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Host:  There's no handbook for your child's health, but we do have a podcast featuring world-class clinical and research physicians covering everything from your child's allergies to zinc levels. Welcome to Kids Health Cast by Weill Cornell Medicine. I'm Melanie Cole. And today, we're talking about keeping your family safe this summer, COVID and beyond.

Joining me is Dr. Chandrika Sridharamurthy. She's an instructor in pediatrics at Weill Cornell Medicine and an assistant attending pediatrician at New York Presbyterian Weill Cornell Medical Center.

Dr. Sridharamurthy, thank you so much for joining us again. You are such a great guest. I look forward to this topic because a lot of parents have questions about this summer, and we're not sure about the recommendations and what we're supposed to do. So as the summer gets into full swing, tell us the current recommendations as to activities that families can do. What are some of the guiding principles to keep in mind?

Dr. Chandrika Sridharamurthy: Hi, Melanie. Thank you so much again for having me. That's a really great question. Summer is upon us. And after the tough year that we've had, I know that many people are ready to return to fun summer activities. And I would say that as long as many Americans continue to be vaccinated against COVID-19, there's reason for great optimism about this summer. The recommendations in terms of activities are much less restrictive for those who are fully vaccinated.

Per the Centers for Disease Control or CDC guidelines at this time, people who are fully vaccinated, can gather more safely, both indoors and outdoors. And that means participating in more summer activities like traveling, attending parks and museums and certainly summer camp as well. So it's important to use those guidelines, the CDC guidelines, as just that a guide and make decisions about gathering based on individual risk factors and the rates of infection in your community.

Host: So tell us a little bit about after receiving the vaccine, how long does it take to become immune to where you can feel a little bit more confidence? And once they get the vaccine, do we still follow the safety protocols, masks, social distancing. Tell us a little bit about how that works.

Dr. Chandrika Sridharamurthy: Yeah. So in general, people are considered fully vaccinated when it has been two weeks after their second dose in those two-dose series vaccines, such as the Pfizer and Moderna vaccines or two weeks after the single-dose vaccine, which is the Johnson and Johnson one in the United States. that's typically how long it takes for the body to build protection or immunity, as you said, against the virus.

And if you've been fully vaccinated, as of now per CDC guidance, you can feel safer. So you can feel safer to gather indoors with other fully vaccinated people without wearing a mask necessarily or staying that distance, that six-feet apart that we've been doing all year. However, if you're in certain crowded settings or venues, the recommendation is still to continue masking and, you know, follow your local and state guidelines.

If you haven't yet met these requirements for the two-week post vaccination, regardless of your age are not considered fully vaccinated. So it's important to take all those precautions until you are fully vaccinated. And it's important to note that if you have a condition or are taking medications that potentially weaken your immune system, you may not be fully protected once you get fully vaccinated. So it's important to have that discussion with your doctor, whether it's the pediatrician or internal medicine or family medicine doctor.

In terms of travel, if you're fully vaccinated, if you travel within the United States, you don't necessarily need to get tested before or after travel, that's the newer recommendation. But if you're going to be traveling outside internationally, it's important to pay close attention to the situation at those destinations. But yes, overall, it's safer once that two-week window is done to do more activities.

Host: So I think one of the things that many parents, including myself, except for now my 18 and 21-year-old got their vaccines, once the adults in the family have been vaccinated and just now they recently released Pfizer could do 12 to 15 year olds, right? So what about those under 12 years old? If the parents are vaccinated, but the kids are still waiting, what about doing things? Seeing relatives that are vaccinated or not vaccinated, is it safe to hang around? What do we do with this gap between our kids and the adults?

Dr. Chandrika Sridharamurthy: That's a really good question because everyone's eager to hang out and get back together and get back to some idea of normalcy. So when it comes to children, as you mentioned, sort of those younger children, it's important to note a few things that we've learned in the past year. The good news is at this time, children are more likely to be asymptomatic or have mild non-specific symptoms and they're less likely than adults to have severe disease. It is important to know of course that if they have underlying medical conditions, then they're at higher risk for having more severe disease. So it's important to keep that in mind.

But overall, as you mentioned, if the adults in the room are vaccinated, fully vaccinated, then we can start getting together and it is safe to do so if those who are eligible are vaccinated and not immunocompromised. And in the case of children who are not eligible to be vaccinated, it will be safest if those around them are eligible and vaccinated.

Host: Thank you for clarifying that. So let's talk about travel itself and as our knowledge of surfaces and COVID living on surfaces is continuing to evolve. This is something that has still stumped me. What if we decide to travel? What should we keep in mind as regards to air travel, road trips, public restrooms. Last summer, you know, we were bringing our sanitizing wipes and things on any road trip. What are we doing now, doctor, that might be different than we did last summer or still pretty similar?

