’t yet protected.
Such a visit isn’t entirely risk-free, says Dr. Richard Malley, a senior physician in Boston Children’s Hospital’s division of infectious diseases. Malley says he is confident that a fully vaccinated person is less likely to spread the virus than an unvaccinated person, but exactly how much less likely they are remains unclear. Without that information—and with new variants complicating our knowledge of the virus and how it spreads—it’s impossible to say exactly how risky it would be for an unvaccinated child to spend time unmasked around other people, even if those other people have had their shots.
Can the kids have a playdate?
Until your kids are vaccinated, Kimberlin says he wouldn’t invite anyone unvaccinated into the house without a mask—even another child. The kids could potentially infect each other, and then pass on the virus to someone else, he says.
This situation will improve with time, Malley says. As more adults get vaccinated, case counts, test positivity rates and hospitalizations should continue to fall. As they do, you may feel more confident about expanding your social bubble, since it will be increasingly unlikely that anyone in your circle was exposed to the virus. “That risk declines as the intensity of the virus in that community drops,” Malley says.
But for now, it’s still safest to arrange playdates for the kids outside, or inside wearing masks, Kimberlin suggests. And if your child has a health condition that puts them at higher risk of severe disease, you may want to continue taking precautions until he or she can get vaccinated.
What about vacations and public places?
Dr. Guliz Erdem, a pediatric infectious diseases physician at Nationwide Children’s Hospital, says you should be more cautious outside your home than in it. In a private home, you have a pretty good handle on how many people will be there and who has been vaccinated. That’s not true in, say, a restaurant or movie theater. “The main point is to avoid crowds and crowded settings—places that you cannot control what will happen,” she says.
Here, too, the situation will improve as more people get vaccinated and there’s less virus circulating in your community. But right now, the virus is prevalent enough in most areas of the U.S. to justify avoiding shared indoor spaces, particularly those where people won’t be wearing masks.
As for vacations, the CDC does not yet recommend recreational travel, even for those who are fully vaccinated. But if your family decides to take a trip, try to pick a destination where the virus isn’t spreading widely—and, ideally, one within driving distance. Airplanes haven’t proven to be common places for the virus to spread, but the family car is even lower risk, Malley says.
And plan your activities with COVID-19 in mind, Malley says. If you’ve got an unvaccinated child, spending time at the beach is likely a safer choice than a day full of indoor activities.
Can the kids go back to school?
Luckily, data are increasingly suggesting that schools are not a major breeding ground for the virus, as long as the institutions take proper precautions around masking, social distancing and ventilation. Schools will also become increasingly safe as more adult employees get vaccinated.
As long as your kid’s school is following COVID-19 protocols—like requiring masks inside and keeping students spaced a few feet apart—it’s probably safe to send them back to the classroom. Malley, Erdem and Kimberlin all say they’d feel comfortable sending a school-aged child back, provided the school has implemented the right precautions.
But if you don’t feel your school’s safety plan is adequate, or if there’s an outbreak in your area, that may be an argument for keeping the kids home at least a while longer.
When can my kids get vaccinated?
That depends on when vaccine makers finish their secondary studies. Pfizer-BioNTech, Moderna and Johnson & Johnson are all currently studying their shots in kids of various ages to make sure they are safe and promote an immune response in younger people.
Once those data are finalized and submitted to the U.S. Food and Drug Administration, the agency will decide whether to authorize the vaccines for younger people. Adolescents will likely become eligible for vaccines at some point in 2021, experts say.
After that, manufacturers will likely keep working their way down in age. Younger children and babies may be the last to become eligible for the shots. But with each age group that gets vaccinated, herd immunity will grow stronger, offering more protection to those who remain unvaccinated.