Pediatricians Weigh In On What's Safe And Not Safe For Unvaccinated Children

Apr 29, 2021
Originally published on April 30, 2021 11:48 am

After more than a year of hunkering down during the pandemic, many people who've been vaccinated for COVID-19 are feeling a little safer about stepping out. This is great for adults. But the vaccine isn't presently available to people under the age of 16 — children.

As a result, NPR listeners have questions on what exactly children (and parents) can and can't do outside. How do you navigate life when parents are vaccinated and kids aren't? Dr. Nia Heard-Garris of Northwestern University in Chicago and Dr. Jose Romero, the Arkansas secretary of health, are both pediatricians who fielded some of these questions Thursday on NPR's All Things Considered.

This interview has been edited for length and clarity.

Amy Blackman of Fayetteville, Ark.: Is it safe for my fully vaccinated husband and I to go out with other fully vaccinated adults but then come home to our unvaccinated children?

Dr. Jose Romero: I think that couples that are both vaccinated and spend time together can return to the child feeling safe about not bringing home a virus because the risk of those individuals being infected, even asymptomatic, without any signs or symptoms, is extremely low.

Brigid Boettler of Lakewood, Ohio: Little kids are like human petri dishes in the best of times. How do we safely and considerately approach interactions with other parents and kids? And how in the world do you take two toddlers into a public restroom?

Romero: Taking them into the public is certainly a risk. And trying to be around individuals that have been vaccinated is the best thing to do. Any time you're in a group where you don't know what the vaccination status of the individuals around them is, is significant. So using a mask when possible is the best thing to do. We don't recommend masks under 2 years of age, so that's something that needs to be taken into consideration. Certainly the twins issue and taking them into a public restroom is a big issue. I have twin grandchildren and trying to corral them both is an issue. Main thing is, wash your hands and also use the gel after you close the door behind you.

Dr. Nia Heard-Garris: What I'll say is that outdoor play dates are probably the safest right now, especially for unvaccinated children. Indoor play dates are a significantly higher risk. And so if you're trying to organize a play date with multiple households, my strong recommendation is that it would be outside with kids wearing a mask and vaccinated adults.

Jim Boehm of Sykesville, Md.: Our daughter is at a prime age for making long-term friends, but we've had to start saying no to unmasked neighborhood kids coming to the house, asking her to come out and play. How do we navigate keeping our daughter safe while society will demand that we relax our stance, even though we really can't?

Heard-Garris: In my opinion, if your kid is not vaccinated, they should be wearing a mask to play with other children, whether they have Type 1 diabetes or not, and I don't know that you should feel guilty about saying no when kids come to your door and they're unmasked.

Audie Cornish: Are kids allowed to travel?

Heard-Garris: I am recommending against travel, especially airborne travel on an airplane. However, parents are trying to go anyway. And so I am recommending that they do as much as they can to keep their child safe wearing a surgical mask and on top of that, even wearing a cloth mask.

Romero: I think that foreign travel is very inadvisable at this time, and that's because of the level of the disease in many countries. If they do want to travel, I suggest that they travel by car. We want to try to travel as a unit in your car if possible.

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AUDIE CORNISH, HOST:

After more than a year of hunkering down during the pandemic, many people who've been vaccinated are feeling a little safer about stepping out. But what if you have kids in tow who are too young to get vaccinated? Or what if your unvaccinated child gets invited to a birthday party or a sleepover? These are some of the questions you've asked when we put a call out for listeners' questions about COVID recently. So just how do you navigate life when parents are vaccinated and kids aren't? We've brought in two pediatricians for answers. Dr. Nia Heard-Garris is with Northwestern University in Chicago. Welcome.

NIA HEARD-GARRIS: Thank you.

CORNISH: And Dr. Jose Romero is the secretary of health in Arkansas. Welcome to you.

JOSE ROMERO: Thank you for having me.

CORNISH: And we're going to start with you because our first question actually comes from Arkansas. This is Amy Blackman of Fayetteville.

AMY BLACKMAN: Is it safe for my fully vaccinated husband and I to go out with other fully vaccinated adults but then come home to our unvaccinated children? It's just all very scary. We've told ourselves no for so long, it still feels kind of wrong to be thinking about yes again.

CORNISH: All right. Dr. Romero, your response to having the adult time all vaccinated, but coming home to kids who are not?

ROMERO: So I think the way to couch this is in the issue of the safest things to do. And I think that two couples that are both vaccinated and spend time together can return to the child feeling safe about not bringing home a virus because the risk of those individuals being infected, even asymptomatic or without any signs or symptoms, is extremely low.

CORNISH: There's a follow-up idea, which is people are also going to want to take their kids with them - right? - essentially, the kind of family play date or even to a restaurant. What are your thoughts on that?

HEARD-GARRIS: Of course we want our kids to also have a more normal life now, but we have to understand, depending on how old your kid is, if they're not eligible for vaccination right now, we still have to look at every activity through a lens of caution. So taking your kid out to eat at a fully outdoor place might be a lot less risky than, you know, trying to go somewhere where there's multiple different households indoor with your unvaccinated kid.

CORNISH: This next question kind of follows this idea. This is a question from Brigid Boettler of Lakewood, Ohio, who has two year-old twins.

