The government official spoke exclusively with about COVID-19 vaccines for kids, breakthrough infections with the Delta variant, staying safe in school, and more.

girl wearing mask for stop corona virus outbreak
Credit: Getty

Just as Americans started to feel optimistic about the pandemic, they were hit with the Delta variant, which currently accounts for 93 percent of COVID-19 cases in the U.S. Delta is nearly twice as contagious as previous coronavirus strains, and some studies suggest it causes more severe illness. It's led to reinstated mask guidelines, vaccine mandates for some employees, and delayed returns to offices across the country.

COVID-19 vaccines currently authorized for emergency use (Pfizer, Moderna, and Johnson & Johnson) still effectively protect against hospitalization and death. Even so, children under 12 years old aren't able to get vaccinated yet, which naturally raises some concerns in parents—especially as back-to-school season has arrived in many states and quickly approaches in others. 

So when will a COVID-19 vaccine be available to younger children, and how can we protect vulnerable populations in the meantime? Also, what's the deal with breakthrough infections and teacher vaccine mandates? Parents spoke with U.S. Surgeon General Vivek Murthy, M.D., about some of the most pressing new questions regarding COVID-19.

COVID-19 vaccines are currently approved for everyone 12 and older, and pediatric clinical trials are underway for younger kids. When might children under 12 get the go-ahead for vaccination?

It's hard to pinpoint exactly when COVID-19 vaccines might be approved for children, but Dr. Murthy says it could possibly happen by the end of the calendar year. After pediatric trials end, drug manufacturers must analyze the data. Then they can submit an application to the Food and Drug Administration (FDA) for emergency use authorization. 

"The FDA will work very quickly to evaluate those proposals," says Dr. Murthy. "They'll do it thoroughly and they won't cut any corners, but they will prioritize it. The COVID-19 vaccines are their highest priority. Especially when it comes to our kids, we want to make sure we do everything we can to protect them."

Pfizer, Moderna, and Johnson & Johnson are currently approved under emergency use authorization. When might these vaccines receive full FDA approval?

Dr. Murthy predicts the FDA will have an update sometime in the near future. "I can't give you an exact date, because that is something the FDA alone knows," he says. "Vaccines for COVID-19 are the top priority for the FDA, so they're working hard on it." 

The good news is that experts have plenty of experience with COVID-19 vaccines, and this could help streamline the approval process. "We've actually administered over 350 million doses of the vaccine in the United States alone, and millions more around the world," he says. 

California just required teachers to be vaccinated against COVID-19 (or get tested regularly). Could vaccines become federally mandated for teachers? 

Dr. Murthy doesn't believe we'll see federal vaccine mandates for educators in the near future. However, these mandates may happen on a local or state level, like in California. "I think it's very understandable that you see localities and states moving in this direction," he says. "First and foremost, what they're trying to do is create a safe environment for our kids. They want to make sure those who are young and don't have the opportunity to get vaccinated yet will be exposed to as little virus as possible, so their chances of staying healthy are high."

Along those lines, a federal mask mandate is also unlikely. School districts, cities, and states generally make their own guidelines for students and staff.

Could schools mandate COVID-19 vaccination for students, once they're approved for pediatric use? 

It's actually a common practice for localities to require vaccinations. Many schools already mandate vaccines like MMR, varicella, and DTaP. And while Dr. Murthy doesn't believe the federal government will mandate COVID-19 vaccines for students, he says it could happen at the state or local level.

Are schools required to report positive COVID-19 cases? Do protocols exist for this scenario?

While COVID-19 protocols vary by state, "we certainly want schools to be reporting the infections they have and working with their local health departments," says Dr. Murthy. "Testing is our vision. It's what allows us to see what's happening." By sharing COVID-19 testing results, communities are better able to build strategies and acquire necessary resources to fight COVID-19. 

"When we have a cluster of cases that develop a community, it's not just a problem for the people who get sick. It's a problem for the broader community, especially with the highly contagious variant," says Dr. Murthy.

There have been increasing reports of breakthrough infections after vaccination. What have experts been seeing in terms of rates and symptoms? 

Breakthrough infections take place in someone who is fully vaccinated against COVID-19 (two weeks after their last shot). While experts have been seeing more breakthrough infections with the Delta variant, Dr. Murthy stresses they're still the exception rather than the norm. The vast majority of people who are fully vaccinated will not get sick from COVID-19.

Additionally, if you're one of the unlucky ones who manages to get breakthrough COVID, you'll likely have a mild or asymptomatic case. Current statistics show that hospitalizations and deaths are far less common among the vaccinated population. 

Can vaccinated people with breakthrough infections transmit the virus? Many parents are worried about infecting children who aren't able to get vaccinated yet.

Yes, data shows that vaccinated individuals might transmit the virus if they get a breakthrough infection. Given this news, unvaccinated and high-risk individuals (and those who spend time with them) may want to take extra precautions. This includes social distancing, washing hands frequently, and wearing a mask in public indoor spaces.  

Dr. Murthy stresses that vaccinated individuals will likely be fine if they contract a  breakthrough COVID-19 infection. "It's more to prevent you from passing it on to somebody who may be unvaccinated in your home," he says. 

In order to stay safe from the coronavirus, kids rely on the people around them being vaccinated—including parents, educators, family members, child care providers, etc. "Until there's a vaccine available for them, we have to be their shield," says Dr. Murthy. 

Dr. Anthony Fauci recently said that everyone will likely need a COVID-19 vaccine booster shot soon. What do you know about this?

Over time, many vaccines have waning protection, even if they work really well. Experts are currently looking at data to understand how immunity is impacted over time, and whether there's a notable increase in breakthrough COVID-19 infections. If they decide a booster shot is needed, drug manufacturers will move forward with making it.  "I can't give you an exact date when that might happen," says Dr. Murthy. "I'm optimistic that as we learn more, we'll have more clarity on if and when a booster is required."

Furthermore, if vaccine manufacturers move forward with the booster shot, "we'll have the supply ready to make sure the folks who need the boosters will get them expeditiously," says Dr. Murthy.