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Medical leaders call for mask requirements, stronger action against COVID-19 in Mass. schools

Many parents are on edge about school plans, lawmaker says

Secretary of Health and Human Services Marylou Sudders
Secretary of Health and Human Services Marylou SuddersAlyssa Stone/The Enterprise

Top public health leaders and physicians called Monday for stronger measures to protect children against COVID-19 infection in Massachusetts schools this fall, including requiring masks and even automatically vaccinating students at school — unless parents specifically opt out of the shots.

The appeals for stronger measures punctuated a day-long hearing by lawmakers on whether the state is prepared to vaccinate more than 880,000 children under age 12 once the shots are authorized by federal regulators, which is expected later this fall. But the session quickly expanded to a wider discussion about keeping all schoolchildren safe.

“Masking in schools, certainly until we can ensure that we’ve reached a critical mass of children, is almost a no-brainer,” said Dr. Vincent Chiang, a pediatrician and chief medical officer at Boston Children’s Hospital. “If anything, many of our children are showing us that they are far more compliant with masking than we as adults were or are.”

The urgings by a steady parade of pediatricians and other medical leaders at the hearing mirror recommendations last week from the American Academy of Pediatrics, which called for everyone older than age 2 to wear masks in school this fall, even if they have been vaccinated against COVID-19. The academy said millions of youngsters nationwide are vulnerable to infections because federal regulators have not yet authorized the shots for children under 12.

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Three days after the academy’s recommendations, Acting Mayor Kim Janey said Boston Public Schools students will be required to wear masks when they return to classrooms in the fall.

But Governor Charlie Baker last week said he has no plans to reinstate statewide restrictions, leaving decisions about stricter measures up to each community. Leaders from the Department of Elementary and Secondary Education have said they’ll work with state public health officials this summer to determine if additional health and safety recommendations are needed in the schools this fall.

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Department officials were invited to Monday’s legislative hearing, but declined to attend, said Representative Marjorie Decker, cochairwoman of the Legislature’s Joint Committee on Public Health, which sponsored the session, along with the Joint Committee on COVID-19 and Emergency Preparedness and Management.

Many parents are “sitting on edge,” Decker said, waiting to hear about how the schools will handle mask-wearing when classes start in several weeks. Specifically, she said, parents and lawmakers want to hear how schools will handle situations when some families decline to get their children vaccinated, particularly with the rise of the more contagious Delta variant, and no clear state rules for mask-wearing in school.

“This is very unnerving,” Decker said.

“Moving forward we are going to want to hear more nuanced conversations from the governor and from DESE,” on these issues, Decker said.

State health leaders said Monday they will send letters this week to superintendents explaining the process for setting up school-based COVID-19 vaccine clinics and free pooled COVID testing for any district that wants them this fall.

“As we actively plan for pediatric vaccinations, we will continue to think outside the box,” to increase access to vaccines by using “a wide range of strategies and settings from pediatric and primary care offices, to museums, school settings, retail pharmacies, community health centers, and anything else in between that makes sense to us,” said Marylou Sudders, the state health secretary, during her testimony to the committees.

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Several physicians noted that schools and pediatricians could be overwhelmed this fall trying to administer annual flu shots to children as well as COVID vaccines, unless the state and health leaders better coordinate the system.

Dr. Matthew Sadof, a pediatrics professor at the University of Massachusetts Medical School and a former school physician, suggested a new approach.

“Instead of requiring parental consent for this and other vaccines, parents and guardians should be given the opportunity to opt out of vaccination,” Sadof said. “Students who do not have an opt-out note filed this fall will be vaccinated by school staff.”

“This,” Sadof said “is a public health imperative.”

Fifty-eight percent of the state’s 12- to 15-year-olds have received at least one dose of vaccine, much higher than the 36 percent nationwide, said Sudders, who noted the state is a leader in vaccinations.

But statewide figures mask a continuing disparity among communities of color, several health leaders said.

Thirty-eight of 42 such high-risk communities are still well below the state average for vaccinations among 12- to 15-year-olds, said Alan Geller, a senior lecturer at Harvard’s T.H. Chan School Of Public Health, who presented a granular look at the state’s progress.

“Because of this data showing this vast inequity and vast disparity by community, we have to have an added special focus on parent outreach in high-risk cities,” Geller said.

Representative Mindy Domb, an Amhest Democrat, said Geller’s data is a wake-up call.

“It’s not,” she said, “time to run a victory lap.”

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Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar.