Schools reopening: American Academy of Pediatrics recommends masks in schools for everyone over 2, regardless of vaccinations

“The AAP believes that, at this point in the pandemic, given what we know about low rates of transmission in school when appropriate prevention measures are used, along with the availability of effective vaccines for children 12 years and older, the benefits of personal school outweigh the risks in all circumstances,” the guidance says.

One of the most important measures of the AAP is that all students over the age of 2 and all school staff at school must wear masks unless they have a medical or developmental disability that prohibits this.

Reasons for this advice include, but are not limited to: a significant proportion of the student population is not yet eligible for vaccination; masking protects those who are not vaccinated against Covid-19 and reduces transmission; and potential difficulties in monitoring or enforcing mask policies for those who have not been vaccinated.

“There are many children and others who cannot be vaccinated,” said Dr. Sara Bode, chair-elected of the AAP’s School Health Executive Committee, said in a statement.

“That’s why it’s important to use every tool in our toolkit to protect children from COVID-19. Universal masking is one of those tools, and it’s proven to be effective in protecting people from other respiratory illnesses as well. It is also the most effective strategy for creating consistent messages and expectations among students without the added burden of monitoring everyone’s vaccination status.”

The AAP’s recommendation on universal masking differs from the CDC’s guidance, which also prioritized personal learning, but advised that fully vaccinated students, teachers, and staff should not wear masks in school.

AAP’s more cautious mask guidance is understandable, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

“If you have some level of viral dynamism in the community and you have a significant portion of the population that has not been vaccinated, then you really want to go that extra mile, the extra mile, to make sure there isn’t a lot of transmission , even breakthrough infections among vaccinated individuals,” Fauci told CNN on Monday.

The different guidelines can cause some confusion, Fauci acknowledged, noting that the CDC’s guidelines allow local states, cities and other agencies to make their own judgments.

“I think the American Academy of Pediatrics is a thoughtful group. They’re analyzing the situation and if they think that’s the way to go, I think that’s a reasonable thing to do,” he said.

AAP and CDC align with the need for personal school

Aside from the masking guidelines, the AAP and CDC agreed on the importance of personal learning.

And the AAP “strengthens” the CDC’s other recommendations on ventilation, testing, quarantine, cleaning and disinfection, the pediatrics group said in its statement.

The AAP has also recommended that all eligible individuals be vaccinated; that sufficient and timely testing resources are available; and that the strategies developed can be revised and adapted according to the situation in the community.

“With the above principles in mind, the AAP strongly advocates that all policy considerations for COVID-19 plans in school should begin with the goal of keeping students safe and physically present at school,” the guidance says. “The importance of personalized learning is well documented and evidence is already emerging of the negative impacts on children due to school closures in 2020.”

The discussion about masking and other Covid-19 protections on campus comes just weeks before some schools in the South reopen for the school year.

When Covid-19 hit US shores last spring, most schools stopped in-person learning and switched to online teaching. But distance learning has exposed inequalities in education, harmed education for students of all ages and exacerbated a mental health crisis in children and adolescents.” and their teachers — and we all play a role in making sure it’s done safely,” Sonja O’Leary, chair of the AAP Council on School Health, said in Monday’s statement.

“The pandemic has taken a heartbreaking toll on children, and it has not only been their education that has suffered, but their mental, emotional and physical health as well. The combination of layers of protection, including vaccinations, masks and clean hand hygiene, makes personal learning safe and possible for everyone.”

Eric Levenson of CNN contributed to this report.

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