Editor's note: This page was updated on April 6, 2022. Please follow all rules and guidelines set by state and local public health and safety authorities. Reference the Centers for Disease Control and Prevention, the Colorado Department of Public Health and Environment and your local public health agency for immediate updates.
As children under 5 remain unvaccinated and newer, more contagious variants continue to spread, parents of young children face a series of questions: How do I protect my children under 5 from contagious variants of COVID-19, such as the BA.2 omicron subvariant? When and where should I wear my mask in public with my kids? What activities are safe to do with my children who are under 5, and what should we avoid?
Since March 2020, parents have had to balance two important needs: protecting their children from the coronavirus while also letting them do the things that let kids be kids — playing, learning and socializing. That challenge remains for parents of small children as they wait for vaccines to be authorized.
To help with your planning, we asked two of Children’s Hospital Colorado’s pediatric infectious disease experts, Sara Saporta-Keating, MS, MD, and Samuel Dominguez, MD, PhD, for some guidelines.
“Focus on what you can control,” Dr. Dominguez says. “That means using all of our tools: good and frequent hand-washing, wearing a mask during times when there is moderate to high community spread, limiting interactions with people outside of your household, testing and staying home when you're sick. Then, when the time comes, get your child vaccinated as soon as possible.
“As parents, we have to be realistic that nothing is risk-free, but the goal is to lower risk as much as possible while allowing your kids to do the things that they enjoy and that they need for healthy development."
Why masks are still important
The contagious omicron variant has highlighted the importance of masking up during times of high virus transmission. Since omicron became the dominant strain of the virus in January 2022 and then mutated into the even more contagious sub-variant called BA.2, it has been proven to cause more “breakthrough infections” — infections in vaccinated people — than prior variants. While unvaccinated individuals are most likely to transmit the virus to others, people with breakthrough infections can also spread the virus.
For parents of unvaccinated children under 5, this means that surrounding your child with vaccinated people and wearing a mask during times of high community spread are the best ways to protect them from COVID-19. The CDC recommends that everyone 2 and older wear masks indoors when local transmission is high, regardless of vaccination status. It’s also advisable to mask up while outside in crowded areas if social distancing isn’t possible. This applies to school, sports, trips to the park and family gatherings.
While vaccinated adults and older children might be more lax about masking, wearing a mask yourself when you’re with your unvaccinated child sets a helpful example, Dr. Saporta-Keating says.
“My 4-year-old is more inclined to keep his mask on if we’re both wearing them,” says Dr. Saporta Keating.
Get a detailed guide to masks and respirators, including the pros and cons of different types and how to select the best option for your child
How to handle social gatherings with unvaccinated kids
You might be wondering how to approach social gatherings with your small children. Whenever possible, attend smaller social gatherings held outdoors and avoid large, crowded events. If a social event is taking place indoors during a time of moderate to high spread in your community, be prepared to mask up.
While this means direct and perhaps uncomfortable conversations with friends and family, it’s important to do your due diligence to protect your kids. Because while COVID-19 still poses a low risk of severe illness to most children, children are getting COVID-19 and some do develop severe symptoms. A small number of kids are also developing an inflammatory syndrome that can affect multiple organ systems — even after asymptomatic infections.
The key is to be mindful of your own risk tolerance and that of others. While some people choose to mask even when there is low community spread, others prefer to go without a mask unless spread is high in their community. It’s important to respect people’s choices and preferences.
Especially when COVID-19 cases are high in your area or if someone in your family may be at higher risk for severe disease, Dr. Saporta-Keating recommends asking that even vaccinated friends or family wear masks while around unvaccinated children, especially indoors.
The good news is that the vaccines are still proving to be highly effective. Even though vaccinated people can become infected and spread the virus, the likelihood of that happening is still less than in unvaccinated people. And when vaccinated people do get infected, the vaccine still protects against severe disease, similar to the flu shot.
Safe activities: childcare, sports and travel
Being out and about
When you’re together in public, make sure to keep plenty of masks on hand for you and your children. Keep several in your car and purse or backpack. If they attend school or daycare, send them with a bag of clean masks and a bag for dirty ones. This will help your child, or their teachers, swap their mask if needed, and it also helps you know which masks to wash if you’re using reusable cloth face coverings.
School and daycare
The CDC, American Academy of Pediatrics and other experts recommend that all staff and students older than 2 wear masks indoors while at school during times of high community transmission, regardless of whether they’re vaccinated or not. If your preschool or daycare doesn’t require masks, you can continue to emphasize the importance of face coverings when you talk with your children and ensure that they have plenty of masks with them each day.
Our experts also recommend finding out what additional COVID-19 safety precautions your daycare or preschool has in place. Some of the most effective measures include requiring all teachers and staff to be vaccinated against COVID-19, enforcing masking requirements for adult staff, implementing enhanced cleaning and sanitization protocols, keeping children in “pods,” avoiding mixing as much as possible, increasing ventilation and using enhanced air purification technology such as HEPA filters.
Since it’s difficult to enforce social distancing with this age group, the precautions listed above are even more important.
As with earlier phases of the COVID pandemic, outdoor activities for unvaccinated kids remain the safest option. While your children may be clamoring to visit indoor spots such as trampoline gyms or popular birthday party locations, we recommend avoiding most indoor locations and large indoor events until they’re vaccinated, and even then, masking while indoors if community transmission is high.
When it comes to travel, driving in your car with your family is the safest option during times of high virus transmission. If you do fly when community spread is high, remember to mask up in crowded airports, on planes and on public transportation. And remember to bring lots of extra masks for the whole family.
If your children play sports, keep in mind that in times of high virus transmission, unvaccinated kids should be wearing masks even during athletics held outdoors if social distancing is not possible. If they’re walking or riding bikes outdoors while maintaining a safe physical distance from people outside of their household, they can remove their face coverings.
Exceptions for wearing masks during sports include swimming (while in the water) and activities such as gymnastics or competitive cheerleading that could lead to mask strings getting tangled and posing a risk of strangulation or injury.
Supporting your child’s mental health
After two years of uncertainty and restrictions on social interaction, many children are struggling. To help protect your children from the virus while also bolstering their mental health, child and adolescent psychologists in our Pediatric Mental Health Institute have some recommendations.
First, pay close attention to your children’s needs and plan activities that give them joy. If they want a play date, plan a get together outside (and if community transmission is high, make sure to bring masks) . Encourage social interactions among family and friends, and work with everyone involved to hold the event in a way that includes precautions.
Quality time is more important now than ever. Spend some special, one-on-one time with your children doing the things that they love to do — without trying to multitask. Making sure your kids are getting active time outdoors is another great way to support kids’ mental health. While too much time spent on devices has been shown to have negative impacts on kids’ mental health, playing outside has positive effects.
Lastly, anxiety and depression in children have doubled during the pandemic, so it’s important to be vigilant, says Jenna Glover, PhD, a child psychologist at Children’s Colorado.
“Check in regularly with your kids about how they’re feeling, and if you notice any changes in their mood, especially increased anger, irritability, anxiety or gloom, that could be depression,” says Dr. Glover. “Reach out to your pediatrician to screen for symptoms.”
Find suggested questions for checking in with your child or learn how to support your teen throughout the pandemic.
Getting your child vaccinated
“Of all the tools we have in our toolbox to prevent COVID-19, vaccination is the most effective,” Dr. Dominguez says. If your child is turning 5, be prepared ahead of time and make sure you have a plan to get them vaccinated as soon as possible.
Find the latest COVID-19 vaccine updates or read more about the COVID-19 vaccines: what we know, what we don’t, which vaccine is better and much more.