Let our kids go maskless in school

By DR. NICOLE M. JOHNSON, DR. ELIZA HOLLAND and NATALYA MURAKHVER

In recent weeks, several states have rolled back strict requirements for masking in public and indoor spaces. Even Amazon announced the lifting of mandatory masking in its warehouses.

This is great news for adults — but many children remain masked in schools due to mandates that ignore their whole-health needs. We know by now that the negative effects of pandemic restrictions on children’s health are significant, while offering little to no effect on their infection rates or mortality. Yet children remain hampered by the most restrictions even as governors like Kathy Hochul admit to these negative health effects on children while announcing the expiration of indoor mask mandates for adults.

Adding fuel to the fire for frustrated parents is how many prominent figures they see appearing maskless indoors in public. Georgia gubernatorial candidate Stacey Abrams posed maskless in a school surrounded by masked children. Several California policymakers were posing maskless with celebrities in an NFL stadium, and some 70,000 unmasked fans packed SoFi stadium for the Super Bowl. Even Randi Weingarten, the president of the nation’s second-largest teachers union, was maskless seated across from host Willie Geist during her recent appearance on MSNBC’s “Morning Joe.”

FILE - In this Wednesday, March 24, 2021, file photo, students arrive for the school in the Brooklyn borough of New York. (Mark Lennihan/AP)

So why are children still forced to mask while adults have options? Weingarten and other public officials know that masking interferes with intellectual and social development and is associated with delays in the language and speech development of infants and young children. In her “Morning Joe” appearance, Weingarten agreed with Dr. Lucy McBride, saying masks are indeed “impeding learning, socialization.”

FILE - In this Wednesday, March 24, 2021, file photo, students arrive for the school in the Brooklyn borough of New York. (Mark Lennihan/AP)

Yet Weingarten still hedged on lifting the school mandates without CDC approval. Furthermore, she lauded Massachusetts as a model state for easing mask restrictions when schools hit an 80% school vaccination rate, indicating she would prefer high vaccination rates elsewhere before unmasking kids in schools. She isn’t alone in pushing that linkage. Hochul has made the same connection. California state Sen. Richard Pan believes children should continue masking until vaccination rates increase. Meanwhile, the Los Angeles Unified School District and San Diego Unified School District still want to keep vaccine requirements for school activities.

Using vaccination as a condition for lifting pandemic restrictions on children is impractical and unnecessary. First, U.S. vaccination rates widely vary with locality and ethnicity. Only 8% of all American counties have vaccination rates above 70%. Only 11 states and D.C. have vaccination rates of over 70%, and rural areas generally have lower vaccination rates than metropolitan areas. Black, Hispanic and Native American populations have the lowest vaccination rates.

Whatever the adult rates may be, children have vaccination rates much lower than the aforementioned numbers. So, if school districts hold off on lifting mask mandates until rates rise higher or restrict in-person learning only to kids who are “fully vaccinated,” they risk further harming thousands upon thousands of kids.

The growing rate of immunity in children due to infection underscores why it’s misguided to link students’ vaccination to the lifting of restrictions. More than 13 million children in the U.S. have tested positive for COVID-19 since the onset of the pandemic. This doesn’t account for unreported cases. Looking at the current data from the U.K., it is estimated that almost 60% of children ages 8-11 and about 90% of children ages 12-15 have COVID-19 antibodies from both vaccination and infection.

Other studies provide evidence children have a robust long-term immune response to COVID19 infection and that a SARS-CoV-2 infection confers long-term immunity in at least 99% of infected persons. Therefore, it is highly likely that the reported vaccination rates in U.S. children (22% ages 5-11, 55% ages 12-17) significantly underestimate the true rate of immunity.

Additionally, despite even higher case counts due to omicron, the overwhelming majority of children, whether vaccinated or not, recover without hospitalization, even those with comorbidities. Vaccination further decreases the already low incidence of hospitalization and death in all children but does very little to affect COVID-19 transmission rates.

Our children should not wait for the CDC to reverse its strict guidelines, nor should they have to wait for community or school vaccination rates to reach an arbitrary number. Hinging unmasking on community vaccination rates will penalize lower-resourced communities and those who have infection-acquired immunity. There is no equity in this plan, nor is it supported as a safety measure.

As mask mandates for adults disappear, it is difficult to justify continued masking of children in schools. The time to unmask our children is now. No strings attached, just smiles revealed.

Johnson practices pediatric procedural sedation in Cleveland, and is board certified in pediatric critical care. Holland is a pediatric hospitalist in Charlottesville, Va. Murakhver is a New York City-based child advocate and the organizer of #MaskLikeAKid. All are mothers.