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Question

Should my child still wear a face mask while using public transportation?

Yvonne A. Maldonado, MD, FAAP

Answer

child on airplane wear face mask for COVID

The recent judge's ruling striking down federal mask mandates on public transportation, and justice department appeal to the ruling, has created confusion about whether flying or riding the train is safe without a mask.

I realize that some families may find it difficult to decide what's best for them. For some children, including those too young to be immunized and those with special health care needs, masking is still an important layer of protection.

Face masks can be safely worn by all children 2 years and older, including the vast majority of children with underlying health conditions, with rare exception. In addition to protecting the child, the use of face masks significantly reduces the spread of SARS-CoV-2 and other respiratory infections in schools and other community settings.

When masks are especially important to wear

Parents of children who are over 2 years of age should strongly consider having them wear a mask in crowded public spaces, on trains, and on planes. Masks are especially important for individuals who interact with children under age 5 because these children are not yet eligible for the vaccine, and for individuals who are in close contact with elderly people or those who are immunocompromised or at higher risk for severe disease. Masks also are a good idea in areas where COVID cases are rising. It's important to remember that high-risk children and adults are still vulnerable to severe infection.

Studies have shown that a well-fitting mask helps reduce the spread of the COVID-19 virus. Masks form a barrier that can stop airborne virus particles from being inhaled by an uninfected person.

In addition, everyone ages 5 and older should be vaccinated against COVID-19, and those who are eligible should be boosted. Consider getting a second booster, if you or your child are eligible for one. The vaccine is very effective in helping to prevent hospitalization and death, and a booster reminds the body's immune system about the virus it needs to defend against. This gives the immune system a vital boost.

Make a mask plan that works best for your family

With continued changes to COVID mandates across the country, there may be times when your family is around groups of people who are and aren't wearing masks. Having a family plan about masks will help your child or teen know what to expect.

Parents can help their kids understand that there are many reasons why adults and children may continue wearing face masks in public indoor settings. For example, students, teachers or school staff may choose to continue wearing face masks in school settings, even if not required. Children with special health care needs may rely on masks for protection, so they do not have to miss school or other activities, especially if others around them do not wear masks.

Masking also helps cocoon children who are too young to be vaccinated. Masks can also protect kids who have weakened immune systems that put them at higher risk of serious illness from COVID-19. That's why preschools and childcare centers may have different guidelines about mask wearing indoors. Be sure to check with officials in those places.

Family members who live in the same household do not need to wear masks when they are alone together. But if you are vaccinated and your children are not, you can choose to model mask-wearing behavior in support of your children when you are all out together. For example, everyone can wear masks for a trip to the grocery store or when riding the train.

Remember

The pandemic continues to impact families in many different ways. As a parent, model empathy toward others. Discourage bullying of children who choose to wear a mask to protect themselves and their family even if they are not required.

Pediatricians strongly recommend that every eligible child receive the vaccine. New data may suggest waning ​efficacy of the vaccine in preventing mild infection from the omicron variant in children ages 5 to 11. Without the added layer of protection from the COVID vaccine for kids under age 5, masks are still an important way to protect our loved ones.

More information

Yvonne A. Maldonado, MD, FAAP

​Yvonne A. Maldonado, MD, FAAP, is Professor and Chief of the Division of Infectious Diseases, Department of Pediatrics at Stanford University School of Medicine, Stanford, California. She is also the Senior Associate Dean for Faculty Development and Diversity at the Stanford School of Medicine. With the onset of the COVID-19 pandemic she has over 10 clinical, epidemiology and laboratory-based studies in this area and is involved in epidemiologic modeling at the university, state and national level. She is the Chair of the American Academy of Pediatrics Committee on Infectious Diseases. Dr. Maldonado has published over 200 peer-reviewed articles in scientific journals and is co-editor of the textbooks "Remington and Klein Infectious Diseases of the Fetus and Newborn Infant" and "Report of the American Academy of Pediatrics Committee on Infectious Diseases (Red Book)."

Last Updated
4/21/2022
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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