Sacharitha Bowers was looking forward to a beach vacation with her husband and two kids, ages 5 and 9, in Florida in August after canceling last year’s Disney World trip because of the pandemic. But as the highly transmissible delta variant sent cases soaring, the family called it off.
“We just didn’t feel like it was a necessary thing that we would want to put my kids at risk for,” said Bowers, an academic dermatologist in Springfield, Ill. She added: “It was almost a no-brainer to cancel.”
In late spring and early summer, with vaccines widely available and COVID-19 infections plummeting, parents might have understood the risks of traveling with unvaccinated kids. It’s more complicated now, but relief for parents is coming. With the Food and Drug Administration’s authorization of the Pfizer-BioNTech shot for kids 5 to 11 on Oct. 29, it will be many weeks still before children are fully vaccinated.
“The delta variant has upended everything. It is very important for people to recalibrate their risk,” said Leana Wen, an emergency physician and public health professor at George Washington University. “Some people may decide that nothing has changed for them, and that’s reasonable. But for families with young children in particular who are not yet vaccinated, they should consider using much more caution than before.”
The Centers for Disease Control and Prevention said in August that vaccine effectiveness is decreased against the delta variant, but vaccinated people still have strong protection. Several factors are causing alarm for parents, including the hyper transmissibility of the variant and increasing numbers of cases in children.
The American Academy of Pediatrics says that over the course of the pandemic, almost 6.3 million kids in the United States had tested positive for the virus as of Oct. 21. Nearly 118,000 of those cases were added in the prior week.
It is not clear whether the variant causes worse illness in children, or if more kids are getting sick simply because of how contagious it is. But regardless of the reason, infectious-disease experts say families need to be extra vigilant.
“We need to be more aware of COVID when we travel now than has been the case any time this year,” said David Kimberlin, co-director of the division of pediatric infectious diseases at the University of Alabama at Birmingham and Children’s of Alabama.
Not every trip carries the same level of risk, and experts say some types of travel can be fairly safe. For higher-risk vacations, families should take additional precautions.
Road trip with immediate family
Experts say the safest type of trip keeps the family bubble intact and doesn’t allow much opportunity for interaction with anyone else.
“A road trip with a single family staying in a rented house, with very controlled exposures mostly within your own bubble, is going to be very safe,” said Henry Wu, director of the Emory TravelWell Center and an associate professor of infectious diseases at Emory University School of Medicine.
Staying outdoors as much as possible will also keep the trip as safe as possible, doctors said.
For Bowers and her family, the alternative to a flight to Florida was a three-hour drive to Chicago, where local transmission was lower and the family was rigorous about wearing masks.
“It ended up being a really good compromise,” she said. “I feel like we were able to get a little bit of a getaway enough to feel like they did something fun for the summer, but really minimize our risk.”
Plus, she said, “Disney World’s not going anywhere.”
Vacation with extended family
Adding people outside your own household makes things a little more complicated.
“Obviously the more different households are commingling, the more you go out, the higher the risk,” Wu said. “A lot of that risk will also depend on the local transmission rates.”
Kimberlin said he would suggest gatherings take place outdoors, even if every member of the group is vaccinated. Families should also be aware of whether anyone has underlying conditions that could contribute to more severe disease if they were to get infected.
Wen, a contributing columnist for The Washington Post, said that in cases where multiple families with young kids are getting together indoors, everyone should agree to the same pandemic rules — even if the adults are vaccinated.
“One should not assume that just because everybody in a group is vaccinated that they are safe around your unvaccinated children,” she said.
If unvaccinated children and vaccinated adults are getting together, Wen said, everyone should reduce their risk for three to five days in advance by taking precautions like wearing a mask in public and not gathering indoors with unvaccinated people. Then they should take a coronavirus test.
“Assuming that it’s negative, you’re probably pretty safe to gather,” she said.
If there are unvaccinated adults in the mix, they should only spend time with kids outdoors. And if they have to be indoors, they should follow the same quarantine and testing protocols, Wen said.
Taking a flight
While there are layers of protection involved in flying itself – including air circulation and mask mandates on planes – several experts said there are enough variables to make it risky.
“Driving with unvaccinated children is certainly going to be safer than taking any other form of transportation because you cannot control any other people’s behavior,” Wen said.
The process of traveling by plane – including transportation to and from the airport and waiting around on the jet bridge to board – involves a lot of potential exposure, Wu said. And masks can be difficult for families: Kids under 2 aren’t supposed to wear them, and young children who are still adjusting to mask-wearing might find it difficult to keep one one during a long flight.
But Aileen Marty, an infectious-disease expert at Florida International University, said that if a long drive will involve several stops, a short flight could be a good option – as long as families take precautions to protect themselves.
Vacationing among crowds
Many family vacations include visits to theme parks, festivals, sporting events or other activities that involve crowds – which could be risky for unvaccinated kids.
“Any time you’re in larger numbers, you’re more likely to be around somebody who’s infected,” Kimberlin said. That’s especially true in areas where high levels of the virus are circulating.
Marty said she is eager to take her grandchildren to Florida’s theme parks eventually – but not yet.
“It depends on the theme park and what they’re doing and what the protocols are,” she said.
She said it is important to consider the behavior of the population at an event and the venue.
“If you’re going to Lollapalooza and you plan to be in the middle of the crowd with no mask and you haven’t been vaccinated, well, come on now,” she said. “You’re certainly asking for trouble.”
Experts pointed out that many foreign countries have lower amounts of the virus circulating and might be safer than someone’s home in Florida or Alabama, for example.
But Wu said international trips still carry increased risk, as well as extra testing requirements, restrictions for unvaccinated people and the possibility of getting stuck overseas if someone in the group tests positive before returning to the United States.
“I find it hard to absolutely say they can or can’t travel, but I do think really the reason for travel – particularly internationally with kids, given all the potential headaches and pitfalls – the reasons should be fairly strong,” he said.
Parents should make sure they understand testing requirements in their destination for unvaccinated children.
Parents traveling without kids
Many people have worried about traveling on their own because they don’t want to risk catching the virus and spreading it to their kids once they return home — or to kids they will see on the trip.
Wen said parents who travel should always wear an N95 or KN95 mask on a plane or train, and not remove it to eat and drink, especially not when other people have their masks off. They should also avoid high-risk activities such as eating indoors, going to indoor events or mingling with unvaccinated people who aren’t wearing masks.
Spending time with elderly parents who are vaccinated and have no risky exposures, on the other hand, would be low risk, she said.
Wen said those who have run into risky situations when traveling should avoid sharing space with family for three days after that risky activity and then take a coronavirus test.
Marty said vaccinated adults should avoid peer pressure on a trip to interact without masks, even among fellow vaccinated people.
“Not if you’re worried about who you’re going home to afterwards,” she said.
Agnes Barton-Sabo, an artist who lives in Oregon, is fully vaccinated and had hoped to see friends with young kids and a baby on the other side of the country this fall. That is no longer in the cards. Her partner has a 15-year-old who is vaccinated, but Barton-Sabo said she wants to do what she can to keep other people safe.
She felt comfortable taking a trip earlier in the year, but she was uneasy even then about bad behavior and a lack of compliance with mask rules at airports.
“With the current information we have about how contagious the delta variant is, it does not feel safe to enter any place that’s going to be crowded like that, for fear of what I might unknowingly pass along more than anything else,” Barton-Sabo said in an email. “I’m very relieved to be vaccinated and have that level of protection, but if the virus is circulating this wildly, we need to remove as many possibilities for spreading as we can. This is one bit I can do.”