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What should vaccinated parents with unvaccinated children do?

We asked CNN Medical Analyst Dr. Leana Wen for helping us resolve the issues. Wen is an emergency physician and visiting professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is the author of the upcoming “Lifelines: A Doctor’s Journey in the Fight for Public Health” and important in this case – also the mother of two young children.

Dr. Leana Wen: While children are much less likely to get seriously ill from Covid-19, they can get it and get sick from it. According to the American Academy of Pediatrics, nearly 4 million children in the United States have been diagnosed since the onset of the pandemic, and more than 1
8,000 have been hospitalized. Tragically, more than 300 children have died.

As more and more adults are vaccinated, the overall level of Covid-19 is lower in many communities, but children are still at risk. In fact, pediatric infections are now nearly 1 in 4 of total coronavirus infections in the United States.

CNN: Can Vaccinated Parents Transmit Covid-19 to Their Children?

When: This is a really important question. We know that getting the coronavirus vaccine protects you very well from getting sick yourself, and it also reduces your likelihood of being an asymptomatic carrier that can transmit the virus to others.

Having parents get the vaccine certainly reduces the Covid-19 risk for the whole family. However, there is still a small chance that vaccinated parents can transmit coronavirus to their children. It is difficult to quantify exactly what this risk is because it also depends on the rate of coronavirus spreading in the community. The higher the level of Covid-19 around you, the more likely you are to become infected and contagious even despite being vaccinated.

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For parents who want to remain as careful as is reasonable, I would encourage them to try to reduce their own risk. For example, my husband and I want to see friends who we know are vaccinated indoors without masks or distance, and we will definitely socialize and participate in all outdoor activities. But if we are to be indoors with other potentially unvaccinated people, we still wear masks. We continue to stay out of the highest risk settings, such as overcrowded indoor bars, until the level of community dispersal in our area drops further.

CNN: What about day care and summer camp are they safe? What would you look for to make sure they are?

When: I am sending my almost 4 year old son to summer camp in a daycare and here is what I was looking for. At first, I was happy to see that the kids spent most of their time outdoors, even when it was raining. Outdoors are much safer than indoors when it comes to reducing coronavirus transmission. It would be nice to have a daycare that does not require masks when I am outdoors. The meals are all outdoors, which is important as masks can not exactly be worn when children eat.

Second, all day care staff are fully vaccinated. This gave us additional peace of mind. Third, masks are still required when children are indoors. In the area where we live, in Baltimore, there is still transmission of Covid-19 with large community, so it was important that indoor masking is required.

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CNN: What if daycare, camp, or school do not require masks when indoors?

When: This depends on your comfort level and risk tolerance as well as the level of transmission of the community in Covid-19. If you live in an area where there is fairly low transmission, it is likely to be low risk even if children are not masked indoors. On the other hand, unvaccinated children are more likely to transmit coronavirus to each other in high-society transmission areas.

I would advise you to ask the daycare or school how many children wear masks indoors. If most children have masks indoors, yours can too, and this will help protect your child. However, if none of the children have masks, while your child is likely to still be able to choose to wear a mask, this may create discomfort for your child and you may want to see if you can find another facility that more closely matches your risk tolerance.

CNN: Many parents are now being asked to go back to work in person. Should they still wear masks even though they are not required?

When: It depends on. If you walk into an office and you’m pretty sure everyone else is fully vaccinated, I think it’s fine to give up masks in the workplace. However, if you are a retail worker or in another job where you have to interact with many customers indoors who may be masked and unvaccinated, you may want to consider keeping your mask on. The vaccines protect you very well and your chance of carrying coronavirus back to your unvaccinated children is low. But the mask is an extra layer of protection, especially if you are near many other potentially unvaccinated people.

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CNN: Are there situations in the workplace that make you feel uncomfortable from a coronavirus security perspective?

When: Yes. I had a patient who felt very uncomfortable being asked to walk into tightly packed conference rooms, sitting shoulder-to-shoulder with colleagues, she was pretty sure they were not vaccinated. This patient lived with an elderly parent with a compromised immune system, and I advised her to let her supervisor know that she would rather attend such meetings virtually. The supervisor accepted and she and other people can convene the meeting while sitting in their own offices. If you have young children and are in a similar situation, you can ask for such types of accommodations.

CNN: What if you’re in a cabin and the people around you are less than 6 feet away?

When: If the people in the cabins around me are vaccinated, I would be fine when we all do not wear masks. If someone has not been vaccinated and masks are not required – and there are no other safety precautions such as regular testing – consider asking your supervisor if you can be moved to a place where people around you are known to be vaccinated. .

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CNN: Would you wear a mask to go to the restroom or break room at work?

When: If people around me are not all vaccinated, yes, I would wear a mask crowded, common places. And I probably do not eat in the break room.

CNN: Does it matter if my kids have already had Covid-19?

When: Yes. If your children have already had coronavirus and recovered from it, they probably have some level of immune protection. We do not know how long it will last and it is possible that they could be re-infected, but I think you could feel a little less worried about them immediately contracting coronavirus again.

CNN: What if I have to take public transportation to get to work?

When: Masks are currently required on buses, subways, trains, etc. I would wear a well-fitting mask, but otherwise I would not worry so much about the exposure during transport if you are vaccinated.

CNN: What if I have children over the age of 12 who have not yet been vaccinated?

When: I would encourage you to get them vaccinated as soon as possible. The Pfizer BioN-Tech vaccine is approved for children 12 years of age and older. It has proven to be safe and very effective.

A study by the US Centers for Disease Control and Prevention showed that there has been an increase in the level of infections and hospitalizations among young people aged 12 to 17. Although infections and hospitalizations have decreased for adults in the same time period, they have increased in this age group , perhaps due to the dominance of more infectious and more virulent variants.

This study also showed that almost 1 in 3 children in this age group who were hospitalized were so seriously ill that they required ICU treatment. Mens ca. 70% had underlying medical conditions, 30% were previously healthy.

We are fortunate to have the vaccine available to children aged 12 and over. Getting them vaccinated will protect them and give you as parents and the whole family peace of mind.

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