The COVID-19-related mask mandate requiring that everyone wear masks when indoors has been lifted for vaccinated people as of May 17th, 2021. While this may seem like great news at first, it may not be the time to celebrate. If you are a healthy individual with no underlying conditions and can guarantee that the rest of the maskless droves are healthy, then all is well. Sadly, there is no way to see the vaccinated in this scenario.
When relying on the honor system, we have found many throwing rules and caution to the wind in the United States. Many US parents are becoming hesitant regarding routine childhood vaccinations. Vaccine hesitancy, even for the annual influenza vaccine, is prevalent in the United States. Now imagine these parents' feelings for the COVID-19 vaccinations. Vaccinations that are approved through Emergency Use Authorization by the FDA have been deemed safe and highly effective. From an article in Pediatrics, "almost 1 in 15 US parents are hesitant about routine childhood vaccines, whereas 1 in 4 are hesitant about influenza vaccine. Furthermore, 1 in 8 parents are concerned about vaccine safety for both routine childhood and influenza vaccines, and only 1 in 4 believe influenza vaccines are effective."
Even with the frightening trope of “papers, please,” that the opposition will present when talking about masks and vaccinations, many of us would argue that the honor system may be too highly valued when coming to this hot button issue. Currently, children under 12 are still not approved to get the vaccine and be protected from COVID-19. So far, approximately 4 million children between 12-17 have been vaccinated against COVID-19.
As a member of the Parent Advisory Board of Voices for Vaccines and a board member of Transplant Families, I have seen how human behavior works regarding vaccine hesitancy and antivaccine reactions. This is especially true in the pediatric transplant world and very prevalent in the pediatric world at large. As of the 2019 census, over 3 million children in the United States (4.3% of the under 18 population) have a disability.
Sadly, these are the same parents that are going to go unmasked. The past year has shown that these parents who choose not to vaccinate are the same parents that do not want to have a mask on them or their child. What does this mean? Children with disabilities, these adults with disabilities, are all affected. Our most vulnerable now must go back to staying inside because the mask mandate has been lifted. Their parents cannot trust that the person in the store without a mask is vaccinated. The child who had an organ transplant and is now sitting next to his friend in school will have to go back to remote learning because of this sudden shift in policy, and it's not safe for him anymore.
As of 2021, in the United States, 850,423 people are transplant recipients. Of these people, 57,419 are children under the age of 18. These people, adults, and children alike, are immunosuppressed for life. The gift of science, medical research, and groundbreaking surgical techniques has made life for transplant recipients much more rewarding than it was 15 years ago. These adults and children look just like you and me. Except they are immunosuppressed and will be able to get sick much easier. One such recipient is my son, Benjamin. He received a heart transplant at just seven weeks old and is now 9. He was starting to get back to somewhat of normal existence. We had started letting him go back to in-person school in March, along with his sisters. Because his teachers and everyone in the building was vaccinated AND everyone was made to wear masks while in the building, we felt this was a safe choice and a good opportunity for him to get that socialization piece that he was not getting via remote learning. He was also not doing well with remote learning, as many children have not been this year or last year. Returning to in-person learning has allowed him to catch back up. He has been flourishing in this environment, according to his teachers. However, now, with the possibility of schools not requiring masks next year, we may need to revisit the option of remote learning.
The research on this population has shown that COVID-19 can be devastating for them and have serious long-term consequences. When transplant recipients do get the chance to get vaccinated, there is a chance that they will not mount as much of an immune response as other children and adults do from the same vaccine. It has been shown to reduce serious disease and can be effective in the child not getting COVID-19. Precisely the reason that masks are essential. Masks protect the wearer and those around you that are too young or have other compromising issues that would make them susceptible to disease.
We certainly are not taking the mental effect aspect of the pandemic lightly. Our children have suffered from isolation from friends and family. Now our children are invisible again, and it is no longer safe for them due to vaccine uncertainty of the greater public. Isolation will undoubtedly bring depression to many, especially if they have siblings at home who are vaccinated and possibly start doing more things outside again that the transplant sibling cannot . An apocryphal quote, "your right to swing your fist ends where my nose begins," is very applicable to this mask mandate. It means that your rights not to vaccinate and not wear a mask end when it hurts others within our society. If you want to not wear a mask in your own house, around people you know, that's fine. But, when it starts to infringe on other people's health and safety, that's when it becomes a problem. And right now, we have so few people vaccinated that it is a huge problem.
Unfortunately, we have not achieved herd immunity in the United States from the COVID-19 vaccine. To achieve herd immunity, epidemiologists recommend we are to be 70-80% vaccinated. So, why has the CDC reversed its stance on masking when we are barely at 38% fully vaccinated in the US?
Works Cited
Carlsen, A., Huang, P., Levitt, Z., & Wood, D. (2021, 05 20). How Is The COVID-19 Vaccination Campaign Going In Your State? Retrieved from National Public Radio: https://www.npr.org/sections/health-shots/2021/01/28/960901166/how-is-the-covid-19-vaccination-campaign-going-in-your-state
CDC. (2018, 10 12). Morbidity & Mortality Weekly Report - Vaccination Coverage Among Children Aged 19–35 Months — United States, 2017. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/mmwr/volumes/67/wr/mm6740a4.htm#T1_down
Illinois Department of Public Health. (2021, 05 20). COVID-19 Vaccine Administration Data. Retrieved from Illinois Department of Public Health: https://www.dph.illinois.gov/covid19/vaccinedata?county=Illinois
Kemp, A., Saville, A. W., Albertin, C., Zimet, G., Breck, A., Helmkamp, L., . . . Szilagyi, P. G. (2020). Parental Hesitancy About Routine Childhood and Influenza Vaccinations: A National Survey. Pediatrics, 146(1).
O'Donnell, C. (2021, 05 18). U.S. vaccinated 600,000 12-15-year olds last week -health official. Retrieved from Reuters: https://www.reuters.com/business/healthcare-pharmaceuticals/us-gave-covid-19-shots-600000-kids-ages-12-15-last-week-top-health-official-says-2021-05-18/
Statista. (2021, 01 20). Number of children in the United States in 2019, by age group. Retrieved from Statista: https://www.statista.com/statistics/457786/number-of-children-in-the-us-by-age/
U.S. Census Bureau. (2021, 03 25). Disability Rates Highest Among American Indian and Alaska Native Children and Children Living in Poverty. Retrieved from U.S. Census Bureau: https://www.census.gov/library/stories/2021/03/united-states-childhood-disability-rate-up-in-2019-from-2008.html
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