Are the Guidelines for Vaccinated Adults the Same if You Have Unvaccinated Kids?

Congratulations, you received the COVID-19 vaccine and it's been two weeks since your last shot so you're officially "fully vaccinated" from here! But, wait, not so fast—your kids still aren't vaccinated. Um, now what?

March 2021 guidance from the Centers for Disease Control and Prevention (CDC) offers up recommendations for what fully vaccinated individuals can start to safely enjoy again—like getting together with grandparents, for example—but parents are wondering what all of this means for them when their kids aren't even eligible for the vaccine yet. Are they still pretty limited in what they can do?

"Things are definitely looking up and we should be hopeful that vaccinating as many adults as possible will lead to the coveted 'herd immunity' allowing us to return to more normal work and personal life," says Ari Brown, M.D., founder of 411 Pediatrics in Austin, Texas, author of Expecting 411, and spokesperson for the American Academy of Pediatrics (AAP). "We are optimistic that kids ages 12 and up will also be able to be vaccinated by late summer or fall, which will also help lead to community immunity. But it will be quite a while until babies and younger children can be protected by vaccination as the vaccine studies on those age groups are just starting now."

Until all Americans are eligible to get their shot, parents want to know: How cautious do we have to continue to be with our unvaccinated children? Here, experts advise on what you and your family have the green light to start doing amid the pandemic if you've been vaccinated and what you should probably hold off on until your kids are eligible.

According to Mona Amin, D.O., a pediatrician, host of the PedsDocTalk podcas‪t, and creator of PedsDocTalk TV based in Fort Lauderdale, Florida, it's important to get as many adults—loved ones, teachers, neighbors—vaccinated as possible to help decrease opportunities for a child to get sick. While that's happening, and until kids can get the COVID-19 vaccine themselves, we have to consider what level of risk a family is comfortable with.

"Many families are more risk averse and some are more carefree and all can look at COVID as a threat," says Dr. Amin. "The families who are more carefree look at overall risk for a healthy child. Children are spared overall of complications at the rate adults are, but that doesn't mean they can't get the virus or can't get sick. It's important for families to weigh the risks and benefits of certain activities as things begin to open up and as more adults get vaccinated." 

Here's Dr. Amin's checklist to consider before planning an activity for your family:

While no activities have zero risk—and your family's situation may be unique, so you should also consult your own doctor—there are definitely some things you'll want to be more cautious with than others. Here's a rundown of activities you're probably thinking about:

"You want to consider where you are going," says Dr. Amin. "I'm not as worried about the actual airplane travel, but more so the people you will be in contact with at your destination. If you are visiting vaccinated individuals, the risk to your child is lower. If you are traveling to stay at an Airbnb or house rental, your risk is lower than staying at a hotel. I do feel hotels are taking precautions to keep their employees and patrons as safe as possible. Traveling is possible and risk is reduced if all adults are vaccinated, all children are not considered high risk for complications, and you are not engaging in high-risk activities at your destination."

The verdict: Proceed with caution. Driving is safer than flying, and you'll want to consider the risks around your destination. The CDC still currently recommends delaying travel during the pandemic.

While Dr. Brown says going to a theme park or somewhere like Disney "seems like a bad idea" right now, Dr. Amin notes the precautions many of these places are taking and weighing the risk for your family.

"I would only attend these if they are continuing with precautions such as masking, limited capacity until cases continue to come down, if your child is low risk of complications, and if parents are vaccinated," says Dr. Amin.  

The verdict: It depends. You'll have to weigh the pros and cons and assess the risks.

Dr. Brown considers going grocery shopping or to the store with your kids pretty low risk if everyone's wearing a mask and you're not standing in one spot for too long.

The verdict: Go for it.

Since transmission will be lower outdoors, enjoy!

The verdict: Go for it.

"This is dependent on a parent's comfort," says Dr. Amin. "Summer camp and sports increase our risk of exposure through human contact. If summer camps are taking precautions to reduce risk, this is great." 

The verdict: Sign the kids up as long as you know the camp is following necessary safety measures.

With kids in close contact, limited ventilation, and screaming children, the risk of transmitting respiratory viruses at these types of places is greater. Indoor play places that limit capacity, require masks, and sanitize regularly will have a reduced risk.

The verdict: It's probably safest to skip for now.

Outdoor activities like summer barbecues are definitely more favorable than anything indoors, but Dr. Brown stresses the importance of knowing who's on the guest list.

"If you don't know who is going to be there, their vaccination status, and not wearing masks, I'd personally skip that one," says Dr. Brown. Socializing with other vaccinated people outside should mostly be fine, but when the party gets too large or you don't know the status of who's vaccinated and who's not, your family's risk is going to go up. "I would avoid unless you are outside and can physically distance from them."

The verdict: It depends on who—and how many people—will be there.

Experts give outdoor playdates the thumbs up. When it comes to getting together inside, keeping things small—one friend with both kids wearing a mask—will be safest.

The verdict: Enjoy, but shoot to keep things outside as much as you can and limit who's there.

Yes—and that goes for everyone over the age of 2, vaccinated or not, especially in public places. For now, at least.

"I don't see a mask-lifting recommendation for a while," says Dr. Brown. "We need to see how things go with the variants and how well the vaccines protect against them (currently the data is reassuring, which is great). And we need to get to the sweet spot on the number of people vaccinated plus those who had natural disease to equal around 75 to 80 percent of the population."

"Parents of high risk children have great respect for infectious diseases, so they know not to let down their guard," says Dr. Brown. "They will need to continue to be careful. But once the parents are vaccinated, they can breathe a lot easier that the odds are low of bringing the virus home to their child. It is still important to wear a mask out in public, even after vaccinated, to reduce the risk of acquiring or asymptomatically spreading the virus." Dr. Amin says families with higher risk children should speak to their child's doctor to "come up with a plan that works for that family balancing risk and mental health." 

And when it comes to parents welcoming a new baby into the world, Dr. Amin recommends laying out a visitor policy before having the baby. The absolute safest option is to limit contact with others (which was also recommended pre-COVID), have all visitors—vaccinated or not—wear a mask for the most protection possible, and focus on precautions (like washing hands before holding the baby and asking visitors not to kiss your newborn) that you would even without a pandemic.

"Whatever a family decides, keep groups small, prioritize outdoor meetups versus indoors to reduce risk of spreading any respiratory virus (including common cold, RSV, flu, or COVID), avoiding visitors who are sick or under the weather, and limiting visitors if you do not feel comfortable," says Dr. Amin.

"You may still need to be selective about social gatherings and travel with your kids," says Dr. Brown. "While the risk of children getting the illness and having severe illness is low, the risk is not zero." Limiting the amount of people you're around will reduce your risk of getting sick and smaller social activities held outdoors are your best bet.