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Children in masks at school

CDC releases updated school guidance; pediatric COVID hospitalizations hit record high

January 7, 2022

Editor’s note: For the latest news on COVID-19, visit http://bit.ly/AAPNewsCOVID19.

Federal health officials have updated COVID school guidance on isolation and quarantine as some schools grapple with whether to return to virtual learning.

“Our updated recommendations for isolation and quarantine and our prior publications and continued assessment of test-to-stay protocols in schools provide the tools necessary to get these schools reopened for in-person learning and to keep them open for the rest of the school year,” Centers for Disease Control and Prevention (CDC) Director Rochelle P. Walensky, M.D., M.P.H., said in a media briefing Friday.

The recommendations come amid a flurry of COVID-related moves from federal health officials Thursday and Friday. Those included releasing data showing record-breaking pediatric hospitalizations driven by children under 5 years, publishing a new study showing high vaccine effectiveness against multisystem inflammatory syndrome in children (MIS-C) and shortening the interval for adult Moderna vaccine recipients to get a booster.

School guidance on isolation and quarantine

The CDC updated its isolation and quarantine guidance for students and teachers in K-12 settings to align with guidance it recently released for the general public.

Students and school staff infected with SARS-CoV-2 should stay home and isolate for at least five full days following the day that symptoms begin or they tested positive (for people who are asymptomatic), according to the CDC isolation guidance.

People who never develop symptoms can end isolation after at least five days. Those who have had symptoms can end isolation after five full days if they are fever-free for 24 hours without medication and other symptoms have improved. People who develop symptoms after testing positive should restart the isolation period from the time their symptoms began.

After the isolation period, people who were infected should continue to wear a well-fitting mask around others at home and in public through day 10 or continue to isolate for 10 days. They also should avoid people who are immunocompromised or at high risk for severe disease during this time.

Everyone in a school over age 2 years should wear a mask indoors regardless of vaccination status. Anyone coming out of isolation should be adequately distanced from others when removing a mask during lunch.

Students, teachers and staff who have been in close contact with someone who is infected should quarantine for at least five days if they have not completed a primary vaccine series or if they are an adult who did not receive a booster when eligible, according to the CDC’s school guidance on quarantine. Schools may implement a test-to-stay program as an alternative to traditional quarantine.

Quarantine is unnecessary for adults who have been boosted, children ages 5-17 years who completed a primary series of COVID-19 vaccines and those who had confirmed COVID-19 within the last 90 days.

Everyone who is in close contact with an infected person should wear a well-fitting mask around others for 10 days and get tested at least five days after contact. If they test positive or develop symptoms, they should follow isolation recommendations.

Record-breaking pediatric hospitalization

The updated school guidance comes as the rate of children hospitalized with COVID has grown to two of every 100,000 children, the highest since the start of the pandemic. The latest spike occurred largely among those under 5 years, a group that has a hospitalization rate of four per 100,000 children and is too young to get vaccinated.

Dr. Walensky said the CDC has not seen a signal indicating the omicron variant is more severe for children. The increasing hospitalization rates may be due to increasing rates of virus in the community.

Vaccine effectiveness against MIS-C

A new study released Friday in the Morbidity and Mortality Weekly Report found the Pfizer-BioNTech vaccine is 91% effective against MIS-C, a severe condition in children that can follow COVID-19. In addition, none of the MIS-C patients in the study who were vaccinated required life support.

“Vaccination is the best tool we have to protect children from COVID-19,” Dr. Walensky said.

Since the start of the pandemic, there have been about 6,431 cases of MIS-C, and 55 of those children have died, according to CDC data.

About 54% of adolescents ages 12-17 years and about 16% of children ages 5-11 years are fully vaccinated, according to CDC data. Earlier this week, a Pfizer representative said she expects clinical trial data on vaccines for children under 5 years to be available in late March or early April.

Moderna booster interval

The Food and Drug Administration announced Friday adults who received a Moderna COVID-19 vaccine primary series are eligible for a booster at five months instead of six months since their last vaccine. The move, which was approved by the CDC, aligns with the timing of boosters for Pfizer-BioNTech recipients approved earlier in the week.

 

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