Pediatric Experts Answer Reader Questions About COVID-19



By christinalieffring

August 18, 2021

You asked us, so we asked the experts.

With COVID-19’s Delta variant spreading across Wisconsin and schools getting ready to start a new year, UpNorthNews crowdsourced questions from parents of children who are too young to be vaccinated. 

We compiled and posed those questions to child development specialist Dr. Janean Dilworth-Bart and pediatrician Dr. Sheryl Henderson.

Dilworth-Bart is ​​the associate dean for faculty affairs and graduate education in the UW-Madison School of Human Ecology and a professor of human development and family studies. Her research has focused on children and families’  transition to school and how social and environmental components impact that transition.

“My work is highly relevant to what we’re going through right now,” Dilworth-Bart said, “just from the standpoint of, ‘What are the impacts these types of [pandemic-related] stresses have on families?’”

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Henderson is a pediatrician who specializes in infectious diseases and has primarily worked with viruses for over 25 years. She has also participated in vaccine studies. 

“As COVID has hit us, [and] the world, we’ve been involved with trying to understand this virus,” Henderson said. “And as a pediatrician, recognizing how not just the virus but being isolated from schoolmates, everything has really impacted our kids.”

Questions and answers have been condensed and edited for clarity.

Christina Lieffring: One question we got was from a grandmother named Cindy who lives in Illinois, but her grandchildren are in Grafton. She pointed out that officials had said that school age children were supposed to be vaccinated by the beginning of the school year, but that doesn’t seem like it’s going to happen. Do we know what the timeline is now for that?

Henderson: As vaccines are being developed and tested, it is very important to have specific clinical trials that look at the effectiveness and the safety in children. What has been happening are trials on the current vaccines, but looking specifically at the younger children. They require different doses than adults so that’s one of the questions being looked at. The latest I’ve heard, and it’s a projection, is that we’re still looking at perhaps later fall or by the end of the year. That’s an optimistic outlook, but I don’t have the fine details of the trials.

CL: Cindy also had a lot of questions about community spread, particularly with this Delta variant. The way she phrased it was interesting, because she asks, “Are we back at square one?”

Henderson: We’re not completely back at square one. We have learned a lot about how we can prevent COVID from spreading in our community. The biggest tool that we have is vaccination amongst people who can be vaccinated. Unfortunately, as we know, children under 12 cannot be vaccinated yet, but the vaccine still can present a wall, a defense against the virus spreading rapidly. 

The other thing that we have learned very well is that universal masking in schools can really help prevent the spread of the virus amongst people who are not vaccinated. And at the schools where there was universal masking last year, we really saw very little, if any, transmission within the school.

CL: ​​For parents who are vaccinated, there is also concern about being around people who are unvaccinated. Cindy brought up coworkers or childcare workers, or kids spreading it amongst themselves. Another parent, Ashley from Ashland, has a 2-year-old, and she’s worried about getting COVID at the grocery store and passing it on to her son. How would you talk to parents about these concerns?

Henderson: Because we have the Delta variant now, it really is a game-changer in terms of how we think about preventing the spread of COVID. The main thing that has just come out in the last two weeks, is that people who are vaccinated may be infected and shed the virus without even knowing it because they are asymptomatic. That is the main reason for the recommendations to mask again when in public places or amongst people that you don’t know, mainly indoors. Masking is one of the greatest prevention tools we have outside of vaccination.

CL: Ashley said with her 2-year-old, she’s thankful that she doesn’t have to worry about school and community spread, but she’s concerned about his social development. 

Dilworth-Bart: First and foremost, what we provide for our kids at all ages is clear, stable routines, affection, love, and comfort. What’s great about kids at that young age is that, with stability and nurturing and love, they are quite resilient. And so finding ways for them to interact with a playmate can be very helpful if having a “pod family” is available and is a safe option, but also doubling down on the nurturing relationship within the family–not being intrusive, not going overboard, but still providing that stability and play. 

CL: You mentioned routine; this has been a year with a lot of changes. In the last couple of months, things have loosened up and people have felt more relaxed and more free to go out and socialize. As this variant spreads, some of that might have to be rolled back. How should parents approach these changes with their children to make it as comfortable as they can?

Dilworth-Bart: That’s an excellent question and I think about this a lot, myself, as a parent. First and foremost, you want to give the appropriate amount of information in the appropriate way. A 5-year-old is not going to understand all the intricacies of why we can’t go to the park or the water park and hang out the way that we were before. But you can have a developmentally appropriate conversation and a child-specific conversation. 

Every parent knows their child. Some kids, you can just say, “We can’t do that today, honey. I’m really sorry,” and another child is going to need a long explanation of why.

For a younger child, it might be. “Well because of some changes that are going on in the world. We think it might be better if we just hang out together at home.” Your older kids are going to want to have more of an explanation. 

CL: For people who have families with mixed vaccination status or interact with people of mixed status, how do you explain to children that, “We can spend time with these people, but we’re going to have to limit how much time we spend, or maybe just not see the people who are unvaccinated?”

