Will schools and day cares require masks or COVID-19 vaccines in fall 2021?
Most of the country's schools and day cares are preparing to reopen this fall for fully in-person instruction and care, if they haven't done so already. We rounded up the basic rules around masks, social distancing and vaccinations. Details can vary significantly between districts and states, and the guidelines are changing, but here's what we know right now. The Centers for Disease Control and Prevention has not updated its mask guidance for schools for fall 2021. For now, it recommends schools continue to require "universal and correct use of masks"  strictly interpreted, this means also on the playground  through the end of the 2020-21 academic year. But with national guidance slow to change, states and districts are already making decisions about in-school protocols on their own  which means policies vary widely depending on where families live. In Massachusetts, physical distancing can end when schools fully reopen this fall, but state officials said they haven't decided what to do about mask requirements, such as for elementary students. In Maryland, Gov. Larry Hogan recently said children should not have to wear masks or socially distance in schools this fall, because the state's virus positivity rates have dropped below 1%. Other districts plan to continue more strict mitigation measures. In Washington, D.C., public school staff, students and visitors must wear masks this fall, and desks should be separated "as far as possible," according to the district. Confusion reigns in other places, like New York. The state's Department of Health indicated it would lift the statewide mask requirement for schools on June 7. But then the state's Education Department emailed all districts to say officials would wait for a response from the CDC before lifting the mandate, according to the Rochester Democrat and Chronicle. For now, New York students must still wear masks in schools. Before vaccinations became widespread, health measures for the blanket population were easy to apply to everyone, said Amanda Simanek, an epidemiologist at the University of Wisconsin-Milwaukee. "Any situation for schools is now in the context of adult populations being vaccinated," she said. Even after child care providers are vaccinated, COVID-19 restrictions are likely to continue in some fashion, according to the CDC. Right now, the agency recommends children 2 and older should wear masks in public settings, except when they're eating or sleeping. But mask requirements  including age thresholds  are typically dictated by local and state health departments and vary widely based on geography. In states such as Kentucky, Maryland and Oregon, children younger than 5 are exempt from state mask mandates. In Michigan, officials in late April extended the state's mask mandate to children ages 2 to 4 when in public spaces, including day care. Masks have been more widespread for adult child care providers. Even after adult workers are vaccinated, the CDC warns, there will be a need to continue prevention measures for the foreseeable future including wearing masks, physical distancing, and other important prevention strategies.  Other recommended strategies include ventilation, limiting nonessential visitors, temperature and symptom checks, staggered scheduling for pickup or drop-off and grouping children in cohorts. Babies and children under 2 should never wear a face covering because of the risk of suffocation, notes Kim Kruckel, the executive director of the California-based Child Care Law Center. Generally speaking, private institutions, including day cares, can decide whether to require students to be vaccinated against COVID-19 as a prerequisite for enrollment. But vaccines have yet to be approved for children younger than 12. For public schools, vaccine requirements are largely left up to states, but none have yet required children to receive the COVID-19 vaccine to reenter school, according to the National Conference of State Legislatures. As of May, about 61% of parents say they plan to vaccinate all their children, and 27% would not vaccinate any of their children against COVID-19, according to a survey by the COVID Collaborative, Ad Council and the Council of the Great City Schools. Only 55% of Black parents said they planned to vaccinate their children  the lowest rate among racial and ethnic groups. However, about 75% of respondents said they'd be more likely to vaccinate their children if it was required by schools, the survey showed. Generally, schools aren't requiring the shots yet, as COVID-19 vaccines are still being distributed under an emergency use authorization. Once the vaccines are fully approved by the Food and Drug Administration, more schools and employers are likely to require them. "When final approval is issued, and vaccines are accessible, I think that the question is going to be when to mandate the COVID-19 vaccine, and how to uphold that mandate in a consistent way," said John Comegno, an attorney in New Jersey who