Back to School with COVID-19

Virginia’s students head back to school during COVID-19 for the second year in a row. Variants like delta, lambda, and now mu continue making news. With mask protocols in place for students and vaccine availability evolving for children, it’s a lot for parents and students to keep up with.

This blog is for you to share with your pediatric patients and their families to help them navigate the current COVID-19 landscape.


VACCINE EFFECTIVENESS: The Centers for Disease Control and Prevention (CDC) advises COVID-19 vaccines are highly effective at preventing serious outcomes for those who get sick with the virus, including severe disease, hospitalization, and even death.

AGES 12 & UP: The CDC recommends all children ages 12 and older get the COVID-19 vaccine. The American Academy of Pediatrics (AAP) also recommends all children ages 12 and older without contraindications get the COVID-19 vaccine. In mid-August, the Pfizer COVID-19 vaccine was fully approved by the Food and Drug Administration (FDA) for all people ages 16 and up. Its brand name is now COMIRNATY. Children ages 12 to 15 may still be vaccinated under the FDA’s emergency use authorization of the Pfizer vaccine. The Moderna and Johnson & Johnson COVID-19 vaccines are currently restricted to ages 18 and older under the FDA’s emergency use authorization.

UNDER AGE 12: The AAP recommends against giving the COVID-19 vaccine to children under age 12 until it is authorized by the FDA. No COVID-19 vaccine has currently been FDA approved for use in children under age 12. Clinical trials for COVID-19 vaccine use in children under age 12 are ongoing, with the goal of securing the FDA’s emergency use authorization and eventually full approval. Pfizer is reporting it expects to complete studies on children ages 5 to 11 in September, and studies on children up to age 4 shortly afterward. Moderna’s clinical trial data for COVID-19 vaccine use in children is tracking for late fall or early winter. And Johnson & Johnson will begin clinical trials on children ages 12-17 this fall, followed by trials for ages 2 to 11. After the FDA receives clinical trial data, it could take as long as 4 to 6 months to review.

COVID-19 VACCINE WITH ROUTINE IMMUNIZATIONS: According to the AAP and the Advisory Committee on Immunization Practices (ACIP), the COVID-19 vaccine may be given along with a child’s routine immunizations including the flu vaccine.


MASKS INDOORS & ON TRANSPORTATION: Due to the COVID-19 delta variant, the CDC is currently recommending universal indoor masking for all students age 2 and older, in addition to staff, teachers, and visitors to K-12 schools, regardless of vaccination status. Masks are also recommended during school transportation, whether public transportation or on school buses.

MASKS OUTDOORS: Masks should be worn by unvaccinated children and adults when in crowded settings or during activities with prolonged close contact with others. Fully vaccinated people might choose to wear a mask in crowded outdoor settings if they or someone in their household is immunocompromised.

SOCIAL DISTANCING: Current CDC guidelines recommend schools maintain 3 feet of distance between students in classrooms to reduce the risk of COVID-19 transmission. If the 3-foot minimum is not possible, layering other prevention strategies such as screening testing and improving ventilation is advised. A distance of 6 feet is recommended between students and teachers or other school staff.  Social distancing should be maximized, ideally 6 feet or more, when masks are taken off during lunch. Strategies should be employed to minimize the time with the mask off.


BENEFITSRegular handwashing with soap and water continues to be important in keeping children safe from COVID-19 at school and at home — and it protects against other germs as well.

TECHNIQUEHandwashing with soap and water for at least 20 seconds is recommended by the CDC, and especially in these situations that particularly apply to kids: after being in a public place, after blowing your nose, after coughing or sneezing, before eating or preparing food, before touching your face, after handling your mask, and after using the restroom.

HAND SANITIZER OPTION: Soap and water is the preferred handwashing technique, according to the CDC. If soap and water are not readily available, the CDC recommends using a hand sanitizer that contains at least 60% alcohol. All surfaces of the hands should be covered with the sanitizer and rubbed until dry. Children under age 6 should use hand sanitizer only with adult supervision.

To learn more about vaccine myths such as “I don’t need the vaccine if I already had COVID-19” or “The COVID-19 vaccine will disrupt puberty,” see our August 16, 2021 blog, Busting Common COVID-19 Myths.

Michael Martin, MD FAAP
President, Virginia Chapter, American Academy of Pediatrics