American Academy of Pediatrics Inadvertently Promotes 'Common Sense' Approach to School Mask Requirements
On Monday, the American Academy of Pediatrics (AAP) released new Covid-19 guidelines for schools that recommend universal mask requirements for students over the age of two. AAP’s recommendation applies to all students “regardless of vaccination status,” in contrast with recent CDC guidance, which leaves room for vaccinated students to go unmasked. Surely, the AAP’s prescription makes sense in some locales, but their sweeping stance will push many of the districts that most need to hear measured and scientific recommendations to dismiss it in favor of a “common sense” approach to masking.
Last school year, “common sense” had far greater influence over school operations than science-based guidelines. Local attitudes toward masking, vaccine hesitancy, and the 2020 presidential election were stronger predictors of whether school districts offered in-person learning over the course of the 2020-2021 school year than local COVID transmission rates. Districts in red states, often with low public support for masking and high vaccine hesitancy, brought students back to school well before meeting CDC thresholds for in-person learning. In that regard, “common sense” led to more in-person schooling without substantially increased COVID transmission — as analyses have since confirmed — let alone the major outbreaks many feared.
The pandemic looks much different now than it did last year. Vaccines are widely available — including for students aged 12 and over — and highly effective. We also know much more about how to mitigate transmission when schools are in person. However, the threat remains, with the more-contagious Delta variant taking hold in the United States and risking a substantial resurgence in communities with low vaccination rates.
Still, in a growing number of states, “common sense” — based primarily on public opinion —reigns supreme.
Currently, eight states — Arizona, Arkansas, Iowa, Oklahoma, South Carolina, Texas, Utah, and Vermont — have banned mask requirements in schools for the 2021-22 school year. The deep red states on that list are all in the bottom half of states in terms of vaccinations, and all but Texas are in the top half of COVID case rates this week, and thus more likely to benefit from mask usage. (The lone exception, Vermont, has the highest vaccination rate of any state and the second-lowest COVID case rate, and thus the least need for masking requirements.) Precisely because they are overly stringent, AAP’s masking recommendations are more likely to alienate, than inform, the communities where clear public health guidance — and strategic use of masking — is most needed.
Nine states — California, Connecticut, Delaware, Hawaii, New Mexico, New York, North Carolina, Washington, and Virginia — currently require mask usage in schools regardless of vaccination status. (Notably, most of these states have relatively high vaccination rates.) AAP’s recommendations will probably cement those decisions for longer and push risk-averse policymakers — particularly those in blue states with strong public support for masking — to follow suit and take away districts’ ability to make masks vaccine-dependent.
Beyond its masking absolutism, AAP’s failure to discuss how masking could end will encourage many states and districts to ignore it. If AAP had said, “Masking remains vital; these targets have to be met to end masking,” it could usefully push states and districts toward those targets, even where the audience is skeptical. The current message, which is loosely, “Schools should make everyone mask up; we will let you know when things improve,” could not be better designed to be dismissed by doubters whose “common sense” has worked thus far.
Further, AAP’s guidance doesn’t just interfere with institutions’ incentives to take responsible steps to stem the COVID threat, it also interferes with incentives for individuals. Elementary students will remain unvaccinated for the near future, but students 12 and older can get vaccines. Unfortunately, uptake has been slow; 12–15-year-olds and 16–17-year-olds have the lowest vaccination rates in the country, at 25 and 37 percent, respectively. Freedom from masking and from quarantines when COVID cases surface are benefits that could push up these low rates. With relatively little time before the start of the school year, now is not the time to take away incentives for students to get vaccinated.
With COVID still threatening both the unvaccinated and stable school operations in this vitally important school year, masking remains an important layer of protection in schools. It will be a tragedy if overwrought guidance from scientific authorities like AAP keeps flexible masking policies from being part of “common sense” pandemic protections in schools.
Nat Malkus is a senior fellow and the deputy director of education policy studies at the American Enterprise Institute.