Your Questions Answered
The ABC Science Collaborative received many questions about the best practices for keeping teachers, staff, and children healthy during the COVID-19 pandemic. Click the topics below to find answers to the most common questions we received.
Questions were last reviewed in fall 2022.
There are three COVID-19 vaccines that have been authorized or approved in the U.S.
The Pfizer-BioNTech mRNA COVID-19 vaccine is approved by the U.S. Food and Drug Administration for ages 16 and older, and it is released under an emergency use authorization for children and teens ages 12-15, children ages 5-11, and younger children ages 6 months-4 years old.
The Moderna mRNA COVID-19 vaccine has been approved by FDA for ages 18 and older, and it is released under an emergency use authorization for children and teens ages 6-17 years old and younger children ages 6 months-5 years.
The Johnson & Johnson/Janssen vaccine has been released under an emergency use authorization by the U.S. Food and Drug Administration (FDA) for ages 18 and older; however, the Centers for Disease Control and Prevention recommends the Pfizer-BioNTech or Moderna vaccines over the J&J/Janssen COVID-19 for primary and booster vaccination due to the risk of a blood clotting disorder. Learn more.
The Pfizer BioNTech vaccine is ~95% effective against symptomatic COVID-19. It requires two injections about 21 days apart. The Moderna vaccine is ~95% effective against symptomatic COVID-19. It requires two injections about 28 days apart. In initial trials two doses of these vaccines were 95% effective at preventing serious disease; however, both vaccines are less effective against the Omicron variant. Fortunately, a third dose, or booster, given 5 months after dose 2 significantly increases protection against the omicron variant.
The Johnson & Johnson/Janssen vaccine is 74% effective against severe/critical COVID-19, 89% effective against hospitalization, and 83% effective against COVID-19-related death within 28 days after receiving the vaccine. It is a single dose vaccine and boosters are recommended two months after the initial dose for ages 18 and older. The Centers for Disease Control and Prevention recommends the Pfizer-BioNTech or Moderna vaccines over the J&J/Janssen COVID-19 for primary and booster vaccination due to the risk of serious adverse events. The J&J/Janssen COVID-19 vaccine may be considered in some situations, including for persons who:
- Had a severe reaction after an mRNA vaccine dose or have a severe allergy to an ingredient in an mRNA COVID-19 vaccine;
- Would otherwise remain unvaccinated for COVID-19 due to limited access to Pfizer-BioNTech or Moderna vaccines;
- Wants to get the J&J/Janssen COVID-19 vaccine despite the safety concerns.
Learn more about the J&J/Janssen COVID-19 vaccine.
Evidence from clinical research has shown that the vaccines are safe and effective in preventing symptomatic COVID-19. The vaccines have been rigorously tested for safety and effectiveness in each age group, and the data have been reviewed by experts at the FDA prior to authorization.
People who receive the mRNA vaccines (Pfizer-BioNTech, Moderna) may experience mild to moderate temporary side effects, such as pain, redness, and swelling at the injection site and tiredness, headache, muscle pain, chills, fever, and nausea, but severe side effects are rare. Typically side effects from the vaccine occur 1-3 days after vaccination and are more common after the second dose.
COVID-19 vaccines are free and available through health care providers and local pharmacies for the authorized and approved age groups.
Yes, if you have had COVID-19 you should still get vaccinated. Research has not yet shown how long you are protected from getting COVID-19 again after you recover from COVID-19. Vaccination helps protect you even if you’ve already had COVID-19. The Centers for Disease Control and Prevention (CDC) guidelines state that people who have had COVID-19 should wait to be vaccinated until they have recovered from their illness (no symptoms) and have completed quarantine or isolation. Learn more.
It is highly recommended these populations get vaccinated for COVID-19 because they are at higher risk.
The American College of Obstetrics and Gynecology and Society for Maternal and Fetal Medicine both state that COVID-19 vaccines should not be withheld from pregnant women and vaccines should be offered to lactating women similar to non-lactating women and women who are trying to become pregnant. There have been no ill effects noted in immunized pregnant women or their babies to date. Vaccination of pregnant people builds antibodies that might protect infants. Learn more.
For all COVID-19 vaccines, the vaccine dose has been developed and tested specifically for each specific age group, accounting for children’s different immune responses to vaccines.
