The vast majority of youth benefit from in-person schooling and sound evidence exists for gathering safely with the adoption of layers of public health interventions including vaccination of all those eligible, masking, distancing, maximized ventilation and exclusion of any ill students and staff. Yet despite last year’s evidence, experience and the successes of open Maine schools, these protective measures are up for debate for as educators and parents plan for back to school.

Although many children will experience mild COVID-19, many will not and pediatricians are still learning about the nature of illness caused by this new variant.  Nationally, over 400 children have died from COVID-19 or its complications, which is significantly higher than a severe influenza season for children. Major risk factors for severe COVID-19 include obesity (which affects one in five children) and respiratory diseases such as asthma (which affect one in 10 children).  Even children with mild or asymptomatic COVID-19 infection are at risk for multisystem inflammatory syndrome, which can damage multiple organ systems including the kidneys, the liver, the gastrointestinal tract and the heart, causing heart inflammation, which is life-limiting, as children are unable to participate in sports, physical education class or recess for months. These children often have no identifiable risk factors for COVID, and their average age is 10, too young to be vaccinated.

While unseen by most Mainers, pediatricians treat these patients and support parents desperately wishing there was some way to have prevented these infections. There is: One is vaccination, and another is masking.

Both the national American Academy of Pediatrics and the Maine Chapter of the American Academy of Pediatrics strongly recommend that schools adopt a universal masking policy for youth and staff this school year. Why? For a large proportion of children, the pandemic is far from over, as they are age-ineligible for effective, safe vaccines. Thus, identical to the fall of 2020, many primary schools will have no vaccinated students to start the school year. But unlike last fall, the delta variant has proven exceedingly more transmissible among adults and children, but public health measures, including masking, are still effective against this variant.

Additionally, our school communities also have immunocompromised staff, parents and teens who may not have responded to the vaccine fully or for whom even any COVID-19 infection could be health-threatening. Our school communities must be safe for all who enter and layers of protection in school protect them as well. Now, the federal Centers for Disease Control and Prevention has now come to this conclusion as well.

Maine is among the top in the nation when it comes to vaccines; however, all children under 12 and over half of adolescents aged 12-15 remain unvaccinated.  For children to remain safely in school with learning uninterrupted by quarantine, masks must be part of this protective ring.

Maine students proved remarkably resilient wearing masks as an acceptable necessity to being with friends and peers. To keep our schools open and as safe, the Maine Chapter of the American Academy of Pediatrics strongly recommends and supports the adoption of universal masking in the school setting.