As Illinois reopens, what do families with children too young for vaccines do?
Among the many surprises COVID-19 has pulled since the pandemic began 15 months ago is that across the U.S., many kids are eager -- for once -- to get a shot.
The introduction of lifesaving COVID-19 vaccines in December caused case counts to plummet and set the state on a reopening path Friday with lifting of capacity limits on activities.
It's a time of relief, freedom and mask tossing -- unless you happen to be 11 or younger.
In Illinois alone, 1.8 million children aren't eligible for a COVID-19 shot yet, raising concerns about how to keep kids healthy as the vaccinated and unvaccinated mingle with few restrictions.
From March 2020, when the pandemic dug in, through March 2021, almost 4 million children nationwide were infected with COVID-19. Compared to adults, children have experienced fewer severe outcomes from COVID-19, the CDC reports, but 14,000 were hospitalized and 279 died, explained Dr. Shelly Vaziri Flais, an author and a member of the American Academy of Pediatrics.
"When the (new) CDC recommendations came out saying, 'If you're fully vaccinated, you don't need to wear a mask,' I think all pediatricians across the country cringed a little bit," she said.
"We're talking about a whole subset who don't have the benefit of the vaccine, and we're worried about that," said Flais, a partner at Pediatric Health Associates in Naperville.
Nearly 45% of Illinois' 12.7 million population is fully inoculated against COVID-19, but that still leaves millions of adults and children unvaccinated.
On May 28, the CDC released recommendations saying fully vaccinated adults could go without face coverings everywhere with some exceptions, such as on mass transit or in health care settings.
That's a privilege envied by the younger crowd, with the CDC advising unvaccinated Americans to wear masks indoors in public spaces like malls and museums, and indoor summer camps and, later, schools this fall.
Pfizer and BioNTech are holding clinical trials of their COVID-19 vaccine in younger children, but it's unlikely to be approved before classes begin. The FDA, however, did meet Thursday with advisers to discuss next steps in vaccines for the 11-and-under demographic.
When to mask kids
In the meantime, parents should stand firm about masking indoors in public and washing hands, use common sense, and be aware of risks, experts say.
The CDC has ruled that unvaccinated people are safe to unmask outdoors during activities or with small groups but advises masking up in large crowds outside, such as parades or sporting events.
"Pick and choose your spots," said Dr. Michael Bauer, a pediatrician and medical director at Northwestern Lake Forest Hospital.
A child on a playground climbing tower with other children? "It should be fine to be unmasked," he said. Your child "is not going to be close to them for any length of time."
A gathering with multiple families? "If all the adults and older children are vaccinated, that's a pretty safe thing," Bauer said.
It's not only children under 12 who might have vaccination issues. Researchers are studying whether vaccines are less effective for people taking drugs that suppress their immune systems, such as organ transplant patients.
It's a concern for the medical community, but most individuals on biologics to suppress their immune systems who contracted COVID-19 "seemed to handle it very well," Bauer said. In fact, some people who suffered the most severe COVID-19 cases ended up that way because their immune systems "had a hyper-reponse" to the invading virus, he said.
Evidence is showing "people that can't mount that kind of immune response don't get that level of illness," Bauer said.
Illinois residents have an advantage in that daily infections have plummeted and the state is measuring a 1% case positivity rate, Bauer said. Also, one in every two Illinoisans who are eligible has been fully vaccinated.
One family's SOP
Wildwood resident Candice Reimholz, her husband and her son, who is entering eighth grade, are all fully vaccinated.
Her daughter, who will be in fifth grade at Woodland Elementary School District 50 in northern Lake County this fall, is not eligible yet, but the family takes precautions and rolls with it, Reimholz said.
Relatives they see often are also inoculated. "In my little world, I'd say 80% of the people we're going to come across or be near have been vaccinated, so I feel pretty confident about that," she said.
Her daughter does play softball, but the team has a robust safety program, Reimholz said.
COVID-19 won't stop the family from outings, either, because "when we are out in crowds we do wear masks. Why not? It doesn't hurt them, it doesn't bother them. We have (masks) with us wherever we go, so that if we feel we're around too many people, we just throw them on."
Tips for parents
For parents with exasperated kids who are done with masks, here are some expert pointers to ease frustrations.
• Ever told a defiant youngster to buckle up because "it's the law?" Try "your pediatrician recommends this," Flais suggested about masks. "Make me the bad guy," she said jokingly.
• Acknowledge your child's frustration and explain that vaccines for them are coming. In September, Pfizer is expected to ask for emergency use authorization for two cohorts, ages 2 to 5 and 5 to 11, although it could take longer.
• A pediatric truism is "kids are not little adults." Let your children know that scientists want to make sure the vaccines are the right size for them.
• Take one for the team. You might be free to dump the mask, but your child isn't. Parents and older siblings should consider wearing face masks in situations where younger kids must as a sign of solidarity.