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CDC: Schools May Drop Masks When COVID Risk is Low or Medium

Asher Lehrer-Small — Fri, 25 Feb 2022 22:38:06 +0000

School districts in areas where COVID risk is low or medium may now drop masks, the Centers for Disease Control and Prevention announced Friday afternoon.

It’s a major departure from the agency’s prior stance, which held that schools should enforce universal masking regardless of virus levels.

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“Since July 2021, CDC recommended universal masking in schools no matter what level of impact COVID-19 was having on the community. With this update, CDC will now only recommend universal school masking in communities at the high level,” said CDC epidemiologist Greta Massetti in a media call.

The change comes as part of a wider reconfiguration in COVID policy now recommended by the CDC, easing masking guidelines for most Americans. Rather than using community case rates as the sole metric to determine risk levels, the agency will now use a new formula that also takes COVID hospitalizations and hospital capacity into account.

Only in counties where COVID risk is high does the agency now recommend universal masking indoors, though individuals may continue to choose to wear face coverings at lower levels depending on their own personal risk and comfort, officials said.

While only about of U.S. counties were considered low or moderate risk under the old framework, nearly 60 percent now fall into that categorization, accounting for about 70 percent of Americans. Individuals may check the updated risk level for their county on the CDC’s .

Under the old framework, only about 5 percent of U.S. counties were considered low or moderate risk. Now nearly 60 percent fall into that categorization, accounting for about 70 percent of Americans.

The change in school masking guidance comes after weeks of movement at the state and local level to scrap face-covering policies. In early February, several states including New Jersey, Connecticut and Massachusetts announced the end of their school mask mandates, and on Tuesday, the Maryland State Board of Education voted to , though the change needs legislative approval before it will go into effect. Of the 500 largest U.S. school districts, currently require students to wear masks, down from 60 percent at the beginning of February, according to data collected by Burbio, which has tracked school policy through the pandemic.

States such as California and New York have yet to announce an end to their school masking rules. But in a small step toward loosening restrictions, New York City students will on school grounds starting Monday, officials announced Friday morning. California Gov. Gavin Newsom said he will announce an end date for school masking in his state Monday.

The CDC’s move to ease masking guidance represents a broader effort to help Americans return to a “new normal,” even as the virus continues to circulate.

Over 200 million Americans have received their primary vaccine series, pointed out CDC Director Rochelle Walensky, half of whom have been boosted. Many more have a level of immunity due to prior infection.

“With widespread population immunity, the overall risk of severe disease is now generally lower,” said Walensky. “Now as the virus continues to circulate in our community, we must focus our metrics beyond just cases in the community and direct our efforts toward protecting people at high risk for severe ailments and preventing COVID-19 from overwhelming our hospitals and our health care system.”

President Biden and the CDC have previously speculated the end of the pandemic, even giving the summer of 2021 the hopeful title “summer of freedom,” before the Delta surge quickly proved that COVID would continue to disrupt daily life.

Perhaps with awareness of that history, Massetti emphasized that schools — and the wider community, too — should adjust virus mitigation rules based on changing conditions.

“Public health prevention strategies can be dialed up when our communities are experiencing more severe disease and dialed down when things are more stable.”

Walensky added, “We need to be able to dial them up again should we have a new variant or a new surge.”

Still, some have critiqued the choice to ease masking guidelines as motivated by politics and pandemic weariness. As the CDC prepared to announce updated recommendations, several disability advocates the plan on Twitter.

The new metrics do not take community or school vaccination rates into account, though officials emphasized that vaccination greatly decreases the likelihood of severe illness and hospitalization and thus is indirectly reflected in the new thresholds.

Nationwide, a quarter of children aged 5 to 11 and 57 percent of youth aged 12 to 17 are fully vaccinated against COVID-19, according to data from the . Shots for children under 5 will not be available for over a month.

COVID Shots for Children Usher in New Wave of Vaccine Hesitancy

Greg Toppo — Thu, 04 Nov 2021 16:01:00 +0000

This fall in the Elmbrook School District outside Milwaukee, elementary school classrooms come in two flavors: mask-required and mask-recommended. Students in each group, chosen by their parents, rarely interact with one another, except outdoors at recess or in required small-group settings.

“We keep cohorts together during lunch, so if you’re in a mask-required classroom, you’re eating as a group — socially distanced,” said Superintendent Mark Hansen. “We’re keeping those bubbles pretty tight.”

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Until now, elementary schoolers couldn’t get a COVID-19 vaccine. No longer. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky on Tuesday endorsed the unanimous vote of a CDC vaccine advisory panel recommending Pfizer-BioNTech’s pediatric coronavirus vaccine for use in children ages 5 to 11. That means as many as 28 million children can begin receiving shots this week.

