As COVID cases fall, more and more states are lifting school mask mandates. California, Washington, and Oregon are all dropping mask requirements after March 11, and New York will end its on March 7, among others that have already lifted their mandates, will do so soon, or never had them at all. This change comes just as the Centers for Disease Control and Prevention (CDC) loosened its mask guidelines so that it no longer recommends mask requirements in most schools.
Although some parents are relieved by these decisions, others are cranking up the anxiety. After a traumatic two years, it’s easy to understand why — especially as the vaccine for kids under 5 faces delays and news has been released that the vaccine is not as effective as once hoped in those aged 5 to 11. But decisions to lift school mask mandates align with scientific evidence that vaccines work better to protect kids from COVID than masks do, and infectious disease experts agree that children have the most to gain from a mask-free learning environment. So stop thinking about pulling your kid from school; this is why you shouldn’t panic if your child’s school is dropping its mask mandate.
Cloth Masks Don’t Do Much to Protect Kids
A CDC study published last month found that masks with respirators (N95/KN95) are 83% effective in decreasing the chances of getting COVID. But here’s the problem: Most children aren’t wearing N95s. These high-quality masks haven’t been tested or approved for kids, may be unsafe for them, and aren’t recommended for them by the CDC.
Instead, most kids are wearing cloth masks to school. But that same CDC study found that cloth masks were less effective; they reduced the likelihood of getting COVID by 56%. At first glance, it may look like cloth masks still offer protection, but the results were not statistically significant. In other words, cloth masks didn’t seem to change the chance of getting COVID. And the study was conducted before Omicron, which rendered cloth masks even less effective.
“It goes back to the question of what people have been using in school settings, and because it’s more comfortable, children have been using cloth masks for two years,” says Monica Gandhi, MD, MPH, a professor of medicine and associate division chief of the division of HIV, Infectious Diseases, and Global Medicine at the University of California, San Francisco. “The CDC study showed us that cloth masks do not have a sizable or statistical difference in terms of transmission and exposure. This is something that a lot of scientists have been saying for a while.”
Kids also have a tendency to not wear their masks correctly. For example, they have a harder time wearing masks correctly over their noses, according to Jeanne Noble, MD, an associate professor of emergency medicine at the University of California, San Francisco.
“Lots of young kids chew on their masks. As soon as the mask is wet, the filtration ability of a mask goes way down,” Noble says. “Masks are then not serving this filtration barrier that you would see in the lab-based study or on a mannequin study.”
Most School-Aged Children Are Eligible for Vaccination
The best way to protect your child from severe COVID is to get them vaccinated and make sure everyone in your household who is eligible is vaccinated too. The benefits of vaccination far outweigh those of masks. “We’ve oversold the contribution of masks to stop the transmission of COVID,” Noble says. “It was important to wear masks before we had vaccines. But now that we have vaccines which are incredibly effective, we are still reliant on masks when we don’t even have good data that putting our kids in masks is doing much,” she says.
Because kids were already at low risk of severe infection, Noble says vaccination can help drive that risk to almost zero. “It’s time to unmask the kids. Let them go back to a normal school day and encourage vaccination among parents as much as we can.”
Of course, children under 5 still aren’t eligible for the vaccine, which means the the vast majority of preschoolers are unvaccinated. But even without the protection of the vaccine, kids aren’t likely to get very sick if they catch COVID.
Some studies do support mask-wearing in schools, but experts say they’re flawed. For example, a study out of the United Kingdom used to justify mask mandates in schools failed to show statistically significant evidence that mask-wearing by itself reduced the number of school absences, says Bloomberg. Some studies do not consider other factors that reduce transmission, such as vaccination, that may explain a reduction in COVID cases in schools. And an Arizona study often cited by CDC Director Rochelle Walensky, which found that schools without mask mandates had 3.5 times as many COVID outbreaks, is severely flawed and has been dismantled, to the point where some experts consider it entirely unreliable.
Your Child Can Still Mask Up
Let’s get something straight: Lifting mask mandates doesn’t mean schools are banning masks. For parents who still want to mask their children because of personal preference or because their kid is high-risk — particularly if they have obesity or diabetes, but also if they’re immunocompromised — they can still send their kid to school in a well-fitted mask that provides some personal protection.
“I would recommend KF94 or cloth masks with disposable filters inside to be changed every 2-3 day for children,” Gandhi says. “The masks were tested on mannequins, and when you expose them to droplets and aerosols, there’s less transmission of the virus.”
But if parents are looking for the best form of protection for their kid as they go to school, both Gandhi and Noble agree that vaccination triumphs over mask-wearing.
The WHO Doesn’t Recommend Masking for Kids
Countries including the United Kingdom, Norway, Denmark, and Sweden do not require young children to wear masks at school. Their decisions are likely based on the guidance of the World Health Organization (WHO) recommending against mask-wearing for children 5 years and younger. For children 6 to 11 years old, both the WHO and UNICEF say masking should be considered when there is a local surge of infections. Otherwise, it’s unnecessary.
One reason against mask mandates in schools is that children with certain disabilities may not tolerate wearing a mask. The WHO recommends children with severe cognitive or respiratory disabilities forgo masks. They also advise parents to decide to weigh the risks and benefits of having their children wear masks if they have developmental disorders or other specific health conditions.
Masks May Hinder Language Development for Some Kids
Masks help protect against infection and are helpful particularly when local case numbers are high. But there are some concerns that masks affect learning in schools.
Noble says mask-wearing has stunted the linguistic development of children. About 5 million children in U.S. public schools are learning English as a second language and about 4 million children have a speech or language delay. Masking in school makes it difficult for students learning another language or with speech difficulties to read their teacher’s lips. Additionally, seeing the child’s mouth makes it easier for teachers to help with their pronunciation.
Masking may also hurt children’s social and emotional growth. School goes beyond the classroom, and early adolescence is a critical period where children are learning to read another person’s facial expressions (think of a smile that could be out of nervousness, embarrassment, or joy). With kids unable to see each other’s faces, they may have trouble interpreting complex expressions and connecting with others emotionally.
“Masks have been really hard on kids who already are struggling with anxiety issues or who developed anxiety after a period of isolation,” Noble says. “We would like to see kids get back to normal childhood and get over the fear that they’re to blame if one of their parents or their grandparents gets sick.”
Most Kids Don’t Get Very Sick From COVID
It’s been a mantra and a blessing since the early days of the COVID-19 pandemic: The disease is generally mild in kids. Children are mostly protected from the worst outcomes of infection, research has demonstrated time and time again. One study looking at the risk of COVID in children infected by the Alpha variant found that of the 12 million children and young people under 18 living in England, only 25 died due to infection with the coronavirus during the first year of the pandemic. About 99.99% of children who got COVID recovered from it, making the COVID mortality rate two for every million children.
Omicron differs from previous variants in many ways, but it does not cause more COVID and may even cause less severe disease. And although Omicron decreased vaccine effectiveness in protecting against infection, especially among 5- to 11-year-olds, it did help in protecting against severe infection. Indeed, another preprint study found that while Omicron was more infectious, children had less severe infections compared to children exposed to the Delta variant.
So should the evidence have you storming your school board, demanding to get your school’s mask mandate removed? Definitely not. But if your district does stop requiring masks and your child isn’t at high risk, you don’t need to panic. Science is on your side.
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