masked student at blackboard

COVID-19 concerns are front of mind as a second school years begins amid the pandemic. Whether to send children back to the classroom remains a difficult decision for families affected by pulmonary hypertension (PH).

That’s especially worrisome for families who live in school districts without remote learning options this year, pediatric PH physicians tell PHA News. Many parents want to know whether to keep children with PH and/or their siblings home, and if so, for how long. They also want advice on what do if their school districts don’t require masking.

Three pediatric PH specialists offer updated advice on vaccination, masking and other back-to-school health issues:

Ask about vaccination. The COVID-19 vaccine, approved for people 12 years and older, is an important defense against serious COVID illness, says Nidhy Varghese, M.D., medical director of the pulmonary hypertension program at Texas Children’s Hospital in Houston. Ask your PH team whether your child is eligible for the vaccine, and look into getting it for all household and immediate contacts.

“There are many sites where parents and caregivers can get COVID vaccinations, often for free,” she says. “Immunizing the household contacts will decrease the child’s risk of COVID exposure.”

Edward Kirkpatrick, M.D., pediatric PH director at Children’s Hospital of Wisconsin in Milwaukee, is looking ahead. He’s educating parents about getting vaccines for children under 12 after the FDA approves COVID vaccinations for that age group.

Consider your child’s circumstances. When deciding whether your child should return to in-person classes, consider individual risk levels, Dr. Kirkpatrick says. Some children with minimal PH symptoms might be at lower risk of developing COVID-19 or other virus complications. Those with compromised heart function, oxygen requirements or prone to pulmonary infections might be at higher risk of complications. “It is up to the family and their providers to see where the child falls,” says Dr. Kirkpatrick.

Consult your child’s PH care team. The PH care team knows your child’s condition and risk level best, says Dr. Varghese. They will consider your child’s physical and emotional health – as well as your emotional health, she says. “Ultimately, it is a decision that comes down to the parent and the medical team discussing the child from all different angles.”

Weigh your options. There are risks and benefits to online and in-person learning. Consider how many COVID-19 cases are in your area, the school’s practices to protect students, whether masks are mandatory in the classroom and similar issues, Dr. Varghese recommends. “Going back to school can be really anxiety provoking for the family,” she says. Researching ahead of time can help reduce worry when deciding to send your child back to school, she adds.

Those considerations also apply to the child with PH’s siblings, or the children of parents with PH. Take into account the siblings’ vaccine status, as well as their willingness/ability to exercise caution and wear masks indoors at all times, says Eric Austin, M.D., pediatric PH director, Vanderbilt Children’s Hospital in Nashville.

Communicate with the school, Dr. Austin advises. The CDC recommends parents discuss measures to reduce the risks of contracting and spreading COVID-19 with schools and teachers. For example, ask whether the school can install a plexiglass divider or allow your child to stay in one classroom all day, Dr. Varghese says.

Inform administrators and teachers about your child’s condition. “Review plans of action with the school, teacher, staff, and if available, nurse team,” Dr. Austin says. Consider making the discussion part of your 504 planning meeting, Dr. Varghese says.

Learn more in the Pulmonary Hypertension Association (PHA)’s updated COVID-19 FAQ.

Reinforce precautions with your child. Remind children going back to the classroom not to touch their eyes, nose and mouth, Dr. Austin says. Children can wear nonprescription or prescription eyeglasses to shield their eyes if they are comfortable wearing them, he says. Make sure your children have their own water bottles and hand sanitizer to avoid touching shared items. Help your children understand why they should avoid before- or after-school activities to reduce exposure.

Make a contingency plan. Create an action plan for new issues that arise with your child’s PH, Dr. Austin says. If your child’s siblings attend class in person, there is a chance they could be exposed to COVID-19 at school. Make sure you have a plan on how to isolate anyone in your home who is exposed to COVID-19, Dr. Kirkpatrick says. He recommends self-quarantining in a separate room, distancing from other family members and possible wearing masks at home to prevent exposing your child with PH.

Continue your child’s usual medical regimen. It’s important students receive regular pediatric care and take their medications when going back to school. “It’s common for kids to have to take their PH meds while in school, and families need to make sure that the school can accommodate them,” Dr. Kirkpatrick says. Ask the school to let you know if the school nurse will be out for the day, so you can make needed adjustments, Dr. Kirkpatrick says.

Prepare for flu season. Flu season is always a huge risk for young PH patients, Dr. Varghese says. Parents should continue to practice infection control and ensure your children receive their yearly flu vaccines, Dr. Kirkpatrick says.

“Maintain a high index of suspicion, and continue to maintain all of the protection intervention families are doing now through COVID season and through flu and cold season,” Dr. Varghese says. If COVID-19, the flu or other illness flare up in your community, consider keeping your child home for a day or so as extra precaution, Dr. Austin says.

Join PHA’s parent telephone support group at 8 p.m. EDT on Sept. 8. Bring your questions, concerns and tips about going back to school, and connect with other parents. Register here.