Coming Out of COVID: Medical Doctors Working with Youth Share Recommendations as Vaccinations Continue

As families, schools and communities start to navigate this phase of the COVID-19 pandemic, we sat down with two pediatricians to understand more about what adults who engage with youth should be thinking about in terms of medicine.

Leslie M. Booren

Whether you are a parent, teacher or adult who works with youth, this series of Q&As will provide perspectives and considerations through a positive youth development lens. With a focus on the whole child, we talk with experts about mental health, community, and talk directly with youth themselves.

In this Q&A, we talk with two pediatricians who focus on adolescent medicine. Dr. Paige Perriello practices at Pediatric Associates of Charlottesville and specializes in health inequities. Dr. Julia Taylor practices at the Teen & Young Adult Health Center at UVAHealth and specializes in teen health. 

QuestionWhat should adults who are working with youth not assume about the pandemic?

Taylor: That anyone’s experience with health has been the same during the pandemic. Many youth may not have been able to access healthcare as easily (including sexual and reproductive health, mental health, and regular well child check ins), some may have seen an exacerbation of their chronic health conditions during the pandemic, some have gotten new diagnoses, and some may have fallen ill due to COVID (and are now suffering with the long term sequelae).

Perriello: Adults should not assume that all kids and teens are "dying to return to normal." Many are anxious, feeling unsafe and unsure of what is okay to do and some are very unsettled to be without a mask, in crowds or at gatherings. Checking in with them about what feels comfortable to them can help empower them to go at their own pace.

Also, there are many people, teens included, for whom getting a vaccine is not easy. If you are vaccinated and have a way to help a parent or family who needs a vaccine do it! This may include having a conversation about why you got the vaccine and any concerns you had beforehand that got addressed so that you were willing to get the shot. This may include watching someone's child while they go to get a vaccine, or being on "standby" after their second dose in case they are a single parent and have significant side effects that make it difficult to care for their young children. 

Question: What should parents be thinking about as youth continue getting vaccinated and there are families with some members who are and are not vaccinated in the same house?

Taylor: Since many children and adolescents remain unvaccinated and at risk, but restrictions on gatherings and masks are being lifted, families will need to continue to discuss what is safe for their family unit. Many families and young people now have lots of experience with navigating safe gathering practices and they will need to continue to use those skills. Many families might include children too young to be vaccinated (yet), so each family will still need to make decisions about what is ok and what is not.

Also, youth and their parents should remember not to make assumptions about people who are still masking up (like, for example many people may assume that they aren’t vaccinated), but wearing a mask is still a totally appropriate choice for many individuals (and the only choice for some individuals who cannot get vaccinated).

Perriello: This is one of the most challenging things for us right now. As many in our community start to remove masks and attend gatherings, families with younger children are still "stuck." In addition, the fact that so many places are now adopting guidelines that allow for vaccinated folks to be without masks, creates many environments that will feel unsafe or unsettling to families with young children. This is especially true for those with infants and toddlers younger than 2 years old who cannot wear masks, and single parents who aren't able to "leave infants" behind with a caregiver or parent while they do a quick, necessary trip out. 

Parents of small children and toddlers are encouraged to continue to wear a mask even if vaccinated in order to model this behavior and be in solidarity with children who cannot mask.

QuestionWhat should families be thinking about if we always have people and/or young adolescents who are not vaccinated?

Taylor: The fact that we may not reach herd immunity in all populations makes our commitment to health and wellbeing (our own and others’) super important moving forward. All the adolescents I’ve seen in clinic have shown extraordinary flexibility and resilience in the face of ever changing rules/guidance and will need to maintain a commitment to staying home when sick and getting tested when appropriate. 

Also parents should remain aware of the possibility of multisystem inflammatory syndrome in children (MIS-C) as a result of COVID and contact their provider immediately with fever and any new symptoms such as abdominal (gut) pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired (even if they have not previously been diagnosed with COVID – we still see this after an asymptomatic infection).

Perriello: As many return to more activities and involvement in the community, we are starting to see a rise in non-COVID illnesses (as opposed to the last year when masks and quarantining and distancing kept many viral illnesses away). In order to continue to keep cases low in our community and not put anyone in a family at risk, particularly the unvaccinated - anyone with symptoms of illness should still check in with their pediatrician if they are sick. Pediatricians cannot tell the difference between COVID and other respiratory viruses without a test, so be aware that to keep everyone safe, COVID testing still may need to be performed before return to activities and school. 

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