(CNN) — More and more adults are getting vaccinated against COVID-19, but their children under the age of 12 still cannot. What does this mean for parents returning to work and for children returning to summer camps, daycare, and eventually school? The younger children are, the more care they need. What’s the safest thing to do when it comes to childcare arrangements, and what if you live in a state that no longer requires the use of masks in most places?
We asked CNN Medical Analyst Dr. Leana Wen to help us resolve these concerns. Wen is an emergency room physician and visiting professor of health policy and management at the Milken Institute School of Public Health at George Washington University. She is the author of the forthcoming book “Lifelines: A Doctor’s Journey in the Fight for Public Health,” and importantly in this case, she is also the mother of two young children.
CNN: Is there a risk for children from covid-19?
Dra. Leana Wen: Although children are much less likely to get seriously ill from COVID-19, they can contract it and get sick from it. According to the American Academy of Pediatrics, nearly 4 million children have been diagnosed in the United States since the beginning of the pandemic, and more than 18,000 have been hospitalized. Tragically, more than 300 children have died.
As more and more adults are vaccinated, the overall level of COVID-19 is lower in many communities, but children are still at risk. In fact, pediatric infections now account for nearly 1 in 4 of all coronavirus infections in the United States.
CNN: Can Vaccinated Parents Pass Covid-19 To Their Children?
Wen: This is a really important question. We know that getting vaccinated against coronavirus protects you very well from contracting the disease yourself, and it also reduces the likelihood of being an asymptomatic carrier who can transmit the virus to others.
Getting vaccinated by parents definitely reduces the risk of covid-19 for the whole family. However, there remains a small chance that vaccinated parents could pass the coronavirus on to their children. It is difficult to quantify exactly what this risk is, because it also depends on the rate of spread of the coronavirus in the community. The higher the level of covid-19 around you, the more likely you are to become infected and catch it, despite being vaccinated.
For parents who want to be as cautious as possible, I would encourage you to try to reduce your own risk. My husband and I, for example, will see friends we know are vaccinated indoors, without masks or distancing, and we will certainly socialize and participate in all outdoor activities. But if we are going to be indoors with other potentially unvaccinated people, we will continue to wear masks. We will continue to stay away from riskier environments, such as crowded indoor bars, until the level of community transmission in our area decreases further.
CNN: And are daycares and summer camps safe? What should you look for to ensure they are?
Wen: I am sending my almost 4 year old son to a daycare summer camp, and this is what I looked for. First of all, I liked seeing that children spend most of their time outdoors, even when it rains. Outdoors is much safer than indoors when it comes to reducing the transmission of the coronavirus. I would be fine with a nursery that doesn’t require masks when they are outdoors. Mealtimes are all outdoors, which is important, as the masks cannot be used exactly when children are eating.
Second, all daycare staff are fully vaccinated. This gave us more peace of mind. Third, masks are still necessary when children are inside the building. In the area where we live, in Baltimore, there is still a high community transmission of covid-19, so it was important that the use of masks be required indoors.
CNN: What if the daycare, camp, or school doesn’t require masks when they’re indoors?
Wen: This will depend on your comfort level and tolerance for risk, as well as the level of transmission of Covid-19 in the community. If you live in an area where transmission is fairly low, the risk is probably low even if children don’t wear a mask indoors. On the other hand, in areas with high community transmission, there is a higher probability that unvaccinated children will transmit the coronavirus to each other.
I advise you to ask at the nursery or school how many children wear masks inside the building. If most kids use them indoors, yours can too, and that will help protect it. However, if neither child wears a mask, although your child can probably choose to wear it, this could create discomfort, and you may want to see if you can find another facility that is more suited to your tolerance for risk.
CNN: Many parents are now being asked to go back to work in person. Should they continue to wear masks, even if they are not required?
Wen: It depends. If you go to an office, and you’re pretty sure everyone else is fully vaccinated, I think it’s okay to give up masks at work. However, if you work in a store, or other job where you have to interact with many customers indoors, who may not be wearing a mask and may not be vaccinated, you may want to consider continuing to wear the mask. Vaccines protect you very well, and your chance of transmitting the coronavirus to your unvaccinated children is low. But the mask is an extra layer of protection, especially if you are around many other potentially unvaccinated people.
CNN: Are there situations at work that could be uncomfortable from a coronavirus safety point of view?
Wen: Yes. I had a patient who felt very uncomfortable when asked to walk into crowded conference rooms, sitting shoulder to shoulder with co-workers who she was sure were not vaccinated. This patient lived with an elderly parent who was immunosuppressed, and I advised her to let her supervisor know that she preferred to attend these meetings virtually. The supervisor agreed, and she and others can call the meeting while sitting in their own offices. If you have young children and are in a similar situation, you could ask for these types of accommodations.
CNN: What if you’re in a cubicle and the people around you are less than six feet away?
Wen: If the people in the cubicles around me are vaccinated, I would be fine if they all weren’t wearing a mask. If someone is not vaccinated and the use of masks is not required, and there are no other protective measures, such as regular testing, you might consider asking your supervisor if you can be relocated to a place where the masks are known to be people around you are vaccinated.
CNN: Would you wear a mask to the bathroom or break room at work?
Wen: If the people around me are not all vaccinated, yes, I would wear a mask in crowded and common places. And he probably wouldn’t eat in the break room.
CNN: Does it matter if my kids have already had COVID-19?
Wen: Yes. If your children have already had coronavirus and have recovered from it, they likely have some level of immune protection. We don’t know how long it lasts, and it is possible that they will become infected again, but I think you could worry a little less that they will immediately contract the coronavirus again.
CNN: What if I have to take public transportation to get to work?
Wen: Currently the use of masks is required on buses, the subway, trains, etc. I would wear a well-fitting mask, but otherwise, I would not worry so much about exposure during transport if you are vaccinated.
CNN: What if I have children over the age of 12 who have not yet been vaccinated?
Wen: I would recommend that you vaccinate them as soon as possible. The Pfizer-BioNTech Covid-19 vaccine is licensed for children 12 years of age and older. It has been proven to be safe and very effective.
A study by the US Centers for Disease Control and Prevention (CDC) found that there has been an increase in the level of infections and hospitalizations among adolescents aged 12 to 17 years. Although infections and hospitalizations have decreased in adults over the same time period, they have increased in this age group, perhaps due to the predominance of more contagious and virulent variants.
This study also found that nearly one in three children in this age group who was hospitalized was so seriously ill that they required intensive care unit care. While about 70% had underlying medical conditions, 30% were previously healthy.
We are very fortunate to have the vaccine available for children 12 years and older. Vaccinating them will protect you and give you peace of mind, as parents, and the whole family.