The COVID-19 vaccine can be given with an annual flu vaccination or separately.
In general, you can receive whichever one is available; they are all excellent at preventing infections. The Centers for Disease Control and Prevention recommends the Pfizer-BioNTech or Moderna vaccines over the J&J/Janssen COVID-19 for primary and booster vaccination due to the risk of serious adverse events. Learn more about the J&J/Janssen COVID-19 vaccine. The Johnson & Johnson is recommended if you had a severe allergic reaction after dose one of an mRNA vaccine (Pfizer-BioNTech or Moderna) or if you have a known allergy to polyethylene glycol. If you are not sure if you are allergic to these ingredients, but you have had an allergic reaction to medicine in the past, ask your doctor or pharmacist if you could be allergic to these ingredients before getting vaccinated.
The CDC recommends that everyone ages 5 and older should receive a booster shot, when eligible.
The CDC recommends wearing a mask to maximize protection from the Delta and Omicron variants and prevent spreading it to others in public, indoor settings, if you are in an area of substantial or high transmission. The CDC also recommends fully vaccinated people wear a mask if you are in an area with high numbers of COVID-19 cases in crowded outdoor settings and when you are in close contact with others who are not fully vaccinated.
It is important to remember that COVID-19 vaccines prevent death from COVID-19. Thousands of Americans die each day due to motor vehicle accidents, heart attacks, and other causes. Because more than 226 million people in the U.S. have received COVID-19 vaccines, there have been vaccinated people who have died in the month after receiving a COVID-19 vaccine. However, this does not mean they died because of the COVID-19 vaccine.
Administration of mRNA vaccines has occasionally been associated with myocarditis (Learn more). Myocarditis (inflammation of heart muscle) and pericarditis (inflammation of the pericardium, tissue that surrounds the heart muscle) presents with chest pain, shortness of breath, and feelings of having a fast-beating, fluttering or pounding heart. The CDC continues to recommend that everyone aged 6 months and older get vaccinated for COVID-19. The known risks of COVID-19 illness and its related, possibly severe complications, far outweigh the potential risks of having a rare adverse reaction to vaccination, including the possible risk of myocarditis or pericarditis.
Today's scientific guidance states that pregnant people might be at an increased risk for severe illness from COVID-19 compared to non-pregnant people. The guidance for pregnant women to avoid contracting COVID-19 is similar to guidance for non-pregnant people: be vigilant about masking, physical distancing, and hand hygiene.
No. Science and data from around the world have shown that the best defense against COVID-19 infection is wearing a mask, washing hands (either via regular hand hygiene or using a waterless alcohol-based product with 60%-90% alcohol) regularly, and maintaining physical distance. The data so far indicate that if teachers, staff, and students adhere to these strategies, there will be no greater risk to other employees (teachers, bus drivers, etc.) or students as a result of in-person education.
The scientific community recognizes that wearing masks may not be possible in every situation or for some individuals. Wearing masks may be difficult for people with sensory, cognitive, or behavioral issues. Masks prevent reading lips and observing facial expressions. However, there is not a medical indication for children in the mainstream curriculum to seek mask exemption.
Scientific guidance suggests consideration of adaptations and alternatives, whenever possible, to reduce the risk of spreading COVID-19 when wearing a mask is not feasible. In schools, these exceptions should generally be limited to students outside of mainstream education (sometimes referred to as "adapted curriculum" or "adaptive instructional" programs).
When this group of teachers and students are in close contact with a student who cannot wear a mask, they should take need additional precautions. This might include additional PPE, eye protection, flexible hours, face shields, and creative approaches to ventilation and airflow.
Yes. One study published in the January 2017 issue of the Journal of the American Academy of Audiology compared the effect of noise and various visual input conditions on speech understanding for listeners with normal hearing and hearing impairment using different surgical masks. Findings demonstrated improved speech perception amidst noise for listeners with hearing impairment when visual input is provided through the use of a transparent medical mask. Most importantly, the use of the transparent mask did not negatively affect speech perception performance in noise.
In these settings, scientists recommend the use of enhanced PPE in the form of medical gowns, gloves, eye protection (e.g., face shield) in addition to a surgical mask. Parents must be relied on to closely monitor symptoms in their children to ensure any potential infection is identified quickly. COVID-19 vaccination provides additional protection from close contact with the virus.
