While many parents can breathe a sigh of relief with their own vaccinations, it may be hard to feel really free as long as their children are unvaccinated. It's children who need to play on the playground, socialize with classmates and friends, and hang out without parents worrying all the time.
How should vaccinated parents approach decisions about play dates, going to restaurants, and vacations while their children are unvaccinated? CNN Medical Analyst Dr. Leana Wen, an emergency physician and visiting professor of health policy and management at the George Washington University Milken Institute School of Public Health, weighs in.
CNN: When do you think Covid-19 vaccines are going to be available for children?
Dr. Leana Wen: The Pfizer-BioNTech vaccine is currently authorized for people 16 and older; all the other vaccines are for 18 and older only. Studies are underway for younger age groups. Dr. Anthony Fauci (the longtime director of the National Institute of Allergy and Infectious Diseases) has projected that by the late summer, results could be available for those 12 years and older, and teenagers could start getting vaccinated by the start of the school year. Younger children probably won't be able to receive the vaccine until 2022.
CNN: That's a long way away. Will kids be able to return to school for in-person instruction in the fall?
Wen: Yes, and they should be able to return to in-person school now, too. Numerous studies have shown that mitigation measures like universal mask-wearing can reduce risk such that the rate of transmission in schools is lower than the rate of transmission in the community. That means schools can be some of the safest places for children.
It will be important for all teachers, school staff and parents to be vaccinated going into the fall. That helps reduce community transmission even further and protects those who are unable to be vaccinated yet, especially children.
CNN: In the meantime, a lot of parents are getting vaccinated. What's your advice to them? Can they have grandparents visit, if kids aren't vaccinated?
Wen: Getting parents vaccinated is really important. It reduces their own chance of illness, and also reduces their likelihood of transmitting coronavirus to people around them including their children. It also makes visits from other family members safer. The US Centers for Disease Control and Prevention has said fully vaccinated people can visit another family in which not everyone is vaccinated, so long as those who are not yet vaccinated aren't at high-risk for severe disease from Covid-19 themselves. That means it's fine for grandparents to visit their children and grandchildren, and stay with them, have dinner with them indoors, hug them, and not wear masks.
CNN: What about visiting another family where parents are vaccinated but the children aren't?
Wen: Here's where we get into tricky territory. Grandparents who are vaccinated visiting a family with some unvaccinated members is one thing, but it's another when it's two families, each with unvaccinated people, visiting one another.
What we know is that adults are more likely to transmit coronavirus than young children. It's also worth noting that teens appear to transmit coronavirus at the same rate as adults. If people who are unvaccinated are gathering, there is risk of them acquiring and transmitting Covid-19.
For now, while the United States has a high baseline level of coronavirus circulating, it's best for families with any unvaccinated individuals to see one another outdoors only, with members of different families spaced 6 feet apart. If children are playing together and can't always abide by 6-foot distancing, they should be wearing masks.
Try to be outdoors at all times. If people must be indoors, they should wear masks around one another. And take extra care if your child has underlying medical conditions. Again, mask-wearing for them and everyone around them is really crucial.
CNN: Are there any circumstances when families with children can get together safely? What if three families want to rent a house together?
Wen: If there are three families, all with unvaccinated children, that want to get together for an extended period of time and want to be in a shared space like a house, I would suggest they all quarantine and test. Specifically, I advise that the unvaccinated members of each family should reduce risk for seven days and then get tested, or reduce risk for 14 days prior to the get-together, if testing is not easily available.
What this means is no other gatherings, especially indoors, during this period. My guidance here is that those who are vaccinated probably do not need to get tested, as their likelihood of contracting and transmitting coronavirus is much reduced. But out of an abundance of caution, before such an indoor get-together, I'd still encourage for the vaccinated individuals to reduce risk in this period, too.
CNN: What about going to restaurants? Should parents go alone, or is it OK to bring their kids?
Wen: I think it's important to clarify that there's virtually nothing that's 100% safe. Everything is about understanding the relative risk and then trying to gauge the risk and manage it for each family.
Takeout is still going to be safest, followed by outdoor dining. Indoor dining still has some degree of risk. The risk to vaccinated parents is much lower than before they were fully vaccinated. It's fine for people to weigh their risks and decide that after vaccination, they want to enjoy some of their pre-pandemic activities. Parents who want to go to restaurants once in a while should do so and try to be outdoors. If they're going for indoor dining, choose places that have strict safety protocols including distancing between tables and good ventilation.
It's an individual family decision about whether to bring unvaccinated children into these circumstances. The risk isn't zero, but probably pretty low, at outdoor restaurants. Indoors, that risk is going to be higher. I'd be particularly cautious if there's a child who is immunosuppressed or has additional risk factors for severe Covid-19.
CNN: What about attending birthday parties? Does it matter if all parents in these settings have been vaccinated?
Wen: I'd certainly feel better about a birthday party in which I know that all the parents of children attending have been vaccinated, because the chance of someone there being an asymptomatic carrier of Covid-19 is much decreased. Still, given the number of unvaccinated children there, I wouldn't want to gather indoors. I'd still make sure that the get-together occurs outdoors and that there is at least 6-foot distancing between families. Everyone should be wearing masks. The same goes for play dates, family reunions and other gatherings.
CNN: Lots of parents want to travel with their children over the summer. Is that safe?
Wen: This is another situation where we have to talk about relative risk. A road trip by car is low risk. Air travel is also pretty low risk, as long as everyone is masked. My major concern with travel isn't so much the risk during transit but what people are doing at their destination. If every meal has to be in restaurants, that substantially increases risk. On the other hand, if you plan on cooking or doing takeout, that's much lower risk. Same with the activities you pursue while traveling. Going to amusement parks and movie theaters that are pretty crowded is much higher risk than a vacation of hiking and camping. A large family reunion or wedding will be higher risk than a small gathering with just the grandparents.
At this point in the pandemic, we need to move to the concept of weighing risk and then trying to reduce it as much as possible. Having parents vaccinated is an important step to reducing risk, even if children are not yet vaccinated, but there are still steps that must be taken to protect the kids — and everyone around us — from Covid-19.
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