Each week, we answer frequently asked questions about life during the coronavirus crisis. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line "Weekly Coronavirus Questions." See an archive of our FAQs here.
Do kids really need masks if they've been vaccinated and had COVID?
Most kids who were either recently infected or vaccinated should have a strong enough immune response to protect them from getting COVID for several weeks or longer, says Dr. Abraar Karan, an infectious disease physician at Stanford University.
The combination of being vaccinated and having had COVID induces stronger immunity than just one or the other, he says in an email. "Of course, if they are immunocompromised, [the decision not to mask] will be more complicated and parents should consult with their physicians."
In general, though, recent infection and vaccination makes the risk of getting COVID so low that the extra benefit of a mask is negligible, says Seema Lakdawala, an associate professor at the University of Pittsburgh School of Medicine who specializes in respiratory viruses with pandemic potential.
That could change over the next year "if a new variant comes along that doesn't care very much about your recent omicron infection," says Dr. Emily Landon, an infectious disease specialist and chief hospital epidemiologist at University of Chicago Medicine.
But for now, if your vaccinated kid has recently recovered from COVID, the choice of whether to mask is up to you and your child, as long as you're not violating any mandates.
Many parents in this situation choose to keep masking their children "because it's part of the social contract of all of us trying to get through this together," Lakdawala says. If one kid stops wearing a mask to school, another may decide to opt out as well, she points out, since keeping track of everyone who got COVID and who is vaccinated is not feasible.
If you and your child decide to forgo masking, make sure your child is not pressuring classmates to take theirs off.
"If your kid is the only one not wearing a mask and they're trying to push other kids to not wear masks, even though it may be best for them to [mask]," she says, "that's not OK. So it's really important to talk with your kids in mask-optional settings about not trying to influence others and to be really tolerant of what they need."
So if I really don't want my elementary school-age kids to get COVID, what's the best way to protect them?
First, get your 5- to 12-year-old vaccinated, doctors and experts say. In a study published online Wednesday, scientists in Israel found that vaccinated children were half as likely to catch COVID as their unvaccinated peers. But this protection was short-term. After about five months, the rate of infection was almost the same for vaccinated and unvaccinated teenagers.
Even as case rates are plunging in some areas, multi-layered strategies are still necessary. Lakdawala compares the situation to a battlefield.
"If we're at war with the virus, the vaccine is our armor," she says. "That helps us from getting badly beaten. But it doesn't help us win, so we also need a mask as a shield that helps us block the virus, and then other ways to fight back — like ventilation and ways to clean the air — as a sword."
Parents should check whether their schools are up-to-date on their ventilation and air cleaning systems. That could include opening doors and windows at certain times of the day when classrooms are busiest, according to Lakdawala, and using portable air cleaners or a built-in air filtration system. Teachers wearing masks can also make a dent in classroom transmission. According to a study from Germany published in December, teachers wearing masks at school was a more effective strategy at reducing transmission of the virus than students wearing masks.
"Everyone wants kids to be in school and learning and interacting safely," Lakdawala says. "So we need to continue to think about all of the ways to reduce risk in all environments."
And what about masks for the kids?
Many experts have recommended upgrading to high-filtration respirators during the omicron surge. Indeed, these respirators (N95s, KN95s, KF94s) may be the only masks that are helpful against omicron.
N95 masks aren't available for children, but KN95 and KF94s are. Such masks could help kids in situations that call for added caution. If your kid's environment includes spending time with anyone at higher risk of complications from COVID, for example, keep that person in mind when making decisions about masking, advises Landon.
"If their best friend has Type 1 diabetes and has been battling some infections recently or has a primary immunodeficiency and has to take immunoglobulin infusions, then your kid should be [extra careful]," she says. "If your kid wants to keep being friends with that kid, they need to wear a mask all the time."
But for many families, KN95s or KF94s aren't a viable option. They are much more expensive than cloth or surgical masks and less reusable than cloth masks. On top of that, a child needs to wear the mask consistently to make it effective.
Sheila Mulrooney Eldred is a freelance health journalist in Minneapolis. She has written about COVID-19 for many publications, including The New York Times, Kaiser Health News, Medscape and The Washington Post. More at sheilaeldred.pressfolios.com. On Twitter: @milepostmedia.
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