Since the COVID-19 vaccine rollout began in December, 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 under 16, however, it’s more complicated. While most children between the ages of 12 and 15 are now eligible to get the shot, many parents will 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 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 question is, where do we qualify children in terms of risk?” said Dr. Neil Rellosa, a pediatric infectious disease physician at Nemours duPont Pediatrics. “We know that children overall are at a lower risk of developing severe disease, but it doesn’t mean they don’t get infected.”
Most children who are infected have mild or asymptomatic cases. However, Rellosa has treated some young patients who develop multisystem inflammatory syndrome, a serious condition that results in the inflammation of organs and other body parts, which has been linked to COVID-19 infections.
Dr. Aimee Ando, family medicine physician and director of diversity, equity and inclusion at Penn Medicine, said coronavirus cases among children are rising even as the percentage of vaccinated adults increases.
There could be many reasons behind this spike, including schools reopening for in-person learning, the relaxation of social distancing regulations in some areas, the spread of highly contagious variants and better access to testing.
Dr. Susan Coffin, pediatric disease specialist at Children’s Hospital of Philadelphia, said families with unvaccinated children should continue to exercise caution when socializing with other households. Indoor playdates and large family gatherings are still not recommended.
“Unfortunately, when we’re thinking about people gathering who are unvaccinated, the same principles still need to hold in terms of keeping your gathering sizes small, keeping them outside, keeping participants masked and having a more consistent small cohort that you get together with rather than a different playmate every day of the week,” said Coffin, who also co-leads CHOP’s coronavirus response.
Guidelines from the Centers for Disease Control and Prevention say 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 — though she recommends keeping these visits limited.
She added that it’s important to maintain open and honest communication about safety with friends and family when planning in-person interactions. This includes discussing vaccination status, recent travel and if you are experiencing any COVID-19 symptoms.
What about long-awaited visits with grandparents, many of whom have not been able to hug their grandchildren in over a year? Rellosa said that vaccines greatly reduce seniors’ risk of infection, and provided that fully vaccinated grandparents seldom attend indoor social events, visits with grandchildren are unlikely to infect children with COVID-19. Rellosa said that when he takes his own children to visit their grandparents they hang out indoors and give hugs — albeit while wearing masks.
As for parents who have been dreaming of returning to the gym or a date night inside a restaurant, they can do so…on a limited basis, according to Ando.
“I think having an occasional date night out is fine, but I wouldn’t have it become a regular practice,” she said.
And for parents who are wondering whether a summer getaway will be possible this year, Coffin said travel is reasonably safe as long as children take the usual precautions, like consistent mask-wearing and hand-washing. For air travel, Coffin recommended finding direct flights to reduce exposure to the virus. Rellosa agreed that travel should not be a major source of outbreaks, provided travelers maintain masking and social distancing.
But even though these safety precautions can reduce risk during travel, Ando said she’s not planning to fly or take a train with her children any time soon; not only would the kids be required to quarantine before returning to daycare, but any travel makes you more likely to come into contact with residents of states that prematurely loosened restrictions and are experiencing unchecked community spreads. For her family, she said, it’s not worth the risk.
Ultimately, the doctors agreed that parents must weigh factors like their children’s health conditions, childcare arrangements, 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.
Which is to say that, ultimately, you have to decide what you’re comfortable with. But unlike last summer, at least you have some options this time around.