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Too young for the vaccine, too fidgety for masks. How do we keep toddlers safe?

As the mom of a 22-month-old son, I feel left out of the conversation about COVID-19 and kids.
Moody illustration of woman and toddler behind a fence feeling left out of the COVID conversation
It's a scary time to be a mom of a toddler. Katty Huertas / TODAY

Throughout the past few months, I’ve felt a seed of resentment brewing as I hear people talk about what they perceive to be the light at the end of the tunnel: the day kids can get vaccinated.

My problem with that is it's referring to a specific group of children, a group that does not include mine: kids aged 5-11.

As the mom of a 22-month-old son, I feel left out of the conversation about COVID-19 and kids, and, as more children wind up in the hospital, increasingly helpless when it comes to keeping my son safe.

The Food and Drug Administration is expected to soon approve the Pfizer vaccine for children as young as 5 years old. Don’t get me wrong: That’s incredible news as I believe increasing the number of vaccinated humans helps everyone. But, my own son still won't be eligible to be vaccinated, and I’m not sure when that will happen.

It’s not just about the vaccine, though. There are other factors putting our precious toddlers in a precarious position. Consider masks: Some toddlers are still too young to wear them, and even if they’re old enough, how many 2-year-olds do you know who are diligent about mask-wearing? The same goes for other safety precautions. My son does not understand the concept and importance of social distancing. Sure, we wash his hands. But does he grasp that we are doing so because a deadly virus is circulating and we need to be extra vigilant about personal hygiene? Of course not. I have heard multiple parents of toddlers make nervous jokes about the unlikely timing of the pandemic and the stage in which their children put every single thing into their mouths.

Then, for working parents like me, there’s the day care situation. Younger kids share toys and are harder to keep contained in their own cohorts. They need more physical help — putting a jacket on, opening a lunchbox — than older children do, meaning more hands-on interaction with potentially unvaccinated adults. Plus, unlike public schools for older children, day care centers are typically privately owned businesses, which means they don’t have the same oversight as schools. When it comes to COVID-19, many are simply figuring out the plan as they go. (The child care industry is also burdened by a severe worker shortage, which I can only assume makes many day care centers wary of setting too stringent guidelines, such as vaccine mandates.) This is changing, slowly. In New York, where I live, Gov. Kathy Hochul recently expanded the state’s mask mandate to include child care centers. It’s a start, but sending my son to day care every morning still feels like a crapshoot. I cross my fingers and pray that he’s going to be OK. In fact, that’s really what raising a toddler right now feels like in general: a lot of guessing, uncertainty and fear.

I’m not alone in my feelings. Other parents of toddlers I’ve spoken to have expressed the same helplessness. In fact, that feeling is why Dr. Nhu Thao Nguyen Galvan, M.D., a transplant surgeon at Texas Children’s Hospital in Houston, enrolled her two toddlers in vaccine trials earlier this year.

“I was so scared and I just wanted my children protected,” she told TODAY. “I knew that if I had the chance to get them vaccinated, I would take it. Because despite the risks that are reported, they are nothing compared to the risks of COVID infection.”

Her youngest son, Nathan, 21 months, received two doses of the Pfizer vaccine. But Galvan doesn’t know if her oldest, Charlie, 3 years old, was in the placebo group or the treatment group of his trial.

Experts say there’s a chance the vaccine could be approved for children 2 and up as soon as the end of this year. But, as you may have guessed, it’s a complicated process to get there. Important ethical considerations have to be made when it comes to using children in clinical trials. Plus, kids’ bodies simply work differently.

“The bottom line is that kids are not small adults,” said Dr. Moshe Arditi, M.D., a specialist in pediatric infectious diseases at Cedars-Sinai Medical Center in Los Angeles. “You don’t just cut a dose in half.”

So what can parents of unvaccinated, unmasked (or undermasked) kids do until then? Perhaps the burden shouldn’t fall entirely on parents. Dr. Ayman El-Mohandes, M.D., dean of the Graduate School of Public Health at the City University of New York in New York City, said that society as a whole needs to start thinking about toddlers the same way it was the elderly at the beginning of the pandemic.

“I’ve heard people say, ‘Be careful, my mom lives at home with me.’ Now it’s going to be, ‘I have a toddler at home,’” El-Mohandes said. “And people need to be respectful of that.

“The numbers we see now are significant. Kids below 12 years of age are becoming a larger share of people who are exposed to the virus and getting sick. (Toddlers) are a special social behavioral group because they don’t understand some of the things that are easier to communicate to kids who are maybe 6 or 7 years old. Furthermore, developmentally speaking, they are not going to be easy to restrict. Therefore, we have to reverse the concept of protection — meaning, create an environment that is as safe as possible for them, rather then putting the responsibility on them to protect themselves.”

That’s easy enough to do at home, but it gets tricky when our kids are out of sight — and with flu season upon us and colder temperatures around the corner, it’s no wonder parents like me are freaking out about the next few months. And yet, it’s helpful to remember that while more children are contracting COVID-19, they don’t appear to be getting seriously ill or dying at the same rate as adults.

“It’s not a great thing to hang your hat on, but the likelihood that a healthy child will succumb to this is very low,” Galvan said.

She added that most parents who are concerned are already doing the right things: wearing masks, vaccinating themselves and their older children and avoiding high-risk environments.

“It’s very easy to kind of get lost in this rabbit hole of darkness,” Galvan said. “There’s a point where worrying and having all this consternation is going to be defeatist. But we'll be OK as long as we're mindful. I think we'll be OK."