Beyond the recommended exemptions from the scientific community-children younger than 2 years, and anyone unable to place or remove the mask-there are certain categories of disability that may undoubtedly warrant medical exemptions. Some individuals, particularly children, with sensory processing disorders may be unable to tolerate masks. Facial deformities that are incompatible with masking are an additional category of exemption. A child's physician should assist in making individual determinations as to whether a patient should be exempt from mask wearing.
Note that all children in the mainstream curriculum should mask. Asthma is not a valid medical exemption for masking. The only asthma exemption is for children suffering from an acute asthma exacerbation and shortness of breath; however, in those cases, children should not be in school and should seek medical attention.
No. The scientific community does not recommend use of face shields alone for normal everyday activities or as a substitute for masks because of a lack of evidence regarding effectiveness controlling the spread of the virus from the source. In general, a snug fit around the face and the tightness of the material weave to filter particles are the most important components of the mask efficacy.
Scientists also do not recommend the use of masks with exhalation valves in schools. These masks are intended for industrial workers to prevent dust and particles from being breathed in as the valve closes on inhalation. The valve opens on exhalation, making it easier to breathe but also allowing any virus to funnel through the valve opening. For that reason, these masks are ineffective at preventing the spread of COVID-19.
It should be noted that successful school districts are not using N95 masks, and hospitals/clinics provide strong supporting evidence to support this practice. We can use data from private clinics, free clinics, and health department clinics as a guide for schools because the conditions are so similar. Specifically, in both clinics and schools:
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- Employees and children are asymptomatic (this will be provided by attestation in schools and local clinics require the same attestations).
- Children wear a cloth mask.
- Employees wear a surgical or cloth mask.
When these conditions are met, transmission has been limited primarily to breaks in mask protocol.
Yes. Scientists tell us that for proper sanitation and efficacy, fabric masks must be washed in soap or detergent and preferably hot water (at least 60 degrees Centigrade/140 degrees Fahrenheit) at least once a day. If it is not possible to wash the masks in hot water, then:
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- Wash the mask in soap/detergent and room temperature water, followed by either boiling the mask for 1 minute, or;
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- Soak the mask in 0.1% chlorine for 1 minute and thoroughly rinse the mask with room temperature water (there should not be any toxic residue of chlorine on the mask).
Follow the care and washing instructions on the package of your mask; for example, Hanes Cloth Masks can only be washed 15 times before they lose effectiveness and should be discarded or recycled. If your mask didn't come with care instructions, we recommended that cloth face coverings/masks be washed daily or rotated in a three-day cycle.
Ideally, you should change your mask each time you use it in a new setting. A teacher or student who is in the same classroom with the same people can wear one mask until the school day ends, assuming it is still dry and without visible dirt or markings. If the mask becomes wet or soiled, then the mask should be replaced with a clean mask.
Yes. Scientific guidelines suggest a cloth face covering should be worn whenever people are in a community setting. Anywhere on school grounds (including outdoors), all teachers, staff, and students should keep their face covering on unless they are eating and drinking.
Out of an abundance of caution, there are no exceptions even when you are alone in your office space or classroom with or without windows open or in the presence of an air purifier.
The CDC guidance on mask fit include: masks should completely cover the nose and mouth; and fit snugly against the sides of the face and not have any gaps.
This year, children or staff with new or worsening symptoms consistent with COVID-19 should stay home. For additional guidance see the StrongSchoolsNC Public Health Toolkit (K-12).
Strong Schools NC Public Health Toolkit (K-12)provides guidance on singing, stating, “Instruction that includes singing, shouting, playing wind instruments, rigorous dance, or exercise, should be held outside if possible. If held indoors, ensure consistent mask use and 6-feet physical distancing between students.” Additionally, schools can consider implementing screening tests for activities that involve singing, shouting, band, and exercise that could lead to increased exhalation for participants who are not fully vaccinated.
Scientists have found that transmission of COVID-19 is low when students and staff are properly masked. The CDC recommends, regardless of the mask policy at school that, "all passengers and drivers should wear a mask on school buses operated by school systems."
Additionally, schools should:
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- Encourage vaccination of all eligible students and staff members.