BRIGID BOETTLER: Little kids are like human petri dishes in the best of times, so how do we safely and considerately approach interactions with other parents and kids? Should we do masks on toddlers, ask other parents for proof of vaccine before play dates? And how in the world do you take two toddlers into a public restroom?

CORNISH: OK (laughter). A rapid-fire list of questions there. Dr. Romero, do you want to take one or two of those?

ROMERO: Yeah. So taking them into the public is certainly a risk. And trying to be around individuals that have been vaccinated is the best thing to do. Any time you're in a group where you don't know what the vaccination status of the individuals around them is, is significant. So using a mask when possible is the best thing to do. We don't recommend masks under 2 years of age, so that's not something that needs to be taken into consideration. Certainly, the twins issue and taking them into a public restroom is a big issue. I have twin grandchildren and trying to corral them both is an issue. The main thing is wash your hands and also use the gel after you close the door behind you.

CORNISH: Dr. Heard-Garris, what does this mean for play dates - right? - especially if you try and mix households?

HEARD-GARRIS: What I'll say is that outdoor play dates are probably the safest right now, especially for unvaccinated children. Indoor play dates are a significantly higher risk. And so if you're playing - if you're trying to organize a play date with multiple households, my strong recommendation is that it would be outside with kids wearing a mask and vaccinated adults.

CORNISH: A lot of advice for parents turns on the phrase healthy children. What about kids with underlying conditions? Listener Jim Boehm of Sykesville, Md., has a 7-year-old who was diagnosed with juvenile Type 1 diabetes a year ago, and he's worried about how to get her back out into the world with her health risks. Here's his question.

JIM BOEHM: Our daughter's at a prime age for making long-term friends, but we've had to start saying no to unmasked neighborhood kids coming to the house, asking her to come out and play. How do we navigate keeping our daughter safe while society will demand that we relax our stance, even though we really can't?

HEARD-GARRIS: So in my opinion, if your kid is not vaccinated, they should be wearing a mask to play with other children, whether they have Type 1 diabetes or not. And I don't - if other parents - I don't know that you should feel guilty about saying no when, you know, kids come to your door and they're unmasked.

CORNISH: You're advising parents it's pretty much business as usual in terms of COVID protocols, right? It sounds like the wave of vaccinations doesn't really change things for them.

HEARD-GARRIS: I think it changes things from the standpoint of the adults that they're potentially able to interact with, so again, other parents and grandparents that have been vaccinated. So from that standpoint, things are much better and things look great. From the standpoint of interacting with other kids, from that standpoint, it is business as usual.

CORNISH: How do you have those kinds of conversations with other parents? I've never had one that didn't feel fraught or judgmental, frankly.

HEARD-GARRIS: Yeah. You know, I think it really - how you have that conversation also depends on your relationship to that parent and how well you know them because if you're really good friends, you could be like, you know, girl, we're not - we are not going to have our kids play without a mask. You understand?

CORNISH: Yeah, we're not there yet.

HEARD-GARRIS: And it goes from there. But if this is a, you know, new relationship or a relationship that you don't - hasn't formed as well, you can come, again, from a place of empathy. I know this time has been so hard, right? Like, I really want to get our kids together, and we have a strict rule in our house that we can't do play dates without masks. Are you OK with that? And if yes, you know, proceed and have the play date. And if the answer is no, well, sorry, we can't do that at this time; we have a really strict rule in our house.

CORNISH: So we are heading into summer. People are going to start thinking about vacation. Again, adult's vaccinated and they want to bring the kid on that flight - what's your thinking on that?

HEARD-GARRIS: I am getting so many questions about travel, whether that's domestic travel - but actually, I'm getting even more about international travel - parents, especially from other countries, wanting to go back home. I am recommending, honestly, against travel, especially airborne travel on an airplane. However, parents are trying to go anyway. And so I am recommending that they do as much as they can to keep their child safe - wearing a surgical mask and, on top of that, even wearing a cloth mask.

Dr. Romero, are you getting these questions, too, about travel yet?

ROMERO: Yes, I am, Dr. Heard-Garris, and exactly what you're saying - that is that I, tactfully, but at the same time let them know that I think that foreign travel is, I think, very inadvisable at this time. And that's because of the level of the disease in many countries. If they do want to travel, I suggest that they travel by car. We want to try to travel as a unit in your car if possible.

CORNISH: All right. Well, thank you both. I have to say, it's sobering heading into the spring and summer. You haven't given me carte blanche to have all the play dates my child's friends are demanding.

HEARD-GARRIS: You can have them, but outside.

(LAUGHTER)

ROMERO: Yes. And this - I just want to say, the vaccines are coming. They really are. And that is really what is going to give the safety to our children.

HEARD-GARRIS: It is coming. Keep the faith. Like Dr. Romero said, it is coming.

CORNISH: Dr. Heard-Garris, thank you so much for your time.

HEARD-GARRIS: You're welcome.

CORNISH: Dr. Romero, thank you for your time as well.

ROMERO: Thank you for having me.

CORNISH: That was Arkansas Secretary of Health Jose Romero and Dr. Nia Heard-Garris of Northwestern University. Both are pediatricians.

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