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21 June 2022

Dear Dr. Jha and Dr. Walensky,

We strongly urge you to revise the CDC’s COVID-19 guidelines with regards to testing, isolation, and vaccine recommendations for children to ensure that public health policies are not doing more harm than good.

Many European countries, U.S. states and Canadian provinces have already updated their COVID-19 policies to reflect that vaccines and infection-acquired immunity have reduced the risk of a severe COVID-19 outcome for youth, and to acknowledge that all mitigation measures have unintended consequences. Massachusetts, the United Kingdom, Denmark, Norway, British Columbia and elsewhere have recommended an end to routine screening testing and mandatory isolation periods for children. Most have also eliminated any COVID-19 vaccine requirements for children to fully participate in public life.

The CDC’s COVID-19 school guidelines continue to cause significant disruption to children’s education and to working parents, while providing no demonstrable public health benefit in limiting COVID-19 spread. These policies have serious unintended consequences–-such as school closures, increasing school absences, forcing parents to miss work, and the expense and time of testing. At this point, nearly all U.S. adults and children are protected by either vaccination or infection-acquired immunity, and the U.S. is seeing far lower hospitalization and mortality rates than in prior surges.

Our nation’s children suffered tremendous learning loss as a result of prolonged school closures and are battling a well-documented mental health crisis, and ongoing COVID-19 testing and isolation periods are causing additional harm.

Time away from school is known to negatively impact students and contribute to long-term school absenteeism, as seen during the 2020-21 school year when attendance rates dropped significantly compared to pre-pandemic years. This drop in attendance is more severe in school districts with longer educational disruption during the COVID-19 pandemic, which often have higher concentrations of Black and Latino students and higher rates of poverty. The impact of low attendance includes nutrition lost from missed school meals, greater risk of drop-out, and farther reaching consequences including lower lifetime earning potential, greater mental health and occupational problems, and reduced life expectancy.

We have never systematically screened and isolated children, nor forcibly excluded them from school or other activities, for other respiratory viruses. Instead, affected individuals have been able to return to work or school as soon as they are fever-free for 24 hours and symptoms are improving, without testing. At this point, the CDC should recommend these same common-sense policies for COVID-19, as other nations have done, protecting high risk groups while facilitating unrestricted return to work and school.

We Propose the Following Changes:

Test to Treat

Symptomatic and asymptomatic testing should be replaced by a “test-to-treat” approach, with the goal of identifying and treating only those at highest risk (immunocompromised children with complex medical conditions such as cancer) while avoiding disruptions to those at low risk of serious illness. We must focus on vulnerable people by encouraging vaccination and making prophylactic medications (Evusheld) and treatments (Paxlovid and monoclonal antibody therapy) widely available for higher-risk individuals.

Retire Vaccination Mandates

CDC recommendations to vaccinate and boost healthy young individuals have led many schools, colleges, sports organizations, and summer programs to require up to three doses of mRNA vaccine, regardless of prior infection. Such requirements exclude unvaccinated children or those not boosted from important opportunities. Data from American colleges (UCI, UCLA, Cornell, Stanford, Harvard) and around the world (United Kingdom, Iceland) clearly show that COVID-19 vaccines do not stop acquisition nor transmission of the virus. Vaccines and boosters can be offered based on individual health considerations, but should never be used to exclude children from school or social activities.

Recommendations should be changed to “COVID-19 vaccines are available for children ages 6 months-17 years and boosters are available for children 5 and older and their administration should be a choice to be discussed between the individual and their primary care physician.”

The emergency phase of COVID-19 is over. We call upon the CDC to update current guidelines to reflect the era of endemic management in which COVID-19 infections are treated similarly to other seasonal respiratory viruses, which do not require routine testing or isolation. It is time to join our peer countries in recognizing the importance of restoring equitable and maximal access to education, sports, and social connectedness for all children. Their health and well-being depend on it.

Sincerely,

This letter is supported and co-signed by the following parent organizations:

Other individuals who support this open letter are listed here.

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