Mark Hansen (Elmbrook School District)

But just as parents split on masks, they’re also divided on vaccines: Nearly half say they may pass on vaccinating their children for now, mostly because they aren’t especially worried their children will get seriously sick from coronavirus — even as doctors warn the virus will become endemic and virtually unavoidable in coming years, much like the annual flu.

That could set up a tense confrontation in coming months between schools and parents as public health officials push to make the shots part of mandatory school vaccine regimens. And as with the divide over masking, social distancing, and other practices, it could also change how schools operate, as pro-vaccine parents insist on keeping their kids apart from unvaccinated classmates.

Even requiring the vaccine for enrollment might not settle the dispute: An Oct. 23 poll found that 46 percent of parents simply wouldn’t send their child to school if COVID vaccinations are required.

In southern California’s ABC Unified School District near Los Angeles, Superintendent Mary Sieu said many cautious families are already hesitant to send their children back to school — about 700 have remained in remote instruction programs this fall. Overall, she said, the district has lost more than 1,400 students over the past two years, forcing her to consider closing one of her schools next year.

“I just feel that a lot of people are afraid of coming back to school,” she said.

While suggests that children remain at a lower risk than most adults of contracting serious illness due to the virus, outbreaks happen. In , conducted in early October, nearly one in three parents said their child’s schooling had been disrupted by COVID-19.

“Look at your ZIP code and see what your vaccination rates are, and your infection rates are,” said Daniel Domenech, executive director of the American Association of School Administrators. “That’s going to tell you the quality of education that those kids are getting in those schools. If a child isn’t in school consistently, they’re not going to be getting the quality education that they need. That’s the bottom line.”

Domenech, a former superintendent in Fairfax County, Va., said he fears that the vaccination gap taking shape between districts could replicate the existing achievement gap. Recent research in has found, for instance, that communities with high poverty rates had COVID-19 infection rates in 2020 that were two to three times as high as those in wealthier areas.

“What we’ve seen is that the areas that are suffering the most in terms of lack of a vaccine and high infection rates are exactly [high-poverty] areas, where families of color are afraid to get their kids vaccinated and are afraid to send their kids to school,” Domenech said.

‘Ripe for a contentious situation’

Though they typically get a raft of vaccinations just to attend school, children’s COVID-19 vaccination rates have already shown evidence of parental hesitation. In September, the CDC said just of children ages 12 to 17 had gotten at least one shot and 32 percent had completed the two-shot dose by July 31. That’s more than two months after the FDA granted it emergency use authorization — and more than seven months after it first approved the vaccine for adolescents aged 16 to 17.

In Marshalltown Community School District, northeast of Des Moines, Iowa, as many as 90 percent of school employees are vaccinated, said Superintendent Theron Schutte. But just 40 to 50 percent of eligible students have been vaccinated so far. For the youngest eligible students, ages 12 to 13, the vaccination rate is closer to 40 percent. “My guess is that a lesser percentage of the younger kids’ parents will probably get them vaccinated,” he said. “I’m hoping that more of them do.”

Dr. William Raszka, a professor of pediatrics at the University of Vermont’s Larner College of Medicine, said the risk-benefit analysis for vaccination “is just so overwhelming. I have trouble understanding why someone wouldn’t get vaccinated at this point in time.”

So far, he said, life-threatening illnesses associated with the vaccines “are awfully rare.” One of the most common reactions to Pfizer’s vaccine — the only one approved for emergency use in children — is “a sore arm,” he said.

From the beginning of the pandemic, said Schutte, “We operated on the premise that we know COVID’s going to come into the school. There’s no way we can know whether it is or isn’t coming in – but what we can control is its opportunity to spread.”

He couldn’t immediately predict how his school board would respond to the recent FDA approval of childhood COVID vaccines. “They’re a reflection of our community. So if our community is split on whether we should or shouldn’t require vaccinations, I think it’s always going to be ripe for a contentious situation.”

Mandates are years off

Once COVID vaccines earn full FDA approval, states could move quickly to mandate them for school attendance — California Gov. Gavin Newsom has he plans to add it to the list of vaccinations required to attend school in-person for middle and high school grades, as with vaccines for measles, mumps, rubella, and the like. “We want our kids back in school without episodic closures,” on Oct. 27.

Speaking after he received a COVID booster shot in Oakland, Newsom said children already receive 10 other vaccinations in order to attend school. “The politics around this are disturbing to me. Lives are quite literally at risk.”

A child in Hartford, Connecticut, covers her face as she waits for her turn to receive the Pfizer-BioNTech COVID-19 Vaccine for kids on Tuesday. (Joseph Prezioso / Getty Images)

Leaders in four of the state’s — Los Angeles, Sacramento, San Diego and Oakland — have already said students must get a first shot of the vaccine or attend school virtually from home in January.

