What to do when your kids aren't vaccinated yet

At present, people 12 and older are eligible to receive the COVID-19 vaccine. That leaves many families with adults and adolescents who have been inoculated and children who are still unprotected.

This poses dilemmas for families about how to protect their children, other children, and at the same time resume family fun. Dr. Taylor Heald-Sargent, attending physician and infectious disease specialist at Ann & Robert H. Lurie Children's Hospital of Chicago, offers guidance to keep children safe while enjoying the summer. Since the pandemic started, she has led research on COVID-19 in children.

In May, the Centers for Disease Control eased protection guidelines, saying vaccinated individuals who are outdoors by themselves or in small groups do not need to wear masks. However, Heald-Sargent and many other pediatric experts are more cautious about the need for masks.

"We cannot throw away our masks just yet," she says. "The pandemic is not over."

The vaccine provides "protective immunity," meaning that recipients are significantly less likely to get severely ill. The vaccine does not provide "sterilizing immunity," or 100% prevention against getting infected, which means adolescents and adults can have the virus with no symptoms but pass it on children who may get sick. Children can also pass the virus to each other or other adults who may be at high risk and didn't respond to the vaccine, such as patients on immunosuppressive medications like steroids.

Protecting vulnerable children

Healthy children are less likely to become severely ill from the virus, but the same is not true for children who are immunocompromised or have other health conditions. Young people at higher risk include children with asthma, a prevalent condition, diabetes and obesity, in addition to children who have decreased immune systems from cancer therapy, organ transplant, other medical conditions or don't handle colds well.

At the beginning of the pandemic, many people formed "pods," a group of trusted individuals for in-person interaction with who have no signs of the virus. Today, despite the increasing numbers of inoculated people, pods still help protect high-risk children and their family members, according to Heald-Sargent. The opposite may be best for children with mental health difficulties, who may need to break out of pods to increase socialization under safe circumstances.

Families are yearning to return to their routine lives, but there are some cautions when venturing outside pods and resuming normal activities this summer.

"You don't always know who is healthy and who is not," she says. "Families need to talk with each other and bring up those questions about who has been vaccinated. It should be a natural conversation, similar to asking if there is a gun in the home or if a child has food allergies."

When families decide on activities with just immediate family or larger groups, they should ask the following questions. The answer to at least one of these questions must be "yes":

1. Will people be wearing masks?

2. Will there be adequate ventilation if indoors?

3. Have the people who will be there been vaccinated?

Safe summer fun

Heald-Sargent also offers guidance on some of the summer's most common pursuits for families whose children will be unvaccinated, balancing the need for socialization with safety:

• Playgrounds: Err on the side of caution and wear masks because you might not know if other kids or their family members are at higher risk.

• Playdates: Keep them outdoors, if possible. Whether outdoors or indoors, unvaccinated people, including children, should wear a mask as much as possible.

• Travel: Visit anywhere in the U.S. and follow the principles above, no matter where you are going or how you are getting there. If traveling internationally, pay close attention to the current situation in that country and follow local regulations.

• Swimming: Swim in pods outdoors for the best protection and keep a safe distance from others. Swimmers will be maskless so avoiding crowded pools is key.

• Camps: Find out if the camp follows CDC measures to avoid potential viral spread, in particular for indoor activities. Indoor singing without masks should be avoided.

• Restaurants: Dine outdoors if possible, but if you must eat inside, try to sit by an open window or in a well-ventilated area.

• Visiting family and friends: Know who has been vaccinated and visit them! Encourage grandparents to get vaccinated to help improve your child and grandparents' mental health with the special bond they have together.

"With rising numbers of vaccinated people and warmer weather allowing for outdoor activities, we are entering a good time to emerge from our pandemic isolation," Heald-Sargent says. "By applying what we've learned this past year to reduce risk, we can make sure everyone stays safe, even our most vulnerable individuals."

• Children's health is a continuing series. This week's article is courtesy of Ann & Robert H. Lurie Children's Hospital of Chicago. For more information, visit www.LurieChildrens.org.