Since the COVID-19 vaccine rollout began in December 2020, health experts have touted the shots as a pathway back to normal life.
While it will take months for the United States to reach herd immunity, many fully vaccinated adults are dining indoors, gathering with friends and making plans to travel again.
For parents with children younger than 16, however, it’s more complicated. While many children between the ages of 12 and 15 are now eligible for the COVID vaccine, many parents may be hesitant to let their kids get vaccinated before the long-term effects are established. Doubtless those concerns will be even greater for parents of younger children, and the vaccine isn’t expected to be approved for the 2- through 11-year-old age group until fall at the earliest. Until the entire family is vaccinated, parents must decide what levels of risk they are willing to take when it comes to making plans.
“The decision to vaccinate your child is certainly a parent’s call to make,” says Dr. Matthew B. Laurens, an infectious disease pediatrician with the University of Maryland Children’s Hospital. “Parents with specific questions that are not answered by vaccine information available on the CDC (Centers for Disease Control and Prevention) website should contact their child’s doctor. Although many physicians are not giving COVID-19 vaccines themselves, they are a trusted source of information for many families.”
Dr. Aimee Ando, family medicine physician and director of diversity, equity and inclusion at Penn Medicine, says that coronavirus cases among children are rising even as the percentage of vaccinated adults increases.
Many reasons could be contributing to this increase, such as schools reopening for in-person learning, the relaxation of social distancing regulations in some areas of the country, the spread of highly contagious variants and better access to COVID-19 testing.
Laurens notes that families with unvaccinated children should continue to exercise caution and follow CDC guidance depending on the setting. “When shopping indoors or going to crowded areas, masks should continue to be worn for now,” he says. “When interacting with other families with children who are not vaccinated, risk of transmission is lowered by wearing masks, social distancing and meeting outdoors.”
Laurens further adds that “if fully vaccinated families are interacting with other families that are completely vaccinated, fewer precautions are needed, as long as no individual circumstances exist that would put an individual at increased risk of severe COVID-19 illness.”
May 2021 guidelines from the CDC say that vaccinated individuals can gather inside sans masks and social distancing with other people who are fully vaccinated. But the CDC also notes that vaccinated individuals can gather indoors with unvaccinated people who are not at increased risk of severe infection from one household at a time. In other words, according to Ando, a family in which all eligible members are vaccinated and the children are unvaccinated can be inside with a similarly vaccinated family, although she recommends keeping these visits limited.
She adds that it’s important to maintain open and honest communication about safety with friends and family when planning in-person interactions. This communication includes discussing vaccination status, recent travel and disclosing any COVID-19 tracing information.
What about long-awaited visits with grandparents, many of whom have not been able to hug their grandchildren in over a year? “While grandparents may be vaccinated, their grandchildren may not yet be eligible for vaccination or may be in the process of being vaccinated,” Laurens adds. “In this case, it would be reasonable for visits to occur outdoors with consideration for wearing a mask. If all family members are vaccinated, then fewer precautions would be warranted, including visiting indoors and with masks off.”
If grandparents and children have medical conditions that limit their ability to respond strongly to a vaccine, visiting should include protective measures.
What about parents who have been dreaming of returning to the gym or a date night inside a restaurant? “Until all children are vaccinated, each family will have to decide what level of risk they are comfortable with,” says Dr. Aaron Milstone, an associate hospital epidemiologist at Johns Hopkins Hospital. “Indoor restaurants and gyms are two settings that are the highest risk of transmission than eating outdoors or exercising outdoors.”
And for parents who are wondering whether a summer getaway will be possible this year, Milstone says that families with unvaccinated children should consider the community prevalence of COVID-19 at their planned destination. “Unvaccinated children remain at risk for COVID and should continue to use masks and practice physical distancing.”
Ultimately, the doctors agreed that parents must weigh factors such as their children’s health conditions, child care arrangements, their community’s level of transmission and the behavior of close contacts to determine the level of risk they can tolerate before their children are vaccinated.
Speaking of vaccinations, Laurens notes that walk-up vaccinations are available in Baltimore without an appointment at the M&T Bank Stadium Mass Vaccination Site and the Baltimore Convention Center Field Hospital for children 12 and older accompanied by a legal guardian.
Managing editor Michael Vyskocil contributed to this article.
This article originally appeared in the June 2021 issue of Baltimore’s Child.