Guidance for Covid-19 Prevention in K-12 Schools

After months of decline, North Carolina is experiencing a rapid increase in Covid-19 cases and hospitalizations among those who are unvaccinated.

The Delta variant, which is now the predominant strain of the Covid-19 virus in North Carolina, is significantly more contagious than the original virus. While the original virus spread from one person to an average of two or three people, the Delta variant is spreading from one person to an average of six people. Therefore, unvaccinated people are at greater risk of catching and spreading Covid-19, and they pose a risk to children under 12 who cannot be vaccinated and those who are immunocompromised.

Getting vaccinated is the most effective way to prevent serious illness, hospitalizations and death, and slow community spread. Rigorous clinical trials among thousands of people ages 12 and older, have proven that vaccines are safe and effective.

With rapidly accelerating viral transmission and the increased contagiousness of the Delta variant, on July 27, 2021, CDC updated the guidance to include recommendations for universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status.

Additionally, on July 19, 2021, the American Academy of Pediatrics (AAP) released updated guidance for schools that recommends the implementation of a multi-pronged layered approach to reduce viral transmission, including universal masking. The AAP recommendations include:

  • All eligible individuals should receive the Covid-19 vaccine.
  • It may become necessary for schools to collect Covid-19 vaccine information of staff and students (as done for other immunizations against other highly infectious diseases).
  • Adequate and timely Covid-19 vaccination resources for the whole school community must be available and accessible.

All students older than 2 years and all school staff should wear face masks at school (unless medical or developmental conditions prohibit use). The AAP recommends universal masking in school at this time for the following reasons:

  • a significant portion of the student population is not eligible for vaccination
  • protection of unvaccinated students from Covid-19 and to reduce transmission—lack of a system to monitor vaccine status among students, teachers and staff
  • potential difficulty in monitoring or enforcing mask policies for those who are not vaccinated; in the absence of schools being able to conduct this monitoring, universal masking is the best and most effective strategy to create consistent messages, expectations, enforcement, and compliance without the added burden of needing to monitor vaccination status
  • possibility of low vaccination uptake within the surrounding school community
  • continued concerns for variants that are more easily spread among children, adolescents, and adults

An added benefit of universal masking is protection of students and staff against other respiratory illnesses that would take time away from school.

On July 9, 2021, the Centers for Disease Control (CDC) issued Guidance for Covid-19 Prevention in K-12 Schools. Key takeaways included:

  • Students benefit from in-person learning, and safely returning to in-person instruction in the fall 2021 is a priority.
  • Vaccination is currently the leading public health prevention strategy to end the Covid-19 pandemic. Promoting vaccination can help schools safely return to in-person learning as well as extracurricular activities and sports.
  • Masks should be worn indoors by all individuals (age 2 and older) who are not fully vaccinated. Consistent and correct mask use by people who are not fully vaccinated is especially important indoors and in crowded settings, when physical distancing cannot be maintained.
  • Many schools serve children under the age of 12 who are not currently eligible for vaccination. Therefore, this guidance emphasizes implementing layered prevention strategies, (e.g., using multiple prevention strategies together consistently) to protect people who are not fully vaccinated, including students, teachers, staff, and other members of their households.
  • Localities should monitor community transmission, vaccination coverage, screening testing, and occurrence of outbreaks to guide decisions on the level of layered prevention strategies.


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