PIDS supports universal masking for students, school staff

The Pediatric Infectious Diseases Society (PIDS) is an organization of healthcare professionals dedicated to the treatment, control, and eradication of infectious diseases affecting children. Since March of 2020, our members have supported children through the COVID-19 pandemic, identifying effective strategies for both treatment and prevention of SARS-CoV-2 infection.

The American Academy of Pediatrics (AAP) has strongly recommended the prioritization of attending in-person school for the educational and social well-being of children.(1) In addition, AAP has released guidance that advocates for the universal masking for all staff and students 2 years of age and older, as well as vaccination for all eligible persons, for the beginning of the 2021-2022 school year.(1) PIDS stands in strong agreement with all components of this AAP guidance, which align with current Centers for Disease Control and Prevention guidance.(2)

While recognizing the importance of in-person education, we acknowledge that challenges already exist for the start of the 2021-2022 school year that support the need for universal masking: children less than 12 cannot yet be vaccinated (8), a new hyper-transmissible variant is currently driving a 3rd surge in the United States (10) with an increasing proportion of cases in children and young adults (12,13) and a large portion of eligible individuals are unvaccinated. Fortunately, these challenges are not insurmountable. PIDS members collaborating with other outstanding pediatric colleagues have conducted studies demonstrating the safety of school where mitigation strategies (masking, distancing, hand hygiene) are implemented. These publications demonstrate COVID-19 transmission in schools are rare (3-6) and that children who attend in-person schooling in which mitigation measures are in place have lower risk of SARS- CoV-2 infection (4, 7, 8). These prevention measures, paired with continued vaccination of all eligible persons, will keep students in school and reduce risk of infection with SARS-CoV-2 for the students, staff, and their household members.

We stand at a crucial phase of this pandemic for our children, one of our most vulnerable populations, and for whom we serve as a voice. Children have suffered tremendous pandemic- related consequences due to missed in-person schooling, which has contributed to immeasurable losses to education, social stability, food security, and mental health.(9, 10) We know that children of color are at the highest risk of the adverse effects related to losing in-person school education (11), and studies have shown a higher rate of children of ethnic and racial minorities testing positive for SARS-CoV-2.(12) We have the tools to promote a safe return to in-person schooling for all children. PIDS firmly and resolutely supports the AAP recommendations of universal masking for students and staff and vaccination for all eligible with the return to school for the beginning of the 2021 school year.


The Pediatric Infectious Disease Society (PIDS) is the world’s largest organization of professionals dedicated to the treatment, control, and eradication of infectious diseases affecting children. Membership is comprised of physicians, doctoral-level scientists, and others who have trained or are in training in infectious diseases or its related disciplines, and who are identified with the discipline of pediatric infectious diseases or related disciplines through clinical practice, research, teaching, and/or administration activities. For more information, visit


  1. AMERICAN ACADEMY OF PEDIATRICS (AAP). Special Considerations for School Health During The COVID-19 Pandemic (COVID-19 Guidance for Safe Schools). 2021.
  2. CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). Guidance For COVID-19 Prevention In K-12 Schools. 2021.
  3. DAWSON P, WORRELL MC, MALONE S, Et Al. Pilot Investigation Of SARS-Cov-2 Secondary Transmission in Kindergarten Through Grade 12 Schools Implementing Mitigation Strategies – St. Louis County and City of Springfield, Missouri, December 2020. MMWR Morbidity and Mortality Weekly Report 2021: 70: 449-455.
  4. FALK A, BENDA A, FALK P, STEFFEN S, WALLACE Z, HØEG TB. COVID-19 Cases and Transmission In 17 K-12 Schools – Wood County, Wisconsin, August 31-November 29, 2020. MMWR Morbidity and Mortality Weekly Report 2021: 70: 136-140.
  5. HERSHOW RB, WU K, LEWIS NM, Et Al. Low SARS-Cov-2 Transmission in Elementary Schools – Salt Lake County, Utah, December 3, 2020-January 31, 2021. MMWR Morbidity and Mortality Weekly Report 2021: 70: 442-448.
  6. ZIMMERMAN KO, AKINBOYO IC, BROOKHART MA, Et Al. Incidence and Secondary Transmission Of SARS-Cov-2 Infections in Schools. Pediatrics 2021: 147.
  7. HOBBS CV, MARTIN LM, KIM SS, Et Al. Factors Associated with Positive SARS-Cov-2 Test Results in Outpatient Health Facilities and Emergency Departments Among Children and Adolescents Aged <18 Years – Mississippi, September-November 2020. MMWR Morbidity and Mortality Weekly Report 2020: 69: 1925-1929.
  8. HARRISON E, GARBUTT J, STERKEL R, Et Al. Collaborating to Advocate in Primary Care for Children During COVID-19. Pediatrics 2021.
  9. VERLENDEN JV, PAMPATI S, RASBERRY CN, Et Al. Association of Children’s Mode of School Instruction with Child and Parent Experiences and Well-Being During The COVID-19 Pandemic – COVID Experiences Survey, United States, October 8-November 13, 2020. MMWR Morbidity and Mortality Weekly Report 2021: 70: 369-376.
  10. CHRISTAKIS DA, VAN CLEVE W, ZIMMERMAN FJ. Estimation of US Children’s Educational Attainment and Years of Life Lost Associated with Primary School Closures During The Coronavirus Disease 2019 Pandemic. JAMA Netw Open 2020: 3: E2028786.
  11. GOLDSTEIN D. Research Shows Students Falling Months Behind During Virus Disruptions. The New York Times; 2020.
  12. INAGAKI K, GARG P, HOBBS CV. SARS-Cov-2 Positivity Rates Among Children of Racial and Ethnic Minority Groups In Mississippi. Pediatrics 2021: 147.