But former FDA commissioner Dr. Scott Gottlieb in October predicted that any COVID vaccination mandate for school attendance would be “a couple of years away, perhaps a little longer,” for children ages 12 to 17, and even further for children ages 5 to 11. Appearing on CBS’s , Gottlieb said CDC has typically taken several years to add most childhood vaccines to their immunization schedule.

That will leave the decision for now to parents like Debra Garrett, a mother of four children, all of them under 12, in Troy, N.Y.

Garrett said she’s vaccinated, but added, “I’m not really sure about my kids getting it done right now.” Parents need more information about how the vaccines affect children, she said. “It’s all brand new. We don’t know how anybody’s going to respond to it.”

That sensitivity is heightened, Garrett said, because she grew up Black in a country with a history of mistreating Black research subjects in the name of medicine. “I just don’t want my child to be looked at as ‘the tester,’” she said.

Debra Garrett and her four children, all between the ages of 5 and 12. Garrett, who is vaccinated, says she’s “not really sure about my kids getting it done right now.” (All In Media & Productions)

Garrett’s four children all attend , part of the Uncommon Schools network of charter schools in six Northeastern cities. She said the school has given parents of students 12 and up the choice to vaccinate.

But if Uncommon makes vaccination mandatory, “that’s when it’s going to be tricky — and it’s going to get tough for the school, and for parents. I just feel like there is going to be some kind of push and pull on both ends. I can’t say whether one is right or wrong, but what I do know for certain is that we have to educate people in order for them to be able to fully get it and fully feel like, ‘They’re not just pricking my kid.’”

Many parents will likely find themselves agreeing with Garrett. In a June survey , as the more-contagious Delta variant began to take hold in the U.S., the parents of just 51 percent of students under age 18 said they’d “probably” or “definitely” have their child vaccinated, with vaccine hesitancy much higher for parents of younger children. They’re far less likely to say they’ll vaccinate their kids compared to parents of high schoolers — 46 percent vs. 59 percent.

Political party affiliation also plays a role: Republican-identifying parents of 35 percent of children say they’ll vaccinate their kids, while that figure is much higher for Democrats at 66 percent.

A September Gallup poll suggests that of parents of children under 12 would get them an available vaccine. Parents’ own vaccination status strongly predicted their attitude toward their kids: 82 percent of parents who were fully vaccinated against COVID-19 said they’d vaccinate their child, while just 1 percent who don’t plan to get vaccinated themselves planned to vaccinate their kids.

Dr. Benjamin Lee, a pediatric infectious disease specialist and associate professor at the University of Vermont Children’s Hospital, said the findings are cause for concern.

Dr. Benjamin Lee (University of Vermont Medical Center)

“It’s discouraging to me to see how many parents have already sort of expressed that they don’t want to get their children vaccinated as soon as vaccines are available,” he said.

While it’s natural for parents to hold out a high threshold for vaccine safety, he said, no vaccine carries zero risk. “And that includes all of the vaccines that we use routinely” for both children and adults. “In all scenarios, the data are so overwhelming that risks from vaccination are far lower than the risks of natural infection.”

Schutte, the Iowa superintendent, said it’s true that children are less likely than adults to get seriously ill due to COVID, but he urged parents to see the bigger picture: Even if kids don’t get sick, they could take the virus home. “We have a lot of multi-generation (families) living under the same roof in our community,” he said. “So it’s not only the parents, but the grandparents, and maybe in some cases, the great-grandparents.”

The longer it takes to get most people vaccinated, he said, “the longer the situation is going to stretch out.”

In reality, said Lee, the Vermont pediatrician, SARS-CoV-2 “is going to be with us from now on. Any chance to completely eradicate this virus is long gone. And this will become an endemic virus,” like the annual flu, sticking around for years. Because it’s so contagious, he said, “what we should recognize is that all of us are going to get this virus. And the question is: Under what conditions or terms do we want to catch it?”

So far, the only statistically significant side effect of the vaccine is a mild case of myocarditis, or inflammation of the heart muscle, in adolescent males. But it’s enough to prompt physicians in a few countries to give young people of the Pfizer-BioNTech vaccine, offering at least partial protection from the virus without this side effect.

“We should acknowledge that that is a known risk of vaccination,” Lee said. “However, when you look at the risk of myocarditis from vaccine versus the risk of myocarditis from COVID-19, the risks are far higher of catching myocarditis if you catch COVID-19 than from the vaccine itself.”

Also, he noted, “almost without exception” the myocarditis associated with the vaccine is “a very, very mild illness that completely resolves.” COVID-19, by contrast, carries a higher risk of severe outcomes.

Lee also warned against taking to heart the many unsupported claims about the vaccines’ quick development and emergency approval, claims that might turn parents, like Garrett, off to vaccination. “When all is said and done, these will end up being the most heavily scrutinized vaccines in terms of safety perhaps ever, compared to any vaccine that we’ve ever used.”