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October 5, 2021

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Community Conversation: Walter Rosenfeld, MD

What parents need to know as kids return to in-person learning

In this Community Conversation, pediatrician Walter Rosenfeld, MD, chair of Pediatrics at Goryeb Children's Hospital and medical director of Children's Health for Atlantic Health System, shared what parents need to know as their kids return to in-person learning, how we’re helping to make schools safer, and the latest pediatric COVID-19 news.

Should students wear masks in school to help prevent the spread of COVID-19?

Masks are an important tool to help reduce the spread of COVID-19.

Dr. Rosenfeld said that, in the absence of a vaccine for children younger than 12, masks are part of a layered approach to prevent the spread of infection in schools. This layered approach also includes social distancing and handwashing. Masks should only be worn by children over the age of two.

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Is there any scientific evidence that suggests wearing masks could be dangerous for children’s health?

Dr. Rosenfeld explained there is no evidence whatsoever that masking is dangerous for children. Masking has been found to be safe for all children older than age two. Even children with asthma or other respiratory disorders can wear masks safely. He recommended changing and washing masks frequently.

What are the COVID-19 vaccination rates for children over the age of 12?

Dr. Rosenfeld reiterated the importance of a layered approach to prevent the spread of COVID-19 and said that vaccinations are a crucial component. All school personnel and students 12 years and older should get vaccinated.

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The rate of vaccination is currently lower than the percentage of people who are eligible, said Dr. Rosenfeld. He acknowledged that parents might be anxious about possible side effects and worried about things they have read on the internet. However, he stressed it is critical for all those who are eligible to get vaccinated.

"Just look around the country at the states and the communities where there are very high rates of people getting admitted, getting very serious COVID-19 illness, and even dying from it. Those are mostly in places, almost exclusively places, where vaccination rates are low," Dr. Rosenfeld emphasized.

How does the Delta variant impact children?

The Delta variant is highly infectious and much more transmissible for both adults and children than previous COVID-19 variants. There is not enough data to determine if the Delta variant causes a more serious case of COVID-19. Dr. Rosenfeld emphasized that the more people get vaccinated, the more children who are not currently eligible for the vaccine will be protected from COVID-19 and the Delta variant.

Despite the focus on COVID-19, are there other conditions that warrant concern as children return to school?

Parents still need to bring their children in for routine vaccinations and health care visits.

Dr. Rosenfeld said he has seen an uptick in respiratory syncytial virus (RSV). The virus can infect children and adults. Cases usually occur in October, November, and December. This year, cases began to appear as early as August. Enterorhinovirus, which can cause the common cold, as well as a host of other viruses, can also spread in school settings.

Finally, Dr. Rosenfeld urged parents to get their children vaccinated against influenza annually. Learn more about the flu vaccine >

Can a child over the age of 12 receive both the COVID-19 vaccine and the flu shot?

Dr. Rosenfeld said there is no harm in getting the COVID-19 and flu vaccines together. He also noted the importance of immunizations for an array of childhood illnesses, including measles, mumps, rubella, and diphtheria. He acknowledged that children don't like to receive shots and some side effects can occur, such as fever, achiness, and a sore arm. However, the lack of immunizations can lead to outbreaks of preventable and dangerous diseases.

How important is it to develop a relationship with a pediatrician for a child's health care needs?

Dr. Rosenfeld said it is critically important to find a pediatrician you trust and to build a lasting relationship for your child's health care needs.

“We have a wonderful group of pediatricians and family medicine physicians who are on our medical staff at Goryeb Children's Hospital, Morristown Medical Center (and throughout) Atlantic Health System. You need to find the right one for you and for your child, and then rely on them. They should be your trusted source of information.”

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Will children under the age of 12 receive a lower dose of the COVID-19 vaccine?

(At this time) the government has not made any determinations or announcements about the dosing rates for children under the age of 12. The U.S. Food and Drug Administration (FDA) needs to look at the data before it makes a recommendation. Learn more about COVID-19 vaccines for children and teens (CDC) >

How can kids stay safe at lunchtime if they have to remove their masks to eat?

The risks of spreading COVID-19 during lunch can be reduced if schools keep children spread apart and have children eat outside, if the weather permits. Schools can also limit the time children remove their masks.

How has the pandemic impacted the behavioral and emotional health of children?

Dr. Rosenfeld said kids need to get back into school as safely as possible. School is not just about learning. It's also about socialization: interacting with other children, having defined limits, and setting rules. After more than a year of remote and hybrid learning, students will need to adjust to full-time, in-person school.

He explained that, over the past year, there has been a major increase in rates of anxiety, depression, eating disorders, and other mental health disorders. Those rates may increase as students struggle with the adjustment of in-person learning.

"I think what parents can do is to recognize that, anticipate it, before it happens. Talk to your child. Get them into the mode of what it's like in school, and (look) for signs and (talk) to them about what their fears or anxieties might be."

What resources are available for parents with children who are struggling?

Dr. Rosenfeld said parents do not have to be the psychologist or psychiatrist for their children. If you see signs in your child that causes worry or concern, talk to a trusted health care professional such as your pediatrician. Reach out to a teacher or a guidance counselor in their school.

Atlantic Health System also has resources and experts to assist your family, including therapists, psychologists, psychiatrists and an extensive eating disorders program.

What are some ways to keep kids healthy as they return to school?

Although many parents are worried about COVID-19, Dr. Rosenfeld said they also need to be mindful of the basics to keep kids healthy: good nutrition, sleep, and exercise, as well as structure and boundaries.

Are children at risk if they spend too much time in front of screens?

Children, like adults, spend a lot of time on their devices. Dr. Rosenfeld said that while we sometimes think it is frivolous or unnecessary for children to do so, they rely on devices to communicate with family and friends, access information and interact with the world. He added that moderation is key, and parents need to set limits. Children thrive in households where parents are clear about what the limits are and what the consequences will be if the limits are stretched.

Has telehealth been used by pediatricians to see patients virtually during the pandemic?

Dr. Rosenfeld said telehealth is a useful tool to help doctors keep in touch with their patients, especially for visits that don't require a physical examination.

However, telehealth cannot replace the benefits of one-on-one interactions between doctors and patients. He said both telehealth and in-person visits with a doctor will continue in the foreseeable future.

If you're vaccinated, does the vaccine make you less susceptible to hospitalization from the Delta variant?

The COVID-19 vaccines were designed to prevent serious infection, hospitalization, and death. Dr. Rosenfeld said the vaccine is very effective in this regard. There are exceptions, where people who were vaccinated got very sick, but those cases are rare.

“Getting vaccinated should prevent serious infection, serious illness, hospitalization (and) admission to an ICU, and that's the emphasis that we want to make here. It is saving lives.”