- Promote and put in place respiratory and hand hygiene, physical distancing measures, and use of masks during transportation in school buses, in accordance with local policy.
- Clean transportation vehicles and frequently touched surfaces in the vehicle.
- If possible and safe, keep the windows of the buses, vans, and other vehicles open.
- Have a place in place that ensures that if a student or staff member becomes sick during the day, they do not use group transportation to return home.
Play is an essential part of the school day and critical to learning. Recess breaks provide children with a much needed change in activity, which some studies have linked to improved classroom behavior. Other research suggests these breaks help maximize cognitive performance and promote brain development. With the recent Delta variant surge and vaccine authorization for children 5-11 years old, children can and should play at recess, if they are able to remain masked. Here are some tips from experts to maintain safety:
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- In order to reduce the number of children students come in contact with it is important to develop cohorts or groups of children who remain together during recess. These students go to an "Activity Zone" and stay in that assigned Activity Zone for the duration of the recess period.
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- Stagger recess periods so that an entire grade level would not go to recess at the same time; rather, recess would be planned and scheduled so the fewest number of classes would be on the playground for recess at one time.
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- Outdoor markings much like game court markings, like hopscotch, can help designate Activity Zones or areas. Markings can serve a number of purposes. In order to designate markings specific to COVID-19 physical distancing, a school can paint dots or outline an Activity Zone for students to remain inside of during recess. These markings can designate spots for actively playing in an activity and dots for waiting in line and maintaining social distancing.
Scientists have endorsed outdoor or in-classroom lunching as an alternatives to cafeterias where many students gather. Eating lunch outdoors with physical distance between students is preferred, as weather permits. Eating lunch in the classroom environment, when weather does not permit outdoor eating, keeps kids in smaller groups separated by desks six feet apart where they can eat and drink without masks. Students should perform hand hygiene before eating, and, ideally, mask-off time (for eating) should be minimized (some schools have kept this to less than 15 minutes). Ensure students perform hand hygiene once again after discarding their lunch and replacing their masks. Ensure new masks are available for children with soiled or torn masks. Read the ABC Science Collaborative resource "Keeping it REAL: Reducing COVID-19 in Schools," which outlines mitigation strategies with an emphasis on Recess, Extracurriculars, Adherence and Lunch.
Options for multi-class teachers (such as second-language, electives in middle school) include:
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- Ensure all eligible teachers and staff members are vaccinated against COVID-19
- Having the teachers, instead of the students, travel to the classrooms to minimize student traffic in the hallways
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- Limit shared equipment or if equipment must be shared ensure proper cleaning/disinfection prior to use in another classroom
- Encourage proper hand hygiene before and after interactions with students
Real-life examples confirm that even in close contact, indoor exposure, wearing a mask is effective at preventing the spread of infection. In one example, two symptomatic hairstylists with confirmed COVID-19 engaged with 139 clients during the contagious window of infection. Zero symptomatic secondary cases were reported, and among the 67 clients who were tested for SARS-CoV-2, all test results were negative. Adherence to the company's face-covering policy likely mitigated spread of SARS-CoV-2.
The science tells us that risk of infection is low in "on the move" scenarios when students are properly masked. Between classes, teachers can ask that students to maintain physical distancing as much as possible. Students should not be permitted to be in the hallways unattended.
Yes. The scientific community encourages outdoor classes when circumstances allow.
Yes, and it is largely positive. In districts that have universal masking in schools, clusters are infrequent and within-school transmission is limited. Recent data published by the ABC Science Collaborative in Pediatrics found that universal masking is effective in limiting transmission of COVID-19 in schools despite the more transmissible Delta variant. The study found a within-school transmission of less than 3% from data collected during the summer 2021 Delta surge. Learn more.
The science tells us that environments ripe for viral spread of COVID-19 include not only indoor environments, but also those involving people breathing heavily, and those that involve close contact with others. Student athletes who are eligible are encouraged to get vaccinated and to wear masks to limit transmission. Where vaccination is not possible, student athletes should wear masks. For some sports, it may be difficult to safely wear masks; in this case, vaccination and pre-participation testing may be the best options. When sports can be played outside, that should be encouraged.
