Such questions can be “really tough and almost unanswerable,” because they often require families not just to assess their individual risk tolerance but also predict the future, said Sean O’Leary, vice chair of the Committee on Infectious Diseases for the American Academy of Pediatrics. But O’Leary and other experts emphasized that it is possible — and necessary — for parents to help their children participate in social activities without increasing risks.
“It is incredibly important for the mental health of our kids to get them back into as normal of a routine as possible,” said Kawsar Talaat, an infectious-disease expert and assistant professor at Johns Hopkins Bloomberg School of Public Health. “And if keeping them masked for a few months longer is the way to do it, I’m all for that.”
Here’s how experts recommend vaccinated parents navigate life at this point in the pandemic and why many are still calling for unvaccinated teens and younger children to wear masks, stay distanced and practice good hand hygiene around their peers.
Know the risks
“It’s not correct to say that it’s a benign disease in kids,” O’Leary said.
The risk to an individual child is just one factor parents should be considering as they make decisions about in-person gatherings, said Erica Shenoy, associate chief of the Infection Control Unit at Massachusetts General Hospital.
“It’s a challenge, because you have to think about your own personal risk and that of your family and then about the others around you,” Shenoy said. “In public, you don’t know who you’re interacting with, and you could be a risk to them and not know it, and then they could potentially be a risk to you.”
Rates of community transmission are still high, and the authorized vaccines, while effective at preventing severe disease, don’t provide complete protection against infection. “We have lots of reasons for optimism as these vaccines roll out, but we absolutely can’t just be careless at this point,” O’Leary said, noting that the highly transmissible virus variants are also a concern.
Robert Jacobson, a pediatrician and vaccine researcher at Mayo Clinic Children’s Center, agrees. For now, “the rules haven’t changed,” Jacobson said. “While the vaccinated adults can visit other fully vaccinated people, either at work or at home or in the neighborhood, it doesn’t automatically protect their children when their children get together with other unvaccinated children. I think there we still have to abide by the same rules as before we had the vaccine.”
Parents need to remember that “children are not living in bubbles,” he added. Many are visiting vaccinated relatives and returning to school or day-care, where risk can be low with precautions in place, but not nonexistent. “Just because the child before you looks well and the neighbors seem to be doing a reasonable job, that doesn’t mean that that child isn’t carrying the virus asymptomatically, putting you at risk.”
This means parents may want to avoid allowing unvaccinated children from different households to get together without any precautions in place, said Allison Bartlett, a pediatric infectious-disease specialist at University of Chicago Medicine.
“For every situation that you want to put forth, there is a safer and a less safe way to do things,” Bartlett said. “There’s never going to be zero risk, but there are definitely ways that we can minimize the risk.”
Think of safe and fun alternatives
In-person play dates and birthdays can be lower-risk and still fun, said Yvonne Maldonado, a pediatrician and infectious-disease expert at Stanford Medicine. “We can be creative with our children.”
Ideally, kids should wear masks and play with a small group of friends outside, Talaat said, especially as the weather warms up. The risk of indoor activities can also be lessened by masks and distancing, she said.
Similar guidelines should be applied to birthday celebrations, Bartlett said.
“Birthdays are really important, and playing games with each other over Zoom is just not the same,” she said. “Being thoughtful about birthday parties and keeping them small or even just picking one or two friends and doing some special outdoor activity can absolutely be done.”
It’s also important to have conversations with other parents you may be interacting with about their approach to pandemic safety, Shenoy said. “You just want to make sure that everyone’s on the same page, so that you’re managing your expectations.”
Use schools as a blueprint
In settings where there may be many children from multiple households, such as summer camps, experts urged parents to assess safety using plans adopted by schools that have reopened largely without incident.
“We’re seeing that kids who are going back to school with masks and distancing are doing fine, we’re not seeing outbreaks,” Maldonado said.
CDC reports on camps that opened last summer suggest that having stringent safety measures in place made a difference. A sleep-away camp in Georgia, which only required masks for staff and did not follow the CDC’s recommendations for ventilating buildings, had 260 children and staffers test positive for the virus after less than a week. But at four overnight camps in Maine that implemented a “multilayered prevention and mitigation strategy” — including pre-and-post-arrival quarantines, testing and symptom screening — outbreaks among the more than 1,000 campers and staff were successfully prevented, according to the CDC.
Day camps and sleep-away camps have different levels of risk. Children won’t be wearing masks while they sleep indoors with other campers, Talaat said. Sleep-away camps, she added, are also potentially drawing kids who are not local and may be coming from areas where there are higher rates of transmission.
Still, if community spread continues decreasing and stays down, and proper safety strategies are implemented, Talaat said she is hoping to let her children attend sleep-away camp. Bartlett said she is also planning to send her children to camp this summer.
“There are actual benefits to going to camp and having experiences away from your parents, especially when you’re locked up with your parents for the past year,” said Bartlett, who signed her sons up for sleep-away camp. “That is a reasonable risk for our family to take, and I trust my kids to wear their masks and remind everybody else to wear their masks.”
Be transparent and validate feelings
Parents deciding what is safe for their family should prepare to help their children cope with feeling left out or jealous if they notice their friends are doing more activities with loosened restrictions, said Mercedes Samudio, a psychotherapist specializing in parenting and families.
“The idea is to figure out what the kid is feeling and not just dismiss it as, ‘Oh, we’ll be doing it in a couple of months,’ ” Samudio said, “but really saying, ‘What is it that you’re missing?’ Because some of the things that kids are missing, you might be able to give them in a socially distanced or safe kind of way.”
By offering realistic alternatives, parents may be able to foster more resilience in their children, said Mary Alvord, a psychologist and co-author of “Conquer Negative Thinking for Teens.”
“People who take initiative and don’t feel like a victim are the most resilient,” Alvord said. When people hit barriers, thinking “What can I do about it?” can be “very empowering.”
Such conversations should also be ongoing, Alvord added.
“There’s some things that may be definitive no’s, but there may be things that are going to evolve,” she said. “At a certain point, parents say, ‘These are our decisions and you may not agree, but we will talk about this in three weeks and we’ll see where we are.’ So it leaves them still with some hope.”
Remember, recommendations are temporary
Vaccine producers are working on trials involving younger populations. Experts are hopeful that companies including Moderna, Pfizer-BioNTech and Johnson & Johnson may have data on teens that can be submitted to the Food and Drug Administration for review soon, Maldonado said, which means an authorized vaccine could be available by the end of the summer. But for children younger than age 12, the wait could be longer. At least two trials — Moderna and Oxford-AstraZeneca — have started enrolling younger children this spring and others plan to do the same.
“There might be data by the end of the year,” but it will probably be closer to the beginning of 2022, said Maldonado, who will lead Stanford’s Pfizer vaccine trial in children.
Experts noted that the risk levels of various interactions should decrease if vaccinations and mitigation efforts continue. As of March 25, more than 44.7 million Americans have been vaccinated, about 13.5 percent of the population, according to The Washington Post’s tracker.
“We are learning more every month,” Jacobson said. “As more people get vaccinated, as we get better control of the disease, these recommendations are very likely to change.”
In the meantime, Bartlett encouraged parents to “let the kids live a little bit in a safe way.”
“They’re so accustomed now to what we’re asking them to do for masking and distancing, that I think it’s going to be less of a big deal than we think to get them back together,” she said.