Dr. Chandrika Sridharamurthy: The question about surface transmission is an important one because at the beginning of the pandemic, we didn't have a whole lot of data about this. So we do know now that COVID-19 is mostly spread through close contact by respiratory droplets that are released when people talk, breathes, sneeze, cough, et cetera, less likely to contract it by touching a surface or object that has a virus on it.

In most situations, cleaning surfaces using soap or detergent is enough to reduce the risk. So in terms of air travel and road trips, if the facilities that you'll be going to are cleaning per CDC guidelines, that should make us feel safer. In terms of travel in general, there are many variables such as how you plan to travel, where you're going and the rates of infection in your destination and your safety practices once you arrive.

Air travel requires spending time in lines and terminals, so it's important to keep that in mind because those locations are a little bit more crowded. Notably, on an airplane, it's good to know that most viruses and germs don't spread easily because of how the air circulates and how air is filtered on airplanes. However, it is difficult to keep your distance on a crowded flight, so it's important to keep all those things in mind. But overall, if you're doing sort of the normal safety protocols such as washing your hands and covering your mouth when coughing or sneezing and those around you are doing that as well, then we can feel a bit safer.

Host: Now, what about things that the kids just do, like summer camp? Because last year, of course it was a different deal. We didn't know what to do. Some parents, many parents, skipped summer camp altogether. What questions do we ask this year as those restrictions are being eased, but still, as you said before, some kids are not vaccinated, but camp and especially overnight camp can be pretty close quarters. So what are we asking now?

Dr. Chandrika Sridharamurthy: As you mentioned, just like school, summer camps are an important aspect of social and emotional development in children. Camps provide opportunities for kids to try new activities, develop social skills and be physically active, which we know is very important for growth and development.

The good thing is that the CDC website has guidelines for operating youth in summer camps during This time. And I encourage parents to visit that site and look at the updated guidelines. You can also talk to your child's summer camp and ask them if they're following certain guidelines, the local and state public health guidelines. For example, the CDC has a guideline about having an emergency operations plan, which includes steps to take when a camper or staff member has been exposed to someone with COVID-19 or has symptoms of COVID-19 or test positive for COVID-19.

And as you mentioned, vaccines are not yet approved in the younger children. Certainly, vaccines are now approved for children ages 12 and up, specifically the Pfizer vaccine for the younger age group. So that's something to discuss at home and with your kids about vaccinating prior to starting summer camp.

Host: This is really great information. Listeners, be sure to share this with friends and family, because you're getting this quality information that you can trust. Now, Dr. Sridharamurthy, once the vaccines are available for the under 12 crowd, do you expect we'll be able to go to our pediatricians to get it? Is this something you want to see happen, because it keeps the medical records within the medical home? Tell us a little bit about what you expect to see or what you would like to see as far as the vaccines in our littler kids.

Dr. Chandrika Sridharamurthy: We're already seeing children age 12 and up being vaccinated with the Pfizer vaccine. Overall, I think the location of vaccine administration will definitely depend on each state, city and community and the distribution plan in those areas. But I do agree with you. I think that, especially having them available in doctor's offices, in pediatrician's offices, will make it easier for our kids to access those vaccines and will create a safe environment for where those vaccines can be administered along with doctors and the parents can have that discussion with the pediatrician and ask the questions that they have. So I think that would be wonderful if more pediatrician's offices will offer those vaccines when they're available for younger kids, certainly.

Host: I think so too. It's kind of a way to keep it all in one place as your kids get all their vaccines, right? So as we wrap up, tell us what you would like us to know about the confusing information that comes at us every single day about these recommendations. In some people, myself included, I still am going to wear a mask for a while. I didn't have a cold for the last year, you know, and it's important we get our flu shots and all of those things. But wrap it up for us with your best advice on how you want us to process all of this information, so that we can have such a fun summer and see the people that we love and that our kids will be able to really enjoy it as they maybe didn't get to last year.

Dr. Chandrika Sridharamurthy: I completely agree with you. Summer is almost upon us and it's been a unique time to say the least. Children in particular have gone through a tough time this year. They've missed school, they've missed other social activities, physical activity, all of which are extremely important for growth and development.

So I do think that with the advent of the COVID-19 vaccines, there are significant reason for optimism. Continue masking where it is appropriate, especially in crowded settings and in public transportation and around people who are vulnerable. And I think as pediatricians, parents, and teachers, we can all work together to create a safe and much better summer for our kids this year.

Host: I agree and thank you so much, Dr. Sridharamurthy, for joining us today and sharing your incredible expertise. You are just an excellent guest. And Weill Cornell Medicine continues to see our patients in person, as well as through video visits. And you can be confident of the safety of your appointments at Weill Cornell Medicine.

That concludes today's episode of Kids Health Cast. We'd like to invite our audience to download, subscribe, rate, and review Kids Health Cast on Apple Podcasts, Spotify and Google Podcast. For more health tips, please visit weillcornell.org and search podcasts. We have some great ones in the library and don't forget to check out Back To Health. I'm Melanie Cole.

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