Schools can routinely test student athletes, participants, coaches, and trainers, and other people (such as adult volunteers) who are not fully vaccinated and could come into close contact with others during these activities. Schools can implement screening testing of participants who are not fully vaccinated up to 24 hours before sporting, competition, or extracurricular events. Schools can use different screening testing strategies for lower-risk sports.
Coronaviruses can survive on surfaces; however, this does not equal transmission of infection. surface transmission should be viewed as possible, and regular disinfecting of these high-touch surfaces is recommended. However, the virus is much more likely to spread from person-to-person.
Air purifiers should be used as an additional layer of mitigation strategies. Classrooms with at least one ventilation intervention have seen less spread of COVID-19 in the classroom. However, masking remains essential. This is evidenced by a COVID-19 outbreak in an elementary school in Marin County, California in which an unmasked teacher spread the virus to students despite air purifiers and open windows in the classroom.
The EPA has developed a comprehensive tool of all disinfectants effective at killing COVID-19.
A peer-reviewed study published in the American Journal of Infection Control in May 2020 is the first comprehensive analysis of the effectiveness of these products to combat the virus. The findings indicate a greater than 99.9 percent efficacy against SARS CoV-2.
Most disinfectants are effective at killing the virus within two minutes of application, so they do not need to be left overnight.
Fortunately, hot water is not required. The science has shown that temperature of the water does not appear to affect microbe removal. Proper hand washing technique (at least 20 seconds, lathering all surfaces) is far more important for hand sanitizing.
Scientists discourage sharing of items, particularly those that are difficult to clean or disinfect, during the COVID-19 pandemic. To support this, try to:
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- Keep each child's belongings separated from others' and in individually labeled containers, cubbies, or areas
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- Ensure adequate supplies to minimize sharing of high touch materials to the extent possible (e.g., assigning each student their own art supplies, equipment) or limit use of supplies and equipment by one group of children at a time followed by cleaning and disinfecting between use
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- Avoid sharing electronic devices, toys, books, and other games or learning aids
Fortunately, hot water is not required. The science has shown that temperature of the water does not appear to affect microbe removal. Proper hand washing technique (at least 20 seconds, lathering all surfaces) is far more important for hand sanitizing.
There are not. Schools should focus most resources on mask compliance, distancing, and hand hygiene.
Along with masking and physical distancing, improving air flow by opening windows can be an effective way to reduce transmission of COVID-19 in the classroom. A study of COVID-19 and airflow in classrooms found that an open window near an infected person reduces pathogens in the air, making them less likely to spread to others.
No-touch or non-contact infrared thermometers are easy to use and may reduce the risk of spreading COVID-19 by allowing more physical distancing. With this thermometer, you aim the device about an inch or so from a person's forehead, press the scan button and watch for the temperature reading on the thermometer screen. Just like the rest of the school day, please use a face mask when checking temperatures.
No-touch thermometers are less accurate than internal thermometers; however, given the ability to avoid contact, no-touch thermometers are preferred in the pandemic.
Regardless of the percent of positive cases in the community, assume that there will always be infected people in every school, every day, and act accordingly (namely assure masking, distancing and appropriate hand hygiene). This is a hallmark of infection control. Still, higher metrics may trigger considerations by the local health department, school board, and other stakeholders to shift to a different learning model. Below are some examples of those triggers:
| Cluster Event | Action Taken |
|---|---|
| Three clusters within a school within a two-week period | District leadership will discuss the safety benefits of school closure with the school board, an independent body, the local health department, and key stakeholders. |
| More than three clusters* per two-week period per 10,000 students in a school district | District leadership will discuss the safety benefits of remote instruction with the school board, an independent body, the local health department, and key stakeholders. |
| Substantial secondary transmission** in a school that does not rise to level of a cluster | District leadership will discuss the safety benefits of school closure with the school board, an independent body, the local health department, and key stakeholders. |
| Substantial secondary transmission** in a school district | District leadership will discuss the safety benefits of school closure with the school board, an independent body, the local health department, and key stakeholders. |
*In school districts of <10,000, greater than two clusters
**Substantial secondary transmission is defined as >5 cases of COVID-test positive, within-school transmission per 1,000 students per 2-week period
Additional guidance is provided by CDC and the Department of Health and Human Services in North Carolina.