Dilworth-Bart: One of the ways that we can do that is I put it in concrete examples. We talk about it like a car in terms of safety: Yes, we get the vaccine but then we wear a mask. In a car, we have a seatbelt, but we also have antilock brakes and we have an airbag. Making those types of analogies—“that is why we do these multiple things”—with your adolescent, that can be helpful.

Also, recognizing if your adolescent has friends who are not vaccinated. It’s like, “Well, we love that person. We care about that person. And not seeing them is something that we’re going to do because it’s what we can do to help keep ourselves, and to keep them, safe.”

Henderson:Another approach can be, at least during the summer, trying to identify activities that one can safely do outside. There may be a way to think about activities that the whole family can enjoy while masked. And it would be a matter of then talking to the friends of the family and saying, “This is how we do it, and if we want to get the kids together, we would appreciate that you’re masking also.”

CL: A lot of parents are concerned because of the stress and also because of the disruption of this virus into kids’ lives and what they want to do. What are some things that parents should keep an eye out for? 

Dilworth-Bart: It would not be surprising to see more separation anxiety or more anxiety overall. Clingy-ness and neediness and anxiety in our kids can look different depending on how old they are. Even our independent teenagers get anxiety and they might get nervous seeing their parents leave. Keeping an eye out for, are they more irritable or more anxious? Are you seeing skills that used to be there that aren’t there anymore? 

Henderson: Parents know their kids the best, and if their behavior is all of a sudden different–that outgoing, independent person has all of a sudden withdrawn–perhaps even just having regular check-ins saying, “You know, I’m feeling anxious too. What’s going on?” Being open, being transparent, developmentally appropriate, but recognizing that it impacts the family. All that structure and nurturing, it still is necessary for a 15-, 16-, 17-year-old, as much as it is for a 2-year-old; that the child knows that the parent is here, we’re all going through this together.

Dilworth-Bart:That also brings back the idea of self-care. Because our kids, they’re watching us and they’re learning from us. In addition to thinking, “We need to take care of ourselves as parents because we are worthy of being cared for and nurtured,” we’re also training our children. Our social-learning theories tell us that our kids are learning through observation, so they are learning how to cope with stress. 

At some point we’re going to get back to some other type of normal, but our children are learning lessons now, like how to manage their stress and how to talk about their feelings. As we take care of ourselves, we’re also engaging in important parenting behaviors: showing our children how to cope with the world.

CL: Our last question: it’s a little specific, but I think, unfortunately, there’s quite a few parents who probably find themselves in this position. It’s from a woman named Ann in Muskego. She writes, “our daughter is 9 years old and has developmental disabilities. Her needs surpass what can be accomplished in the home and disruptions to her ability to learn in person in school are extremely difficult for her at this time. Our school district [Muskego-Norway] has decided there will be no virtual option, no mask requirement, and very little other layered mitigation measures. I am extremely concerned for her safety.”

Henderson: Everything that was stated in the question is so true in terms of the concerns. One could say, “What is the ideal situation?” Well, perhaps find the school that everyone’s wearing masks and you have the teachers who are going to be able to really respond. But we’re living in reality and that’s not open for most people. The mask on the child can help. But as stated, the masks are most useful when they’re on the person who’s infected. It may be that one has to dig in, as she probably is doing, and see if there are ways to support her child and probably others in that school system until the vaccine is available

Dilworth-Bart: There is no easy answer to this question, because keeping ourselves safe and eradicating the virus is not just an individual effort, but a community effort. Some of us are fortunate to live in communities where everyone is going to mask and vaccinate and socially distance. That’s not the case for everyone, and that can feel really lonely. 

While it’s not a solution that I can offer this particular parent, this is also a time to continue with the self-care and understanding that this is a very difficult and tough situation and continue the advocacy that this parent is clearly doing for her child and for the rest of the community.

CL: Is there anything else you want to add or anything you want to say to parents who are trying to figure out how to navigate this time right now?

Dilworth-Bart: Follow the science, listen to your health professionals, talk to your pediatrician, talk to your friends. Parents, take care of themselves. As somebody who studies humans and families I think it’s really important that parents take time out for themselves to address their own stress and their own feelings. Because their kids are watching and they’re learning from us. And we can get through this.

Henderson: Going through these last several months, we recognize that a lot of people’s actions or beliefs are based in fear, whether it’s fear of the virus or fear of the vaccine. And one of the best ways to combat that is, recognizing that this virus is new. We’ve seen guidance change, and it’s because we’ve learned something new or the virus is doing something unexpected. Every family is going to have their own set of values to make their decisions, but we are in a pandemic, and it’s a deadly one.

For more information, Dr. Henderson recommended the Centers for Disease Control’s COVID-19 webpage as well as the American Academy of Pediatrics’ guidelines for schools. 


CATEGORIES: Coronavirus


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