Dr Kristin Moffitt
The concern of every parent is: “How do I protect my child from COVID-19 and safely manage his/her return to school?”
No matter where you live, if you’re a parent you are probably agonising on the ways COVID-19 will affect back-to-school. How will the early weeks and remaining months of the school year look? How flexible will we need to be?
First and foremost, it is important to reconcile that health recommendations will continue to evolve here in Trinidad and Tobago, as it also will across the globe.
Below, we’ll review the current global recommendations as updated in August 2021, for keeping schools and children safe as everyone returns to classrooms in the coming weeks, and explain what families can do outside of school to reduce the risk of infection even further.
Global recommendations for safe schools
The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend:
• All staff and students over age two who are able to safely mask should wear masks indoors, regardless of their vaccination status. It is also important to learn proper mask technique.
• Vaccination for anyone 12 years or older
• Layered protective measures within schools, including maintaining at least three feet of distance between each person when possible and improved ventilation
• Frequent hand-washing via installation of sinks at entrances and access points
• Staying home when sick
• Schools should maintain active policies to contact-trace, isolate, and quarantine affected students and staff if exposures occur in school.
• Robust health advocacy and awareness programmes on risk mitigation for teaching staff and students.
What is driving these recommendations?
Health experts and educators believe having students return to school for full-time, in-person learning should be prioritised, to avoid the enormous psychosocial impact of missed in-person school on children’s growth, development and well-being. Of course, safety for students, teachers, and school staff is a priority too.
A large body of scientific evidence shows that when these layered measures were used in schools before vaccines were available, COVID-19 transmission within schools was very low.
Students under 12 are not yet eligible for vaccination, so layered approaches should be taken to protect these individuals, as well as immunocompromised students and staff who remain susceptible to infection. While data continue to show that available vaccines are highly effective at preventing severe illness, hospitalization and death from Delta variant infections, we must recognise that anyone can transmit the virus and all measures of protection should be adhered.
What do we know about how COVID-19 affects children and teens?
We now know that infected children may develop a serious inflammatory condition called MIS-C in the two to six weeks following COVID-19 infection. This may happen even in children who have mild symptoms or no symptoms. Research has also shown that a small percentage may get very sick and need hospitalization or intensive care.
Data as of May 2021 from CDC shows over 400 children have died from COVID-19 infection. That’s greater than the number of childhood deaths during the deadliest flu season in the US in the past two decades.
Vaccinating children to prevent these outcomes is one of the most important reasons driving vaccine studies in children. Further, vaccinating children will be critical to achieving a population-wide level of immunity — herd immunity — sufficient to slow the emergence of dangerous variants and bring an end to the pandemic.
What do we know so far about COVID-19 vaccines in teens?
• The Pfizer/BioNTech vaccine is authorised for use in children and teens ages 12 and older.
• These authorisations were based on data from participants of these ages in randomized, placebo-controlled trials that demonstrated the safety and efficacy of these vaccines.
• Vaccine research done so far, includes the following results:
Pfizer/BioNTech has completed a trial in 12- to 15-year-olds. The vaccine was safe and well tolerated, elicited strong antibody responses, and had 100% efficacy in preventing mild to severe infection in this age group.
• The FDA has authorised this vaccine for use in this age group after reviewing the study results. Both the CDC and the American Academy of Pediatrics recommend vaccination for children 12 and older.
What about COVID-19 vaccine trials for younger children?
Pfizer/BioNTech and Moderna have both begun trials in children six months to 11 years old.
These trials will each begin by testing smaller doses than those given to older children, teens and adults. This allows researchers to determine which dose is well tolerated and still elicits strong antibody results in younger children. All of these steps will take some time so that they can be done without cutting any corners on safety. The earliest vaccines will likely be available for younger children in late 2021, or perhaps early in 2022.
How can you protect your child and your family?
1 Encourage everyone who is eligible to get vaccinated. Available vaccines are safe and effective in preventing infection, especially severe infections, hospitalisations and deaths. And the more people who are vaccinated, the fewer chances the virus has to evolve to develop future variants that currently available vaccines may be less effective against. If you have concerns about vaccines, call your doctor to talk about what worries you.
2 Consider wearing masks indoors in public settings even if you’re vaccinated, especially if you live in an area of substantial or high community transmission, as noted above.
3 If your child is vaccinated, be sure they understand the measures recommended to keep themselves and others safe, and why it’s important to follow these recommendations.
4 If your child is not yet eligible to be vaccinated, talk with them about the importance of wearing a mask when indoors, good hand hygiene, and staying at a distance from others when possible.
5 Discuss with your family the importance of staying home and trying to isolate from others if you don’t feel well, even if symptoms seem mild. Review any possible symptoms with your doctor, and get tested for COVID-19, if necessary.
Editor’s note: School recommendations will continue to evolve this year, so check regularly with the CDC and your school for updates.
Dr Kristin Moffitt is a paediatric infectious diseases doctor and researcher at Boston Children’s Hospital, and an assistant professor of paediatrics at Harvard Medical School. She is involved in several studies of COVID-19 in children, and has been a regular contributor to local and national news affiliates for paediatric COVID-19 updates.
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