Back-to-school in 2021: Keeping children safe and well

Editor's note: School recommendations will continue to evolve this year, so check regularly with the CDC and your local school for updates.

The US is a sprawling country with rates of COVID-19 vaccination and cases that vary substantially across states — and also within them. And now, the rapid spread of the highly infectious Delta variant is complicating our understanding of how well the vaccines protect us from infection.

No matter where you live, if you're a parent you are probably thinking about how 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? Most likely, health recommendations for the US and state and local rules will continue to evolve. Below, we'll review the current recommendations 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.

National recommendations for safe schools

The American Academy of Pediatrics (AAP) and the US Centers for Disease Control and Prevention (CDC) recommend

• all staff and students over age 2 who are able to safely mask should wear masks indoors, regardless of their vaccination status
• 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, improved ventilation, frequent hand-washing, and staying home when sick
• schools should maintain active policies to contact-trace, isolate, and quarantine affected students and staff if exposures occur in school.

What is driving these recommendations?

Health experts and educators believe having students return to school for full-time, in-person learning should be prioritized, to avoid the enormous impact of missed in-person school on children's psychological and academic well-being. Of course, safety for students, teachers, and school staff is a priority, too.

• A large body of scientific evidence shows that when layered measures were used in schools before vaccines were available, COVID-19 transmission within schools was very low.
• Many schools are not prepared to monitor vaccine status for students and staff, and some staff and students over 12 are not yet fully vaccinated.
• 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.
• As more has been learned about breakthrough infections with the Delta variant of SARS-CoV-2, the CDC modified their recommendation that fully vaccinated students and staff did not need to wear masks. This is because similar levels of the virus that causes COVID-19 were detected in vaccinated and unvaccinated individuals who were infected in a recent outbreak caused by the Delta variant. While data continue to show that available vaccines are highly effective at preventing severe illness, hospitalization, and death from Delta variant infections, vaccinated people may be capable of infecting others if they become infected themselves.

What protective measures might differ from community to community?

• Policies recommending masks in schools may vary among schools, even within the same community.
• Just as community vaccination rates vary from region to region, vaccination rates within school communities may vary depending on the population and ages of students served by that school setting.
• Community spread of COVID-19 varies geographically and will continue to evolve over time. Currently, the CDC recommends that even vaccinated people wear masks in public indoor settings in areas where the spread of the virus is substantial or high as shown on these maps.

How can you protect your child and your family?

• Encourage everyone who is eligible to get vaccinated. Available vaccines are safe and effective in preventing infection, especially severe infections, hospitalizations, 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.
• 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.
• 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.
• 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.
• 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.