With the reopening of concert venues and restaurants at full capacity — places that are objectively safer if you're vaccinated against COVID-19 — parents of young children are facing tough choices this summer. As more adults and teens get vaccinated, the risk of contracting the coronavirus for unvaccinated kids decreases, but does that mean your 11-year-old can safely return to his or her favorite pre-pandemic activities?
In parts of the country with lower rates of vaccination, the delta variant of the coronavirus poses a considerable threat, as growing evidence shows it is more transmissible and may lead to more severe disease. As of Tuesday, it represented 26% of nationwide cases and could be dominant by the fall.
"There are still cases ongoing, and those cases are generally going to be caused by the delta variant, and that's going to be rising," explained Dr. Jaimie Meyer, infectious disease physician at Yale Medicine in New Haven, Connecticut. "Even though we very much want this pandemic to be over ... the fact that some people, including children, aren't vaccinated means we're still vulnerable."
"While it might be exhausting to continue to take precautions, especially for unvaccinated kids, that becomes increasingly important," she stressed.
Because vaccination rates and community spread of COVID-19 varies from region to region, parents should consider what's going on in their area when assessing safe activities for unvaccinated kids, Dr. Kristin Moffitt, an infectious disease pediatrician at Boston Children's Hospital, told TODAY. The lower the vaccination rate, the more careful parents should be about masking and social distancing, she explained.
The Centers for Disease Control and Prevention say that fully vaccinated people don't have to wear masks, but there are no specific CDC guidelines for unvaccinated kids (other than the recommendation that unvaccinated people, including children, don't travel). To better understand what are COVID-19-safe activities for kids this summer, four infectious disease doctors who are parents shared with TODAY what events they're avoiding to protect their unvaccinated children.
Two of four of the experts — Meyer and Dr. Allison Agwu, an infectious disease physician at Johns Hopkins Medicine in Baltimore — said they would not feel comfortable doing sleepovers right now.
"Unvaccinated kids who are not in each other's bubbles and doing indoor sleepovers, I think, is a problem," Agwu said.
Meyer added, "I'm just not ready to risk it, but I do think every parent, you know, has to make their own risk calculation."
Moffitt on the other hand said she'd be OK with her unvaccinated child participating in a sleepover with one or two friends, as long as their families are fully vaccinated and case rates in her community are on a steady decline. Dr. Diego Hijano, an infectious disease doctor at St. Jude Children's Research Hospital in Memphis, Tennessee, said he'd also allow a small sleepover if he knew the families of the kids are fully vaccinated and there are fewer than four or five children.
Day camp and sleep-away camp
Agwu is sending her unvaccinated child to virtual camp this summer because she doesn't know what risk the other unvaccinated kids may pose, as she doesn't know their families' approaches to COVID-19 safety or vaccination status.
Hijano also would not allow his unvaccinated daughter to participate in a sleep-away camp this year, but he would consider a day camp if he felt comfortable with their COVID-19 safety protocols. For example, the staff would need to be all vaccinated, most activities would have to be outside, and kids would have to socially distance during mealtimes.
"You still have a little bit of risk because you spend the whole day with a lot of people, but it's definitely better because you don't have the sleepover," he said.
Meyer believes that day camps can be safe, as well, as long as most of the activities are outdoors, group sizes allow for social distancing among campers and staff is vaccinated.
Agwu said her unvaccinated child has only been doing playdates with other kids his age if they're outside wearing masks. "Not in the bubble, not vaccinated, going to school and indoor play, mixing households ... that makes me nervous," she explained.
Meyer is also only letting her child do outdoor-centric playdates. If they go inside her house, they wear masks, and if they're eating or need to remove their mask indoors, they're socially distanced.
Outdoor gatherings with many households
For her unvaccinated son, Meyer is avoiding large outdoor gatherings if social distancing isn't possible, such as a concert venue at full capacity. But she said she's fine with socializing with one or two households outdoors, even if there are some unvaccinated people, as long as attendees social distance.
Hijano prefers to forgo outdoor events with more than a few different households because, "the more families, the higher the risk," he said. While it's possible to attend such an event in a safe way, with masking and social distancing, these precautions make it less fun, and he'd rather bring two or three households together outdoors, with everyone vaccinated except the kids. He said he doesn't ask his unvaccinated daughter to mask or distance in this scenario.
Moffitt said she allows her child to go unmasked if he's socializing outdoors with his group of three or four friends, but beyond that, she requests he wear a mask.
Indoor parties with unvaccinated people
Hijano called indoor gatherings with a large number of unvaccinated people, whether it's a birthday party or school event, "a high-risk situation. I would definitely avoid those if you have unvaccinated kids."
Meyer added that she also opts out of these scenarios because she'd want her unvaccinated son to wear a mask, "and there's too much peer pressure. I think it's too hard for him to be the only one doing that."
"I've heard a lot about larger sleepover parties, indoor birthday parties, (with) the bounce house. We're not there yet," she continued. "I felt like if I brought my child to something like that or allowed that to happen, I really wouldn't be practicing what I preach."
If Moffitt gets the impression that an event is going to be crowded and indoors, her unvaccinated son will skip it. As Agwu explained it, "A bunch of unvaccinated people in a room, the same rules apply from last summer."
Hijano said his family doesn't do indoor dining for the sake of his unvaccinated daughter because he wants to avoid the risk of her being inside and having to remove her mask to eat and drink.
Moffitt said she'd possibly be comfortable with indoor dining with her unvaccinated child, but she'd want to make sure the tables are socially distanced, the restaurant is well ventilated and the transmission rates in her community are low.
Bowling alleys and movie theaters
Meyer said she's not yet comfortable with the idea of taking her child to a bowling alley or movie theater, which are common rainy day activities in the summer.
Moffitt, meanwhile, would consider it, but if her family couldn't social distance from other people at either activity, she'd pass. She also would want to make sure community transmission is low and that the buildings are well ventilated.
HIjano said he'd be fine with going to the movies, as well, but the theater would need to be at 25-50% capacity and his family would wear masks.
Vacations with unvaccinated people
Agwu said the idea of going on vacation with multiple households that have unvaccinated children, especially if they're traveling from different parts of the country and staying in the same house, makes her nervous.
Hijano, on the other hand, said he'd be willing to go on a vacation staying with another household as long as all the adults and teens are vaccinated and they only have one or two kids who aren't. "I think it comes down to are they vaccinated or not? That should be your starting point to say, 'I'm comfortable having them come,' versus saying no," he explained.
Hijano said he and his family have no international travel plans at the moment, but they are planning to travel just the four of them for a domestic beach vacation. "Obviously, travel increases the risk of exposure to COVID-19, so you have to be very careful," he said.
The CDC recommends delaying travel until you're fully vaccinated. If you're traveling with unvaccinated kids, have them wear a mask in public, stay 6 feet away from anyone not traveling with you and wash their hands regularly. Avoid cruise ships, long-distance train or bus trips, and try to minimize the number of stops or layovers if you're driving or flying.