specializes in education law. COVID-19 vaccines for teachers:Why most schools won't require them - yet  One major network of charter schools in New York City  Success Academy, which serves about 20,000 children in 47 schools  is requiring staff to be vaccinated, the New York Post reported in May. Charter schools are publicly funded but managed by private companies, so they have more flexibility than traditional public schools. The requirement is a way to ensure everyones safety, Success Spokesman Sam Chafee told the New York Daily News in June. There's little current national data on how many educators are fully vaccinated, in part because many districts arent tracking staff immunization rates. As of late March, the Centers for Disease Control and Prevention estimated 80% of teachers, school staff and child care workers had received at least one COVID-19 vaccine dose. But a different national survey launched by President Joe Biden's administration to provide a monthly snapshot of school reopening suggests that CDC estimate is overly optimistic. More than half of elementary and middle schools reported they don't know how many of their teachers are vaccinated, the survey showed. Two states  Utah and Montana  refused to participate in the question altogether. There's no national data on vaccination rates among early childhood education staff. However, a survey conducted in March by the CDC indicated that vaccination rates among preschool workers mirrored that of the general adult population, with younger respondents more likely to express hesitancy, according to Nikki Garro, director of early childhood health programs at Child Care Aware of America. Schools can ask teachers if they're vaccinated, but the teacher doesn't have to answer. Schools cannot ask employees why they haven't gotten vaccinated, as that question could be a violation of the Americans with Disabilities Act, which protects employees from having to share information about their disability with their employers. Schools cannot share with parents information about a specific teacher's vaccination status  that would violate the federal health privacy law known as HIPAA. But schools can release information about aggregate staff vaccination rates at the school, according to Education Week magazine. A parent can legally ask an individual teacher if she or he is vaccinated. But again, the teacher doesn't have to answer. "Anyone can refuse to answer the question, but they should be prepared to be treated as if they are unvaccinated," wrote Sarah Whitley Coles, a University of Arizona College of Medicine professor, in Dear Pandemic, a website and newsletter that offers family-friendly medical advice. The protocols vary by locale and institution. However, the CDC recommends moving school pickup and drop-off to outside building as a means to limit COVID-19 transmission. This practice is very common, according to Garro, of Child Care Aware. CDC guidance as of May 15 also recommends schools require all visitors to wear masks and to maintain physical distance from others. This guidance is likely to be updated. Letting teens skip class to get vaccinated is a common strategy, in use in places such as Hartford, Connecticut. Arkansas is encouraging school districts to use American Rescue Plan money to hold on-site vaccination clinics for students, excusing their absences if they're getting a shot. Some districts are also tapping "youth ambassadors" to encourage their peers to get their shots. COVID-19 cash:Schools are getting record money under stimulus. Here's where it's going  In Washington, Spokane Public Schools offered extra graduation tickets to vaccinated parents, according to the Spokesman-Review. Throughout June  which President Biden declared the National Month of Action for COVID-19 Vaccinations  several large early-childhood education providers are providing free child care to parents and caregivers getting or recovering from their shots, up until July 4. While vaccinations are free, many parents have cited child care issues as a reason for not taking advantage of the opportunity. Parents and caregivers can drop their kids off at KinderCare, Learning Care Group and select YMCA locations across the country. Bright Horizons, a national network of employer-sponsored child care providers, will also provide free child care to 10 million of its workers employed at participating organizations to incentivize them to get their shots. The U.S. Department of Health and Human Services has issued guidance encouraging states to use their American Rescue Plan funds to provide financial incentives such as bonuses to child care providers that offer extended hours or weekend services so parents can get vaccinated. Such incentives are considered "quality expenditures," according to the department. Visit vaccines.gov/incentives for more information. Contact Erin Richards at (414) 207-3145 or erin.richards@usatoday.com. Follow her on Twitter at @emrichards. Contact Alia Wong at (202) 507-2256 or awong@usatoday.com. Follow her on Twitter at @aliaemily.