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AAP updates interim guidance on COVID testing, face masks, MIS-C

November 16, 2021

Editor’s note: The guidance documents have been updated since the time this article was published. Please see the face mask guidance document, testing guidance document and MIS-C guidance document. For the latest news on COVID-19, visit

The AAP has updated its interim guidance on when children should be tested for SARS-CoV-2 based on whether they have symptoms and whether they are fully vaccinated.

It also updated its guidance on COVID-19 vaccination after multisystem inflammatory syndrome in children (MIS-C) and aligned its face mask recommendations with its sports guidance.


Children need to get tested for SARS-CoV-2 if they have been in close contact (less than 6 feet for a cumulative total of at least 15 minutes in 24 hours) with someone who has a probable or confirmed infection.

The AAP’s updated interim guidance recommends the following time periods for testing:

  • Symptomatic: Test immediately regardless of vaccination status.
  • Asymptomatic and not fully vaccinated: Test immediately and if negative, test again five to seven days after exposure (or immediately if symptoms develop).
  • Asymptomatic and fully vaccinated: Test five to seven days after exposure (or immediately if symptoms develop).

Asymptomatic children who have had laboratory-confirmed SARS-CoV-2 infection in the past three months may be exempt from testing after exposure.

The AAP’s guidance aligns with recommendations from the Centers for Disease Control and Prevention (CDC). The AAP also updated the format of its testing guidance to make it more user-friendly for pediatricians deciding when to test and what type of test to use.


Just over 5,500 children have been diagnosed with MIS-C, according to the CDC. The AAP recommends delaying COVID-19 vaccination until these patients have recovered and for at least 90 days after their MIS-C diagnosis. Patients who have been treated with monoclonal antibodies or convalescent plasma also should wait at least 90 days before being vaccinated.

Pediatricians and families should discuss the risks and benefits of COVID-19 vaccination for each patient and consult the CDC’s detailed guidance.

Face masks

The AAP interim guidance on face masks aligns with its sports guidance. It encourages athletes who are not fully vaccinated and all athletes (regardless of vaccination status) living in counties with substantial or high virus transmission to wear a face mask for indoor sports training and competitions as well as when they are on the sidelines.


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